What is neuropathic pain?
Neuropathic pain (NP) is a complex type of pain caused by injury or dysfunction of the nervous system and is defined as pain that occurs as a direct consequence of a lesion or disease of the central or peripheral nervous system.
Causes of neuropathic pain in the central nervous system include: strokes, traumatic injuries, neuralgias, while causes of neuropathic pain in the peripheral nervous system include: compression neuropathy/nerve entrapment, ischemic neuropathy, post-traumatic neuropathy (occurs after injury or as a result of medical procedures – surgery or injection, post-herpetic neuralgia (can occur after a viral infection of herpes zoster, covid) and diabetic neuropathy.
When the sensory system is affected by injury or disease, the nerves in that system are unable to function properly to transmit sensory signals to the brain. Neuropathic pain is described as a pricking, tingling, or burning sensation. This type of pain may go away on its own, but it is often chronic. Sometimes it is severe and continuous, and sometimes it is intermittent (occurs and disappears in periods). It is often the result of nerve damage or abnormal functioning of the nervous system. Nerve damage leads to changes in nerve function at the site of the injury and the surrounding area, i.e., the parts of the body that are innervated by the affected nerve. Neuropathic pain develops gradually, and it is a sudden pain that causes a tingling (pins and needles), burning, stabbing, or lack of sensation (numbness).
For many patients, the intensity of symptoms may decrease and subside throughout the day, while for others, the pain remains continuous and severe. Neuropathic pain is most often associated with peripheral nerve damage (neuropathy) caused by diabetes or spinal stenosis, injury, and nerve compression. The onset of pain may be delayed or even late (months or years after the primary traumatic event).
Neuropathic pain is different from nociceptive pain, which is a type of pain that occurs after an acute injury, such as a bone fracture or stepping barefoot on a sharp object. This type of pain is typically short-lived and usually responds to common pain medications, unlike neuropathic pain.