Neuropathic pain is different from acute pain, or normal chronic pain. And harder to treat. Standard drugs, such as anti-inflammatories or morphine-related drugs, may not give much pain control. Because of this, people with neuropathic pain have to put with significant pain and suffering.
Some kinds of pain are difficult to understand and seem to be unrelated to the normal world of acute and chronic pain, where doing specific things brings specific results. In this kind of pain there may be no obvious causing factors, nothing done to bring on the pain, little way of affecting it by movement or position, no investigatable pathology, no very good treatment and little hope of change in the future.
What is Neuropathic Pain?
A neuropathy is a disturbance of the function of a nerve or a pathological change occurring in a nerve. The International Association For The Study Of Pain (IASP) defines neuropathic pain as:
“Pain initiated or caused by a primary lesion or dysfunction of the nervous system”
Other terms are neurogenic pain and deafferentation pain.
In most normal kinds of pain the nervous system acts only as a transmitter, carrying the pain signals up the spinal cord towards the brain where they can be felt, analysed and acted upon. It can affect the pain signals in various ways, but basically it just carries the message.
In neuropathic pain the nervous system itself becomes the pain generator. Injury, damage or abnormal function of the nervous system generates pain signals which can be very troubling. These signals are just as real to the brain as signals from an acute injury and can be just as disabling.
The original cause of the injury to the nervous system may have resolved but the pain goes on, with the pain becoming a pathology in itself.
There is often no way to easily investigate or diagnose this kind of pain and it can go unrecognized for long periods due to its unusual nature. The pain is not coming from the part which hurts, it’s coming from the nerve to the part that hurts.
Types Of Neuropathic Pain
Neuropathic pain is often divided into physiological pain and pathological pain.
· Physiological pain includes the pain of nerve compression, which if not long-lasting will not cause any long-term changes in the nerve.
· Pathological pain is present where injury to the nerve has become permanent or the nerve has been significantly damaged or destroyed.
Names For Neuropathic Pain
As neuropathic pain has been a mysterious affliction, with confusing signs and symptoms, it has not been well diagnosed or understood. This has led to a large number of names for these kinds of conditions. These include:
· Sudeck’s atrophy
· Reflex Sympathetic Dystrophy
· Sympathetically Maintained Pain
For one of the most common and troublesome kinds of neuropathic pain, the modern name is Complex Regional Pain Syndrome. This name reflects our lack of understanding about the cause of this problem.