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Neuropathic Pain

Understanding Neuropathic Pain

Neuropathic pain is a type of long-term (chronic) pain that is caused by damage to the nervous system.

Neuropathic pain overview

Neuropathic pain occurs because of damage to nerves – cells that send signals to and from the spinal cord and brain.1

 

There are many possible causes of neuropathic pain. In the hands/feet, limbs and body, nerve damage can be caused by injury, surgery, diabetes, poison, infection, or cancer. 1,2 In the spinal cord and brain, nerve damage may arise due to injury, stroke, multiple sclerosis or Parkinson’s disease. 1,2

Facts about Neuropathic Pain

Neuropathic pain is a long-term (chronic) type of pain, which is caused by damage to the nervous system. There are many possible causes of neuropathic pain, such as injury, surgery, diabetes, poison, infection, and cancer.1,2

Neuropathic pain can be described as ‘electric’, burning hot or cold, or like receiving a shock.7 It is commonly felt in the skin, or just beneath the skin.7

Symptoms

Neuropathic pain occurs because of damage to nerves – cells that send signals to and from the spinal cord and brain.1

 

There are many possible causes of neuropathic pain. In the hands/feet, limbs and body, nerve damage can be caused by injury, surgery, diabetes, poison, infection, or cancer.1,2 In the spinal cord and brain, nerve damage may arise due to injury, stroke, multiple sclerosis or Parkinson’s disease.1,2

7-10%

of people worldwide are thought to have neuropathic pain.3,4

17%

of people described their chronic neuropathic pain as ‘worse than death’ in one survey.8

Epidemiology and burden

Worldwide, 7–10% of people are thought to have neuropathic pain, many of whom have been in pain for more than 5 years.4,5

 

Not all people with nerve damage develop neuropathic pain, although the likelihood increases among people with certain conditions.2 For example, neuropathic pain may affect up to a third of people with early-stage breast cancer,6 and half of people with a spinal cord injury.7 Around a quarter to a half of people with diabetes have nerve damage, which can result in neuropathic pain.8 Neuropathic pain is likely to become even more common in the future, due to the ageing global population and increasing rates of diabetes and cancer.2

 

Neuropathic pain adds a greater burden to already burdensome conditions. In one survey, 17% of people described their chronic neuropathic pain as ‘worse than death’.9 The pain is associated with anxiety, depression, disturbed sleep, and impaired thinking, which can affect a person’s quality of life.2 A global survey by the World Health Organization (WHO) found that people with a chronic pain condition miss an average of 14 additional days of work or activities per year, compared with people without such a condition.10

Facts about Neuropathic Pain

Neuropathic pain may affect up to a third of people with early-stage breast cancer,5 and half of people with a spinal cord injury.6

Neuropathic pain is associated with anxiety, depression, disturbed sleep, impaired thinking, and reduced quality of life.2

People who are concerned that they – or their loved ones – are experiencing symptoms of neuropathic pain should see their doctor for help and advice. 

Diagnosis and care

Neuropathic pain is identified using medical history, examinations, and pain questionnaires.2,11 It is important that the correct type of pain is identified, because different types of pain should be treated differently.12

 

While it is important to treat the cause of neuropathic pain, it is usually not possible to repair the damaged nerves.1,2 The aim of treatment is therefore to manage the pain, which normally involves medication.2

  1. Costigan M, Scholz J, Woolf CJ. Neuropathic pain: a maladaptive response of the nervous system to damage. Annu Rev Neurosci. 2009;32:1–32.
  2. Colloca L, Ludman T, Bouhassira D, Baron R, Dickenson AH, Yarnitsky D, et al. Neuropathic pain. Nat Rev Dis Primers. 2017;3:17002.
  3. World Health Organization (WHO). International Classification of Diseases for Mortality and Morbidity Statistics. 11th revision. Geneva, Switzerland; 2019.
  4. van Hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain. 2014;155(4):654–662.
  5. DiBonaventura MD, Sadosky A, Concialdi K, Hopps M, Kudel I, Parsons B, et al. The prevalence of probable neuropathic pain in the US: results from a multimodal general-population health survey. J Pain Res. 2017;10:2525–2538.
  6. Ilhan E, Chee E, Hush J, Moloney N. The prevalence of neuropathic pain is high after treatment for breast cancer: a systematic review. Pain. 2017;158(11):2082–2091.
  7. Burke D, Fullen BM, Stokes D, Lennon O. Neuropathic pain prevalence following spinal cord injury: a systematic review and meta-analysis. Eur J Pain. 2017;21(1):29–44.
  8. Barrett AM, Lucero MA, Le T, Robinson RL, Dworkin RH, Chappell AS. Epidemiology, public health burden, and treatment of diabetic peripheral neuropathic pain: a review. Pain Med. 2007;8(Suppl 2):S50–S62.
  9. Torrance N, Lawson KD, Afolabi E, Bennett MI, Serpell MG, Dunn KM, Smith BH. Estimating the burden of disease in chronic pain with and without neuropathic characteristics: does the choice between the EQ-5D and SF-6D matter? Pain. 2014;155(10):1996–2004.
  10. Alonso J, Petukhova M, Vilagut G, Chatterji S, Heeringa S, Üstün TB, et al. Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys. Mol Psychiatry. 2011;16(12):1234–1246.
  11. Finnerup NB, Haroutounian S, Kamerman P, Baron R, Bennett DLH, Bouhassira D, et al. Neuropathic pain: an updated grading system for research and clinical practice. Pain. 2016;157(8):1599–1606.
  12. Nalamachu S. An overview of pain management: the clinical efficacy and value of treatment. Am J Manag Care. 2013;19(14 Suppl):S261–S266.

  1. Costigan M, Scholz J, Woolf CJ. Neuropathic pain: a maladaptive response of the nervous system to damage. Annu Rev Neurosci. 2009;32:1–32.
  2. Colloca L, Ludman T, Bouhassira D, Baron R, Dickenson AH, Yarnitsky D, et al. Neuropathic pain. Nat Rev Dis Primers. 2017;3:17002.
  3. van Hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain. 2014;155(4):654–662.
  4. DiBonaventura MD, Sadosky A, Concialdi K, Hopps M, Kudel I, Parsons B, et al. The prevalence of probable neuropathic pain in the US: results from a multimodal general-population health survey. J Pain Res. 2017;10:2525–2538.
  5. Ilhan E, Chee E, Hush J, Moloney N. The prevalence of neuropathic pain is high after treatment for breast cancer: a systematic review. Pain. 2017;158(11):2082–2091.
  6. Burke D, Fullen BM, Stokes D, Lennon O. Neuropathic pain prevalence following spinal cord injury: a systematic review and meta-analysis. Eur J Pain. 2017;21(1):29–44.
  7. World Health Organization (WHO). International Classification of Diseases for Mortality and Morbidity Statistics. 11th revision. Geneva, Switzerland; 2019.
  8. Torrance N, Lawson KD, Afolabi E, Bennett MI, Serpell MG, Dunn KM, Smith BH. Estimating the burden of disease in chronic pain with and without neuropathic characteristics: does the choice between the EQ-5D and SF-6D matter? Pain. 2014;155(10):1996–2004.
  9. Alonso J, Petukhova M, Vilagut G, Chatterji S, Heeringa S, Üstün TB, et al. Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys. Mol Psychiatry. 2011;16(12):1234–1246.

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