Skip to main content

Neuropathic Pain

Michael Arnold, MD, CDR, MC Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Defined as pain caused by direct nerve injury (1)

  • Any injury to either the peripheral or central nervous system can lead to neuropathic pain.

  • Can exist without ongoing disease

  • Can arise...

DIAGNOSIS

Diagnosis is based primarily on history (e.g., underlying disorder and distinct pain qualities) and the findings on physical examination (e.g., pattern of sensory disturbance) (3,4)[A]. 

HISTORY

TREATMENT

GENERAL MEASURES

  • Due to multiple neuropathic pain pathways, all medications have limited efficacy and show significant benefit at tolerable doses for a small proportion of patients.

  • Physical a...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Multidisciplinary team

  • Periodic evaluation to rule out other treatable conditions

Patient Monitoring

  • Pain management requires ongoing evaluation, patient education, ...

REFERENCES

1
Cohen SP, Mao J. Neuropathic pain: mechanisms and their clinical implications. BMJ.  2014;348:f7656. [View Abstract on OvidMedline]
2
van Hecke O, Austin SK, Khan RA, et al. Neuropathi...

ADDITIONAL READING

  • Attal N, Bouhassira D. Pharmacotherapy of neuropathic pain: which drugs, which treatment algorithms? Pain.  2015;156(Suppl 1):S104–S114. [View Abstract on OvidMedline]

  • Gilron I...

CODES

ICD10

  • M79.2 Neuralgia and neuritis, unspecified

  • E10.40 Type 1 diabetes mellitus with diabetic neuropathy, unsp

  • E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unsp

  • G54.6 Phantom limb syndr...

CLINICAL PEARLS

  • Neuropathic pain is a common syndrome, affecting between 7% and 10% of the population with major impacts on quality of life.

  • Due to numerous mechanisms of pain, any single treatment wil...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×