What is neuropathic pain
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This document defines neuropathic pain as pain caused by damage or disease affecting the somatosensory nervous system. It discusses neuropathic pain's symptoms, common causes like diabetes and shingles, and treatments including medications, therapies, and surgeries. The document notes neuropathic pain is more prevalent than previously thought and causes high economic costs due to its impact on quality of life and ability to work.
What is neuropathic pain
- 1. What Is Neuropathic Pain? Allan Gordon MD Wasser Pain Management Centre University of Toronto Centre for the Study of Pain
- 2. Definition of neuropathic pain Symptoms and signs Conditions producing neuropathic pain Treatments Cost of NeP
- 3. Definition of Neuropathic Pain Pain resulting from or thought to be resulting from a disturbance of the central or peripheral nervous system Acute vs Chronic (six months) Non Cancer vs Cancer
- 4. How common is it? UK 1% point prevalence But likely more common than that
- 5. Symptoms and Signs Spontaneous vs stimulus evoked Burning, constant, throbbing vs jabbing, stabbing Mild, moderate, severe Distribution may not along classical neuroanatomical lines Associated with analgesia hyperalgesia allodynia
- 6. Fellow travelers Sleep Mood Recreation Anxiety Sex Work QOL and function
- 7. Conditions producing neuropathic pain Diabetic neuropathy Post herpetic neuralgia Cervical and lumbar radiculopathy Post thoracotomy, post mastectomy Multiple sclerosis Post-stroke Phantom limb
- 8. Most likely neuropathic pain Vulvar pain Interstitial cystitis Atypical facial neuralgia Fibromyalgia
- 9. Neuropathic pain a component Post-inguinal hernia Osteoarthritis of knee Post TMJ replacement
- 10. Management Pharmacotherapy Oral: Tricyclic antidepressant Antiepileptic Opiate Methadone Topical: Lidocaine Capsacin Intrathecal: Opiate Clonidine
- 11. Other therapies Rehabilitation therapy Behavioural therapy Psychotherapy CBT; Meditation; Hypnotherapy Alternative: Acupuncture Neurostimulation Neuroblock Injections including Botox Surgery
- 12. Cost of neuropathic pain Mild pain: $2619 Moderate pain: $3972 Severe pain: $8360 Average $4614
- 13. Average cost $4614/3 months Direct costs $1068 Indirect costs $3546
- 14. Conclusions Neuropathic pain is being more commonly recognized Pain can be mild to severe Characteristic symptoms Seen in many common conditions Multimodal treatment Expensive in human and economic terms