Pain Management - Neuropathic Pain

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What are types of neuropathic pain?

Neuropathic pain includes:

  • Complex regional pain syndrome (CRPS), also called reflex sympathetic dystrophy;
  • Sympathetically maintained pain;
  • Fibromyalgia;
  • Interstitial cystitis; and
  • Irritable bowel syndrome.

Treatment of neuropathic pain

The various neuropathic pains can be difficult to treat. However, with careful diagnosis and often a combination of methods of treatments, there is an excellent chance of improving the pain and return of function.

Medications are a mainstay of treatment of neuropathic pain. In general, they work by influencing how pain information is handled by the body. Most pain information is filtered out by the central nervous system, usually at the level of the spinal cord. For example, if you are sitting in a chair, your peripheral nerves send the response to the pressure between your body and the chair to your nervous system. However, because that information serves no usual purpose, it is filtered out in the spinal cord. Many medications to treat neuropathic pain operate on this filtering process. The types of medications used for neuropathic pain include antidepressants, which influence the amount of serotonin or norepinephrine, and antiseizure medications, which act on various neurotransmitters, such as GABA and glycine.

One of the most powerful tools in treating neuropathic pain is the spinal cord stimulator, which delivers tiny amounts of electrical energy directly onto the spine. Stimulation works by interrupting inappropriate pain information being sent up to the brain. It also creates a tingling in the pain extremity, which masks pain.

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Comment from: 55-64 Male (Patient) Published: December 05

I have numbness in the feet and legs; slow response in left leg and hot burning of both thighs with the left being the worse. I have muscle cramps under the rib cage wall below T6 which is where a tumor was removed from the spinal cord. Pain builds to the point of not being able to focus on anything but the pain (8-10 range), I can't take Neurontin.

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