Neuropathic pain

Neuropathic pain
SpecialtyNeurology and psychiatry
DurationVariable
CausesDamage to the nervous system resulting from diabetes mellitus, multiple sclerosis, COVID-19, infection, injury, and stroke, among others
Risk factorsDiabetes mellitus; multiple sclerosis; exposure to neurotoxicants; alcoholism; history of chemo- and/or radiotherapy; & nutritional deficiencies, among others
Diagnostic methodClinical interview; quantitative sensory testing; electroneuromyography; nerve stimulation; biopsy; imaging, & patient self-rating of symptoms
Differential diagnosisDiabetic and metabolic neuropathy; demyelinating disease (e.g., multiple sclerosis); malignancy; spinal cord injury; primary neuralgia; mononeuritis multiplex; sciatica; pruritic processes; fibromyalgia; and functional pain syndrome, among others
TreatmentPhysical therapy; exercise; psychotherapy; antidepressants; gabapentinoids; anticonvulsants; Tramadol; neuromodulation, and topical agents, among others
Frequency4.1%-12.4% (12-month prevalence, US adults)

Neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system. Neuropathic pain may be associated with abnormal sensations called dysesthesia or pain from normally non-painful stimuli (allodynia). It may have continuous and/or episodic (paroxysmal) components. The latter resemble stabbings or electric shocks. Common qualities include burning or coldness, "pins and needles" sensations, numbness and itching.

Up to 7–8% of the European population is affected by neuropathic pain, and in 5% of persons it may be severe. The pain may result from disorders of the peripheral nervous system or the central nervous system (brain and spinal cord). Neuropathic pain may occur in isolation or in combination with other forms of pain. Medical treatments focus on identifying the underlying cause and relieving pain. In cases of peripheral neuropathy, the pain may progress to insensitivity.