Managing Neuropathic Pain

1. What is it?
Neuropathic pain is a specific type of pain that originates from an injury somewhere in the nervous system. It may originate from nerves in the brain and spinal cord (central nervous system) or nerves that have left the spine to reach body parts like the arms and legs (peripheral nervous system). Neuropathic pain is an abnormal signal reaching the brain from the injured nerves. It is often described as a burning, tingling, electric or ‘zapping’ sensation in an area of the body that corresponds to the nerve injury. There may be changes in skin sensation such as numbness or hypersensitivity when the area is touched. Neuropathic pain can fluctuate over the course of the day and can change over time after an injury. The goals of treatment of neuropathic pain are to make it manageable enough to maintain function and quality of life.

2. Assessment (10 point scale)
As part of the assessment of neuropathic pain, the doctor will typically ask you to describe the location, quality, severity and timing of your pain, as well as what makes it better or worse. You may be asked to rate your pain (at its best, average and worst) on a scale from 0 (no pain) to 10 (worst pain imaginable). An exam of the affected area may be done for sensory changes, hypersensitivity, weakness, swelling or any other visible changes.

3. Treatment
Neuropathic pain can be intrusive and disabling. Often a combinations of treatments are required, including pharmacologic (medication) and non-pharmacologic (non-medication) options. Non-pharmacologic treatments may include psychological strategies, manual treatments/exercises, mirror therapy, desensitization strategies, implantable devices and others. Pharmacologic treatment can include oral, topical and sometimes intravenous medications. There are a number of different categories of nerve pain medication and multiple medications may be needed together. Neuropathic pain treatment strategies may change over time after injury, depending on the severity of pain symptoms.

See resources below for further information:
PainBC
Course on understanding chronic pain