What is Neuropathic Pain ?

It is a chronic pain usually associated with tissue damage. It does not start immediately and usually takes a while to resolve.

When nerve fibres are damaged they send messages to the brain and other pain centres to register pain.  Therefore, you could have an injury to your neck and the pain (especially if it occurs for a period of time) could cause nerve endings at other parts of the body other than the injury site to spark off sending messages of pain to the brain. You can have neuropathic pain yet scans and nerve conduction studies can show as normal. You do not need to have nerve damage to have neuropathic pain.  Having said that nerve damage such as through diabetes, chemotherapy, drug or alcohol abuse can result in neuropathic pain.

A common example is where someone has  an arm or leg removed.  The nerves that originally carried messages of pain to the brain misfire and continue to send  incorrect signals to the brain of pain.  This is called phantom limb syndrome.

There is no obvious cause of neuropathic pain.  The symptoms consist of a shooting or burning pain, tingling or numbness.

Treating neuropathic pain can be very hard as neuropathic pain responds very poorly to standard pain treatments (eg: physiotherapy, massage or acupuncture) and may get worse instead of better over time.  Electrical stimulation of nerves  can help to control pain symptoms.  Antidepressant drugs also help as they have the effect of dulling the receipt of pain messages by the brain in response to the nerve sparks. Typical pain relief and control drugs for neuropathic pain are pregabalin, gabapentin, carbamazepine and trapentadol.  More intrusive forms of treatment include spinal cord stimulation where electrical wires are placed under the skin or near to the spinal column and sends electrical impulses which block’s the brains ability to receive pain from the affected area. While spinal cord stimulation  can be used to treat chronic pain from multiple sources, it does not eliminate the source of chronic pain or treats the underlying cause of the pain. Instead, they interfere with the transmission of pain signals to the brain, so the brain does not recognize (or has only limited recognition) of the pain.

Vashti Norman
Solicitor – Serious Personal Injury

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