More Information About Neuropathic Pain

What are the symptoms?

Symptoms of neuropathic pain (NeP) are commonly described as stabbing or electric-shock like. These symptoms are often worse at night.

Other common symptoms of NeP include:

• Allodynia – pain caused by something that is generally non-painful, such as light touch
• Hyperesthesias – an exaggerated response to touch, such as to bed sheets
• Hyperalgesia – an exaggerated painful response to something that is normally painful
• Hyperpathy – pain that persists even after the cause of pain has been removed
• Paresthesias and dysesthesias – abnormal and unpleasant sensations that are described as tingling and pins and needles

What impact does neuropathic pain have on patients, their families and caregivers/carers?

Neuropathic pain can significantly impact a person’s daily functioning and quality of life. Many people with NeP experience difficulty sleeping, a lack of energy, drowsiness and difficulty concentrating. Because of chronic pain, some people are unable to work, walk, or even wear clothes as the contact with their skin can cause an unbearable burning pain.

Painful nerve disorders can be a significant economic burden as patients seek relief from their pain. In addition, patients frequently have other co-occurring disorders, such as depression, and are more likely to use health care services. Total average health care charges are estimated to be three-fold higher among people with painful nerve disorders, compared with the general population.

Additionally, the impact on family members and caregivers/carers is often overlooked. Not only are there social implications, but families and caregivers/carers often feel stress and frustration. They often feel powerless to help their loved one.

What are the different types of neuropathic pain?

There are several types of neuropathic pain. These include:

• Painful peripheral neuropathies, such as some cases of diabetic peripheral neuropathy (DPN) – a complication of diabetes that affects nerve tissue
• Postherpetic neuralgia (PHN) – pain persisting or recurring at the site of herpes zoster (shingles) rash
• Trigeminal neuralgia – periods of sharp, stabbing facial pain interspersed with pain-free periods located near the nose, eyes, lips and ears
• Compression neuropathies such as carpel tunnel syndrome – pain in the hand and wrist
• Phantom limb pain – a sensation of pain arising from an area of an amputated limb
• Multiple sclerosis (MS) – pain at various locations in the lower and upper extremities
• Post stroke pain
• HIV-associated peripheral neuropathies – a broad spectrum of pain disorders seen in people with HIV infection. As many as 50% of HIV-infected people experience peripheral neuropathy during their lifetime
• Cancer-related neuropathic pain (tumor induced or chemotherapy induced)
• Drug-induced neuropathic pain
• Some cases of back and neck pain
• Reflex sympathetic dystrophy also known as Complex regional pain syndrome - is a chronic neurological syndrome

How is neuropathic pain treated?

The symptoms of neuropathic pain can be mild to incapacitating and are often progressive. Treatments may include antidepressants, opioids, NSAIDs and anticonvulsants, however, only a few are approved for the treatment of neuropathic pain.