The clinical challenge of chronic neuropathic pain.

Abstract

The clinician often faces the problem that certain types of chronic pains remain refractory to the commonly used analgesic treatment options. Neuropathic pain, which is defined as pain caused by direct nerve lesions, may have different causes and a variety of clinical presentations. A correct management of chronic neuropathic pain requires a thorough understanding of the potential causes, the diagnosis and the pathophysiological mechanisms. The purpose of this review article is to provide the reader with the latest insights in the diagnostic work-out and the clinical presentation of neuropathic pain. Additionally, the possible pathophysiological changes induced by nerve lesions are explained. An extensive literature review was performed using Pubmed citations. This article, which is based on extensive literature review, aims at providing a concise review of the current knowledge regarding aetiology, diagnosis and pathophysiology of neuropathic pain.