General hospital of Larissa, Greece
Title: Neuropathic pain
Dalamagka Maria, PhD (Pain medicine doctor, Aristotle University, Greece), consultant anesthetist (General Hospital of Larissa, Greece), teacher and trainer, acupuncturist,
Background and purpose: Neuropathic pain (NP) is often refractory to pharmacologic and non-interventional treatment. Neuropathic pain can be distinguished from non-neuropathic pain by two factors. In neuropathic pain there is no transduction (conversion of a nociceptive stimulus into an electrical impulse). Finally, injury to major nerves is more likely than injury to non-nervous tissue to result in chronic pain. This review focuses on the clinical treatment of neuropathic pain as well aims to improve the care of adults with neuropathic pain. Methods: Clinical treatment of neuropathic pain depends on clinical evaluation, as treatment can be pharmacological or not; invasive treatment or other therapies. Results: Neuropathic pain because of its heterogeneity, there is often uncertainty regarding the nature and exact location of a lesion or health condition associated with neuropathic pain. Conclusions: Both peripheral and central nervous system mechanisms contribute to the persistence of most types of neuropathic pain. . Patients with conditions as diverse as diabetic polyneuropathy, human immunodeficiency virus (HIV) sensory neuropathy, poststroke syndromes, and multiple sclerosis frequently experience daily pain that greatly impairs their quality of life. Implications: Progress in basic science will lead to a greater understanding of the pathophysiologic mechanisms of neuropathic pain.