Neuropathic pain is defined by the International Association for the Study of Pain, Neuropathic Special Interest group as “pain arising as a direct consequence of a lesion or disease affecting the somatosensory system”. It can be caused by lesions of the peripheral or central nervous system or both.
The nerves involved can then transmit abnormal or incorrect messages to the brain resulting in increased intensity of pain, pain over a larger area or persistent pain. Neuropathic pain episodes can be divided into spontaneous or stimulus-evoked pain i.e. sensory changes.
It is estimated that neuropathic pain could be a significant feature in up to 40% of cancer pain syndromes and in one case series it was found that 79% of neuropathic pain cases result from nerve compression, 16% from nerve injury and 5% are sympathetically mediated1. Nerve injury in cancer has 3 main causes:
- Tumour infiltration of individual nerves, nerve plexuses or the spinal cord.
- As a result of surgery (post-operative incisional pain and phantom limb pain).
- Radiotherapy and chemotherapy can also damage nerves and alter nerve function.
Other classical forms of neuropathic pain include diabetic peripheral neuropathy, trigeminal neuralgia and post- herpetic neuralgia.
The above is an extract from our Neuropathic Pain guideline.
Neuropathic Pain guideline