Neuropathic Pain
- Neuropathic pain is a latin term for abnormal functioning of nerves and covers a wide range of pain disorders that have an impact on patients’ quality of life and daily functioning.
- Among the common examples, disorders such as painful diabetic neuropathy, phantom limb pain, post-herpetic neuralgia, chemotherapy, and radiotherapy induced neuropathic pain, chronic post-surgical pain…etc
- Patients usually experience symptoms ranging from pins and needles in the area affected to pain in response to non-painful stimuli a phenomenon called allodynia to exaggerated pain to painful stimuli a phenomenon known as hyperalgesia…etc
- Symptoms are sometimes debilitating hence education and reassurance is very important.
- Management largely depends on anti-neuropathic classes of medications and desensitization of affected areas and needless to say, controlling underlying medical condition such as blood sugar level. Also, engagement in rehabilitative programs to resume confidence in using and moving affected body areas is very important.
- In specific cases trial of injection of specific nerves or muscle planes could be tried. Stimulation, by peripheral nerve stimulation or spinal cord stimulation is an advanced treatment that’s offered in specific centres, first as a trial and if successful as permanent treatment with a stimulating battery implanted under skin with reasonable responses in well selected patients.
- Because those pain phenomena are sometimes very difficult to treat, input from pain psychology to develop skills around coping and acceptance and addressing any abnormal thinking or behaviour that could have developed around this pain is almost always very helpful.
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