Column of Hope

Chiari and Syringomyelia Research Foundation - Working toward a life without pain.

Neuropathic Pain

According to Dr. Steven Richeimer on the Spine Universe website, neuropathic pain occurs when there is a malfunction in the part of the nervous system that tells the brain that tissue is injured. While there may be no injury to the tissue where the pain exists, the nervous system tells the brain that there is damage, causing pain. This is the case because the pain is caused by the damage or pathological change in the central or peripheral nervous system. Neuropathic pain is generally described by patients as being burning, electric, tingling and shooting pain. The pain can be constant or come in sudden attack.

Dr. Steven Richeimer, on the University of South California Pain Center website, lists the following examples of neuropathic pain: ’Examples include post herpetic (or post-shingles) neuralgia, reflex sympathetic dystrophy / causalgia (nerve trauma), components of cancer pain, phantom limb pain, entrapment neuropathy (e.g., carpal tunnel syndrome), and peripheral neuropathy (widespread nerve damage). Among the many causes of peripheral neuropathy, diabetes is the most common, but the condition can also be caused by chronic alcohol use, exposure to other toxins (including many chemotherapies), vitamin deficiencies, and a large variety of other medical conditions--it is not unusual for the cause of the condition to go undiagnosed.

As described by Dr. Richeimer on the Spine Universe website, medications used to treat neuropathic pain are as follows, tricyclic antidepressants, anticonvulsants and topical therapy that contain substance P depletors, autonomic drugs and NMDA receptor antagonists. Invasive procedures can also be performed like implanting a morphine pump or nerve blocks. Dr. Richeimer highlights the importance of having a multidisciplinary approach to treating neuropathic pain. Aside from medication and procedures it may be pertinent for the patient to make use of physical modalities, an example being physical rehabilitation. It also may be important to make use of psychological modalities like behavior modification or relaxation training.