About Neuropathic Pain
The International Association for the Study of Pain defines neuropathic pain as the pain arising as a direct consequence of a lesion or disease affecting the somatosensory nervous system or to a malfunction of this system. The initial neuronal dysfunction or damage is only the start of a cascade of changes that lead to and sustain neuropathic pain. It is a sign of poorly adaptive neuroplasticity in the nervous system. The most common types of pain are radiculopathies, painful diabetic neuropathy, central neuropathic pain caused by stroke or spinal injury, pain following amputation, stroke, trigeminal neuralgia and fibromyalgia.
When neuropathic pain is a result of a lesion or disease affecting the peripheral nervous system it is known as peripheral; when the lesion occurs in the central nervous system it is known as central pain.
It is important to understand that neuropathic pain is not a single phenomenon. In fact, neuropathic pain, in the singular, does not exist. It is actually a group of painful or uncomfortable sensory symptoms that a person describes in words using the term “pain”.
These phenomena are diverse and often difficult for the patient to communicate due to the lack of a specific vocabulary to describe them.
The sensation of ones clothes brushing against ones skin becomes an unbearable pain. A constant burning sensation as if one’s feet were submerged in boiling water, the feet are overcome by a “pins and needles” sensation while walking, the sensation of constant crushing pain after an amputation, as if the phantom foot were being squeezed in a tourniquet, the sensation of an intensely painful corset or belt around the chest at the level of a spinal injury. These are just some of the severe symptoms that patients with neuropathic pain may experience.