The clinical challenge of chronic neuropathic pain.
BACKGROUND
The clinician often faces the problem that certain types of chronic pains remain refractory to the commonly used analgesic treatment options. Neuropathic pain, which is defined as pain caused by direct nerve lesions, may have different causes and a variety of clinical presentations. A correct management of chronic neuropathic pain requires a thorough understanding of the potential causes, the diagnosis and the pathophysiological mechanisms.


OBJECTIVE
The purpose of this review article is to provide the reader with the latest insights in the diagnostic work-out and the clinical presentation of neuropathic pain. Additionally, the possible pathophysiological changes induced by nerve lesions are explained.


METHODS
An extensive literature review was performed using Pubmed citations.


CONCLUSIONS
This article, which is based on extensive literature review, aims at providing a concise review of the current knowledge regarding aetiology, diagnosis and pathophysiology of neuropathic pain.
Department of Anaesthesiology, Critical Care and Multidisciplinary Pain Centre, Genk, Belgium. kris.vissers@skynet.be
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Vissers
D002908:Chronic Disease; D006801:Humans; D006930:Hyperalgesia; D006941:Hyperesthesia; D009437:Neuralgia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D010147:Pain Measurement; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000150:complications*; D004561:Transcutaneous Electric Nerve Stimulation