The neuropathic pain

Neuropathic pain is a pain that has very specific characteristics that make it very different both in the symptoms and fundamentally in the treatment of pain that we conventionally know, which is what we call inflammatory pain, the pain that occurs after of a trauma, after an operation, etc.. Neuropathic pain is basically a pain that is related to an alteration of the nervous system, it can be of the central nervous system or the peripheral nervous system, and it has very specific clinical characteristics.

Most patients notice symptoms that are very specific: sharp pain, cramps, a pain that may be burning ... In fact, often for patients it is difficult to explain the symptoms they feel, because they do not correspond normally to the descriptors that we use to describe the pain that is normally felt after trauma, for example. Neuropathic pain has a very complex physiology and needs diagnostic methods that are also a bit more sophisticated than those that are usually used to diagnose painful processes, for example related to trauma or other types of diseases..

In fact, there is a group of tests that are very specific for diagnosis such as electromyography or sensitive evoked potentials and in that sense it is imperative to work together with neurophysiologists to be able to carry out a diagnosis as concrete as possible.

Why does it arise and who does it affect?

Neuropathic pain arises from a variety of causes. The most common are infectious causes - that is, what we call a postherpetic neuralgia-, metabolic causes - for example, diabetic neuropathy-, and then as a condition associated with alterations of the peripheral nervous system - for example, radicular pain associated with hernias discs- or pathologies secondary to diseases of the central nervous system - such as a stroke that can produce a type of pain that we call central pain and that has characteristics of neuropathic pain-. In any case, neuropathic pain may be associated with another type of pain, inflammatory symptoms, such as herniated discs in the case of irradiation pain, and in that sense it can affect a very large population.

How is it treated in a pain unit?

The treatment of neuropathic pain is mainly through pharmacological processes or invasive procedures. Most of the patients who come to the pain unit have already started a pharmacological treatment that we can implement in any case with certain drugs that we use preferentially. However, what we can provide indisputably are the invasive procedures, within which there are various procedures of various kinds that will have an indication depending on the initial picture that produces neuropathic pain.

If it is not treated, what physical and psychological consequences can it have for the patient?

Most patients when they come to the pain unit have already been treated previously and generally never satisfactorily. The treatment of neuropathic pain is complex and, in most patients, difficult to carry out. This undoubtedly has an impact on all spheres of life, in the labor sphere, as well as in the personal and social spheres.. It is indisputable that if we manage to treat pain, the patient will improve in all areas of his life and, therefore, we must try to take the treatment as appropriate as possible. If we fail to control pain, on the other hand, the clinical picture may worsen over time, especially in some neuropathic pain pictures such as the complex regional syndrome in which it is imperative to do the treatment early.