neuropathic%20pain
NEUROPATHIC PAIN
Neuropathic pain is the sensation of pain due to abnormal discharges of impaired or injured neural structures in the peripheral &/or central nervous system.
It is characterized by hyperesthesia, hyperalgesia and allodynia.
Common neuropathic pain syndromes are central neuropathic pain, painful diabetic peripheral neuropathy, postherpetic neuralgia, trigeminal neuralgia, postsurgical neuropathic pain, HIV-related neuropathy, lumbosacral radiculopathy and complex regional pain syndrome.

Patient Education

Central Neuropathic Pain

  • The patient should be given adequate information regarding central neuropathic pain including its underlying cause
  • If the patient suffers from allodynia, application of a protective layer (eg cling film) between the skin and clothing may helpful

Painful Diabetic Peripheral Neuropathy

  • The patient should be educated about diabetic peripheral neuropathy, support should be given and expected outcomes should be reviewed
    • Review mechanisms of neuropathic pain, providing information on what is currently known and unknown
  • Assist patient with practical measures (eg bed cradle to lift bedclothes off of sensitive skin)
  • Patient should be made aware of how important optimal glycemic control is
    • Glycemic control near normoglycemia may help slow or prevent the development of peripheral neuropathy and other complications (eg retinopathy, nephropathy, etc)
  • Patients should be counseled on how to optimize their glycemic control
    • Proper diet, oral antidiabetics and insulin use
    • Glucose monitoring, etc
  • Help patient understand that complete pain relief may not be achieved despite best efforts of patient or physician
  • Inform patients of possible adverse effects from medications and any potential for abuse or development of tolerance

Postherpetic Neuralgia

  • The patient should be given adequate information and explanation regarding postherpetic neuralgia; this may help alleviate anxiety about the disorder
  • Educate about treatment side effects
  • It is important that the patient try to maintain social and physical activities

Trigeminal Neuralgia

  • Inform patient about the available treatment options and the expected outcomes
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