Neuropathic Pain

Nat Rev Dis Primers. 2017 Feb 16;3:17002. doi: 10.1038/nrdp.2017.2.

Abstract

Neuropathic pain is caused by a lesion or disease of the somatosensory system, including peripheral fibres (Aβ, Aδ and C fibres) and central neurons, and affects 7-10% of the general population. Multiple causes of neuropathic pain have been described and its incidence is likely to increase owing to the ageing global population, increased incidence of diabetes mellitus and improved survival from cancer after chemotherapy. Indeed, imbalances between excitatory and inhibitory somatosensory signalling, alterations in ion channels and variability in the way that pain messages are modulated in the central nervous system all have been implicated in neuropathic pain. The burden of chronic neuropathic pain seems to be related to the complexity of neuropathic symptoms, poor outcomes and difficult treatment decisions. Importantly, quality of life is impaired in patients with neuropathic pain owing to increased drug prescriptions and visits to health care providers, as well as the morbidity from the pain itself and the inciting disease. Despite challenges, progress in the understanding of the pathophysiology of neuropathic pain is spurring the development of new diagnostic procedures and personalized interventions, which emphasize the need for a multidisciplinary approach to the management of neuropathic pain.

Publication types

  • Review

MeSH terms

  • Amines / pharmacology
  • Amines / therapeutic use
  • Analgesics / pharmacology
  • Analgesics / therapeutic use
  • Cyclohexanecarboxylic Acids / pharmacology
  • Cyclohexanecarboxylic Acids / therapeutic use
  • Drug Therapy, Combination / methods
  • Gabapentin
  • Humans
  • Lidocaine / pharmacology
  • Lidocaine / therapeutic use
  • Narcotics / pharmacology
  • Narcotics / therapeutic use
  • Neoplasms / complications
  • Neuralgia / complications*
  • Neuralgia / diagnosis*
  • Neuralgia / epidemiology
  • Nociceptive Pain / complications
  • Nociceptive Pain / diagnosis
  • Pain Management / methods*
  • Pregabalin / pharmacology
  • Pregabalin / therapeutic use
  • Quality of Life / psychology*
  • Tramadol / pharmacology
  • Tramadol / therapeutic use
  • Transcutaneous Electric Nerve Stimulation / methods
  • Transcutaneous Electric Nerve Stimulation / standards
  • Voltage-Gated Sodium Channel Blockers / pharmacology
  • Voltage-Gated Sodium Channel Blockers / therapeutic use
  • gamma-Aminobutyric Acid / pharmacology
  • gamma-Aminobutyric Acid / therapeutic use

Substances

  • Amines
  • Analgesics
  • Cyclohexanecarboxylic Acids
  • Narcotics
  • Voltage-Gated Sodium Channel Blockers
  • Tramadol
  • Pregabalin
  • gamma-Aminobutyric Acid
  • Gabapentin
  • Lidocaine