Neuropathic Pain or Neuralgias
Neuropathic pains has been defined by the international association for the study of pain. ( IASP ) as.
Neuropathic pains are difficult to diagnose in the general set up of family practice or even at consultant level- BUT they can be encountered in all specialties of medicine. So much so a German expert committee has developed a simple clinically applicable questionnaire called the “ pain detect” in several languages for detecting the neuropathic pains. Simply speaking, neuropathic pains represent the response of a nerve to any injury, physical, chemical or biological. The injury may be seen and felt- like the pain from cut after surgery which also cuts superficial minor nerves- or it could be Diabetes, causing damage to the nerve fibres manifesting with burning pain in the feet. Nerves react differently to injuries in different individuals, and the pattern and clinical picture seen as a result of these, could be a mind boggling permutation and combination of symptoms.
Neuropathic pains can be quite devastating in terms of the quality of life- these pains can be extremely resistant to standard painkillers and even strong opioids, with absolutely no relief from oral medications. Long standing cases also cause a lot of damage to the patient's social and mental well being because of loss of productivity and constant suffering.
Since many investigations may be normal in such cases- the patients are referred to as having "only psychological issues"
Symptoms may vary from mild hypersensititvity to a florid presentation of CRPS ( complex regional pain syndrome: but as the name suggests, all of them have pain . Some have constant pain along with spontaneous sharp shooting pains, burning sensations etc. Clinical signs could vary, right from hypersensitivity to simple, normal sensations like gentle touch or a breeze from a fan, to severe pain to touch or pressure( hyperalgesia , allodynia ) . Some develop swelling, redness, over growth of nails hair etc ( trophic changes). All of them uniformly show some muscle stiffness with associated weakness and reduced movements. and they may also have numbness, loss of specific sensations etc.
Neuropathic pain may be also associated with post surgery pains, cancer pain, low back pain etc.
One such devastating condition is called Complex Regional pain syndrome, or CRPS, also called reflex sympathetic dystrophy or RSD. The diagnosis is made on the basis of diagnostic criteria defined by IASP( International association for the study of pain) Confusions persist regarding different subtypes and symptom progression through stages of hypertrophy, dystrophy, atrophy. Varying degrees of pain relief from some treatments have been reported but there is no scientifically established treatment that reports long-term functional recovery . In the past 8 years we have evolved a multi-modality treatment regimen (MMTR) that achieved a consistent predictable complete reversal of pathology of CRPS1 with restoration of function
Ashirvad Treatment neuropathic pains
At Ashirvad, patients of neuropathic pain are treated with compassion reinforced by our years of experience with this group of sufferers who seek relief in vain. They are heard patiently- and then treated promptly. The common examples of neuropathic pains are Herpes pains and post herpetic neuralgia (PHN), diabetic neuropathy. A common and important category of neuropathic pains is Post surgical pains that can occur after any surgery anywhere in the body from craniotomy to foot surgery. Another important form of neuropathy is Neuropathy secondary to cancer per se and its treatments like surgery, radiotherapy chemotherapy etc.
Simpler forms of neuropathic pains may require only assurance, physiotherapy, medications http://seeknext.com/designs/paincare/treatment_offered.html#medic, local application of local anaesthetic creams or patches. More severe forms may require and IMS http://seeknext.com/designs/paincare/treatment_offered.html#ims. Complex ones like PHN are treated more aggressively with interventions like continuous indwelling catheters along with IMS, physical therapy as well as medications.