Espai del pacient

Pain, chronic pain and neuropathic pain

Pain is an unpleasant sensory and emotional experience that occurs in response to an injury or disease in the body. It is a warning sign that something is wrong and can vary in intensity, duration, and type of sensation.

Chronic pain, a persistent discomfort lasting more than three months, can persist even after the initial injury has healed. Unlike acute pain, which is a normal response to a harmful stimulus, chronic pain can evolve into a disease itself, significantly impairing a person's quality of life. Recognizing its debilitating nature fosters empathy towards those enduring it.

Neuropathic pain is a type of chronic pain that affects the peripheral or central nervous system. It occurs when the nerves malfunction or are damaged, causing abnormal sensations such as burning, tingling, numbness, or extreme sensitivity. It can be caused by various conditions, such as nerve injuries, diseases such as diabetes, viral infections, or even as a side effect of some medical therapies.

Types of neuropathic pain

Central Neuropathic Pain: This type of neuropathic pain involves the central nervous system, which includes the spinal cord and brain. It is usually the result of injuries or dysfunctions in these areas of the nervous system.

Peripheral Neuropathic Pain: This type of neuropathic pain affects the peripheral nerves outside the central nervous system, which connect the body's organs and tissues to the spinal cord and brain.

Both types of neuropathic pain can be debilitating and affect the quality of life of sufferers. Treatment may include a combination of medications, physical therapies, and other approaches to help control symptoms and improve nerve function.

Processes that lead to neuropathic pain

• Lumbar spine surgery, radiculopathy
• Herpes zoster infection
• multiple sclerosis
• Spinal cord injury
• Phantom Member
• Trigeminal neuralgia of long evolution
• Entrapment neuropathies
• Polyneuropathies
• After Trauma
• After a dental procedure
• After surgical procedures (chronic post-surgical pain)

Diagnosis of neuropathic pain

Diagnosing neuropathic pain involves a thorough evaluation by a healthcare professional team, usually a team of neurologists or pain management specialists.

• Medical history and physical exam: The medical team will collect detailed information about the person's symptoms and medical history, including previous medical conditions, injuries, surgeries, and medications they are taking. He will then perform a physical examination to assess sensitivity, reflexes, and muscle strength.
• Evaluation of symptoms: The characteristic symptoms of neuropathic pain, such as abnormal sensations (burning, tingling, numbness), the location of the pain, and triggering factors, will be mentioned.
• Neurological tests: Neurological tests: Specific assessments can be conducted to evaluate nerve function, including tests for sensitivity, reflexes, muscle strength, and coordination.
• Nerve conduction studies: These tests evaluate the speed and effectiveness of nerves transmitting electrical signals. They can help identify abnormalities in peripheral nerve function.
• Imaging tests: Magnetic resonance imaging or other imaging tests can be used to detect possible lesions or abnormalities in the central or peripheral nervous system that may be causing neuropathic pain.
• Blood tests and specific tests: In some cases, blood tests or other specific tests may be done to rule out other medical conditions causing the patient's symptoms.

Notably, the diagnosis of neuropathic pain can be complex and often requires a comprehensive evaluation to determine the underlying cause and develop an appropriate treatment plan.

Treatment of neuropathic pain

Treatment of neuropathic pain is multidisciplinary and may involve a combination of pharmacological approaches, physical therapies, psychological interventions, and interventional procedures.

• Medications: Antidepressants, anticonvulsants, and pain relievers can help relieve neuropathic pain by modifying pain signals in the brain, stabilizing abnormal electrical activity in nerves, or relieving pain.
• Physical therapy: Physical therapy can help improve muscle strength, mobility, and posture, as well as reduce the sensation of pain. Stretching, strengthening, and mobilization exercises can be part of a physical treatment plan.
• Occupational therapy: An occupational therapist can teach techniques for carrying out daily activities more comfortably and safely, and recommend assistive devices if needed.
• Psychological interventions: Can help patients change their pain perception and develop strategies to manage it effectively. Relaxation and meditation can also help reduce stress and improve your ability to cope with pain.
• Interventional procedures: For neuropathic pain that does not respond adequately to other treatments, medical procedures or surgical interventions may be considered, such as electrical nerve stimulation, nerve block, corticosteroid injection, surgery to correct nerve anomalies, or neuromodulation, both non-invasively and invasively. Working closely with a specialized medical team is essential to develop a personalized treatment plan that addresses individual symptoms and improves the patient's quality of life.
• Nerve conduction studies: These tests evaluate the speed and effectiveness of nerves transmitting electrical signals. They can help identify abnormalities in peripheral nerve function.
• Imaging tests: Magnetic resonance imaging or other imaging tests can be used to identify potential lesions or abnormalities in the central or peripheral nervous system that could be causing neuropathic pain.
• Blood tests and specific tests: In some cases, blood tests or other specific tests may be done to rule out other medical conditions causing the patient's symptoms.

Notably, the diagnosis of neuropathic pain can be complex and often requires a comprehensive evaluation to determine the underlying cause and develop an appropriate treatment plan.

L'Hospital de la Mar, pioner a tractar a un pacient amb neuromodulació profunda

Hospital del Mar in Catalonia has become the first in the region to treat a patient with neuropathic pain by targeting the affective pathway of pain. The nervous system causes this type of pain without a natural stimulus, and consists of somatic and affective components. The treatment involves stimulating the area where the affective part of the pain is perceived, rather than the pain itself. This approach has been carried out in only around thirty cases worldwide. The patient, who became paraplegic in a traffic accident four years ago, has been experiencing debilitating pain in the sacrum ever since. None of the previous treatments have been effective in managing the pain.

 

Read the news