Pain Information

Pain Questionnaires

Are you in pain and need help? Fill out one of the following pain questionnaires:

You are here: Home » Pain Help » Pain Problems » Neuropathic Pain

Unlike “nociceptive” pain, which results from direct stimulation of afferent nerves, neuropathic pain is pain that results from a disturbance of function or pathologic change in a nerve, either in the periphery or in the central nervous system (CNS = brain and spinal chord). Patients often describe neuropathic pain as sharp, shooting or burning. Neuropathic pain may or may not be accompanied by numbness, dysaesthesia/paraesthesia (tingling, pins and needles, crawling feeling), or motor loss. Neuropathic pain is often associated with abnormal painful sensations in the area of pain including allodynia (pain produced from a stimulus that does not normally provoke pain) and hyperalgesia (an increased response to a painful stimulus). Although mechanisms of neuropathic pain are still not entirely understood, current hypothesis include possible genetic predisposition causing susceptibility after nerve injury, interruption of the normal balance of sensory nerve input into the dorsal horn, abnormal growth and synaptic activity of the sympathetic nervous system, and abnormal neuroinflammatory response to injury. Like all pain, treatment of neuropathic pain requires a balanced, multi-modal approach that is individualized and based on proven efficacy, tolerability, and safety. Response to conventional analgesics such as NSAIDs is poor.

Pain is constant but fluctuating over the day
Pain is often worse at night
Pain is often described as burning, freezing, shooting and lancinating
Pain is frequently associated with:
- Allodynia (Pain with non-painful stimulus)
- Hyperalgesia (Increased pain with mildly painful stimulus)
- Hypaesthesia (Less feeling cf. unaffected side)
- Hyperaesthesia (More feeling cf. unaffected side)
- Paraesthesias (“Funny feelings”, e.g. pins and needles)
- Dysaesthesias (“Funny feelings the patient doesn’t like”)
Pain may be associated with signs of sympathetic dysfunction resulting in
- Colour changes
- Temperature changes
- Piloerection
- Changes in sweating
- Spontaneous activity in affected muscles (e.g. fasciculation)
Pain is rarely opioid-sensitive (only 5-10 % of patients will experience pain relief with morphine)

Figures quoted on the Neuropathic Pain Network are as follows : Between 1.5 percent and 7.7 percent of people are believed to be affected by neuropathic pain in the United States and in European countries, respectively. However, it is a syndrome that often is under-diagnosed and under-treated. In European countries, the estimated prevalence of neuropathic pain is:
- 3 million people, or 7.5 percent in the United Kingdom
- 2.5 million people, or 6.4 percent in France
- 3.5 million people, or 6.0 percent in Germany
- 2.1 million people, or 7.7 percent in Spain

Direct trauma to nerves
- Injuries (penetrating or blunt)
- Postoperative / post-procedural (e.g. Phantom limb pain; chronic pain after surgery)
Localised or systemic infections
- Herpes Zoster (Postherpetic Neuralgia)
- Pelvic Inflammatory Disease (Chronic Pelvic Pain)
- HIV / AIDS-related pain
Direct compression of nerves
- By tumour
- Prolapsed disc ("Sciatica")
- Arterial vessels (Trigeminal Neuralgia)
Ischaemia
- Stroke in thalamic region (Central Pain)
Metabolic derangements
- Painful diabetic neuropathy