Neuropathic pain is the result of injured or damaged nerves which send information between the spinal cord (via the skin, muscles and other regions of the body), and the brain. So what kind of symptoms should you watch out for? These include: regions of your body which feel sensitive when you touch them; excruciating pain, numbness, burning sensations, pins and needles; and having trouble sensing temperatures. Further, as even slight pressure can exacerbate the pain, in some cases, sufferers may find it difficult to wear thick clothes [1].
“Patients often say that the pain is unfamiliar, unlike any pain experienced before” [2]
Putting a Spotlight on the Causes
“Long-term neuropathic pain is common & may be related to an underlying health condition such as cancer or diabetic neuropathy, or it could be related to treatments such as chemotherapy” [1]
Nerve damage or pressure on the nerves can be a result of metabolic conditions such as diabetes, or certain diseases such as multiple sclerosis. It can also be brought on by alcoholism; vascular malformations; cancer; viral infections; trauma or surgery. Moreover, it even may come about due to the side effects of certain pharmaceuticals. It is however, important to note that in rare cases, the root cause cannot be established [1]. So this is just one of the reasons why booking an appointment with a highly experienced Pain Specialist, such as those at the London Pain Clinic, is so important. He/she will review your medical history, and conduct a comprehensive examination.
So What Are the Treatment Options?
“Regular painkillers such as non-steroidal anti-inflammatory drugs or NSAIDs (for example ibuprofen, aspirin and paracetamol) are not usually effective for neuropathic pain” [1]
Every patient is different, and prior to working out a treatment plan, your Pain Specialist will look at your specific symptoms and individual needs. The London Pain Clinic treats patients holistically, and offers a spectrum of both cutting-edge and established treatments. You are encouraged to keep a Pain Diary, which will be very helpful when you attend your appointments to discuss your progress.
When you are examined, your specialist may discover that you have: an exaggerated pain response (hyperpathia); a relatively increased or decreased perception of a non-noxious stimulus (hyperesthesia or hypoesthesia, respectively); a relatively increased or decreased perception of a noxious stimulus (hyperalgesia or hypalgesia, respectively); or pain that is generated by a normally non-painful stimulus (allodynia). In addition to the aforementioned, your neuropathic pain may also be due to trophic changes, such as alterations in your skin and subcutaneous tissues, or changes to your nails and hair. Moreover, the pain could be a result of focal neurologic deficits, such as focal autonomic changes or weakness. Focal autonomic phenomena can comprise: vasomotor instability and swelling (which can be seen as colour changes, focal temperature changes, and so on) [2].
At the London Pain Clinic, if your medic suspects that you have a neurologic lesion, he/she may carry out ancillary testing (for example, electromyogram and nerve conduction velocities). Moreover, if your Pain Specialist feels that you may have autonomic dysregulation, then he/she
may conduct other tests such as thermography. Furthermore, QST (quantitative sensory testing) may also be used to help give you a clear diagnosis [2].
References
[1]. Brain and Spine Foundation (2020 ). “Neuropathic Pain.”
https://www.brainandspine.org.uk/information-and-support/living-with-a-neurological-problem/neuropathic-pain/#
[2]. Portenoy, R. K. & Cruciani R (2009). Pain Management Secrets (Third Edition), as cited in Science Direct.
https://www.sciencedirect.com/topics/neuroscience/neuropathic-pain
