Neuropathic Pain

Neuropathic pain results from damage or dysfunction in the nervous system. It is often chronic and can manifest with various symptoms such as burning, stabbing, shooting, tingling, pins and needles, numbness, or sensations resembling electric shocks.

Common Causes of Neuropathic Pain:

Diabetic Neuropathy: Resulting from uncontrolled diabetes

Postherpetic Neuralgia: Occurs after a shingles outbreak (herpes zoster)

Post-Trauma or Surgery: Nerve injury sustained during accidents or operations

Complex Regional Pain Syndrome (CRPS): pain following an injury or surgery

Chemotherapy-Induced Peripheral Neuropathy

Central post-stroke pain: after a stroke

Multiple Sclerosis

Spinal Cord Injury

Trigeminal Neuralgia: facial pain caused by irritation of the trigeminal nerve

Phantom Limb Pain: after amputation

Assessment and Diagnosis:

There is no definitive test for fibromyalgia. Diagnosis is often based on:

Comprehensive history and assessment

Investigations: X-ray, MRI, CT scan, Electromyography (EMG) or nerve conduction studies

Follow-up for a personalised multimodal management plan

Referrals to specialists (e.g. Neurologist, Gynaecologist)

Multimodal Treatment:

Treatment varies based on the underlying cause and may include:

Oral analgesics, including anti-neuropathic medication

Lidocaine and Capsaicin patch treatment for localised neuropathic pain

Pain interventions such as nerve blocks and pulsed radiofrequency of the nerves

Spinal cord stimulation (SCS): Implantable devices that deliver electrical signals to modulate pain perception

Peripheral nerve stimulation (PNS): For specific peripheral nerves

Physical therapy aimed at improving strength, flexibility, and function – Lifestyle and dietary changes – Psychological support: stress management and cognitive behavioural therapy (CBT)