Following the clues to neuropathic pain. Distribution and other leads reveal the cause and the treatment approach.
Neuropathic pain can seem enigmatic at first because it can last indefinitely and often a cause is not evident. However, heightened awareness of typical characteristics, such as the following, makes identification fairly easy: The presence of certain accompanying conditions (e.g., diabetes, HIV or herpes zoster infection, multiple sclerosis) Pain described as shooting, stabbing, lancinating, burning, or searing Pain worse at night Pain following anatomic nerve distribution Pain in a numb or insensate site The presence of allodynia Neuropathic pain responds poorly to standard pain therapies and usually requires specialized medications (e.g., anticonvulsants, tricyclic antidepressants, opioid analgesics) for optimal control. Successful pain control is enhanced with use of a systematic approach consisting of disease modification, local or regional measures, and systemic therapy.
Belgrade
M J
MJ
Fairview Pain Management Center, Fairview-University Medical Center, Minneapolis, MN 55454, USA. mbelgra1@fairview.org
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002908:Chronic Disease; D002940:Circadian Rhythm; D003131:Combined Modality Therapy; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006562:Herpes Zoster / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009410:Nerve Degeneration / Q000150:complications; D009619:Nociceptors / Q000503:physiopathology; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D059408:Pain Management; D059348:Peripheral Nerve Injuries; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis / Q000628:therapy; D012678:Sensation Disorders / Q000150:complications; D013564:Sympathetic Nervous System / Q000503:physiopathology
D000701:Analgesics, Opioid; D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic