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Neuropathic pain is a type of pain that can result from injury to nerves,
either in the peripheral or central nervous system. Neuropathic pain can occur
in any part of the body and is frequently described as a hot, burning sensation,
which can be devastating to the affected individual. It can result from diseases
that affect nerves (such as diabetes) or from trauma, or, because chemotherapy
drugs can affect nerves, it can be a consequence of cancer treatment. Among
the many neuropathic pain conditions are diabetic neuropathy (which results
from nerve damage secondary to vascular problems that occur with diabetes);
reflex sympathetic dystrophy syndrome, which can follow injury; phantom
limb and post-amputation pain, which can result from the surgical removal
of a limb; postherpetic neuralgia, which can occur after an outbreak
of shingles; and central pain syndrome, which can result from trauma
to the brain or spinal cord.
Reflex sympathetic dystrophy syndrome, or RSDS, is accompanied by burning
pain and hypersensitivity to temperature. Often triggered by trauma or nerve
damage, RSDS causes the skin of the affected area to become characteristically
shiny. In recent years, RSDS has come to be called complex regional pain
syndrome (CRPS); in the past it was often called causalgia.
Repetitive stress injuries are muscular conditions that result from repeated
motions performed in the course of normal work or other daily activities. They
include:
Writer's cramp, which affects musicians and writers and others,
Compression or entrapment neuropathies, including carpal tunnel syndrome,
caused by chronic overextension of the wrist and
Tendonitis or tenosynovitis, affecting one or more tendons.
Sciatica is a painful condition caused by pressure on the sciatic nerve,
the main nerve that branches off the spinal cord and continues down into the
thighs, legs, ankles, and feet. Sciatica is characterized by pain in the buttocks
and can be caused by a number of factors. Exertion, obesity, and poor posture
can all cause pressure on the sciatic nerve. One common cause of sciatica is
a herniated disc.
Shingles and other painful disorders affect the skin. Pain is a common
symptom of many skin disorders, even the most common rashes. One of the most
vexing neurological disorders is shingles or herpes zoster, an infection that
often causes agonizing pain resistant to treatment. Prompt treatment with antiviral
agents is important to arrest the infection, which if prolonged can result in
an associated condition known as postherpetic neuralgia. Other painful disorders
affecting the skin include: vasculitis, or inflammation of blood vessels; other
infections, including herpes simplex; skin tumors and cysts, and tumors associated
with neurofibromatosis, a neurogenetic disorder.
Sports injuries are common. Sprains, strains, bruises, dislocations,
and fractures are all well-known words in the language of sports. Pain is another.
In extreme cases, sports injuries can take the form of costly and painful spinal
cord and head injuries, which cause severe suffering and disability.
Spinal stenosis refers to a narrowing of the canal surrounding the spinal
cord. The condition occurs naturally with aging. Spinal stenosis causes weakness
in the legs and leg pain usually felt while the person is standing up and often
relieved by sitting down.
Surgical pain may require regional or general anesthesia during the
procedure and medications to control discomfort following the operation. Control
of pain associated with surgery includes presurgical preparation and careful
monitoring of the patient during and after the procedure.
Temporomandibular disorders are conditions in which the temporomandibular
joint (the jaw) is damaged and/or the muscles used for chewing and talking become
stressed, causing pain. The condition may be the result of a number of factors,
such as an injury to the jaw or joint misalignment, and may give rise to a variety
of symptoms, most commonly pain in the jaw, face, and/or neck muscles. Physicians
reach a diagnosis by listening to the patient's description of the symptoms
and by performing a simple examination of the facial muscles and the temporomandibular
joint.
Trauma can occur after injuries in the home, at the workplace, during
sports activities, or on the road. Any of these injuries can result in severe
disability and pain. Some patients who have had an injury to the spinal cord
experience intense pain ranging from tingling to burning and, commonly, both.
Such patients are sensitive to hot and cold temperatures and touch. For these
individuals, a touch can be perceived as intense burning, indicating abnormal
signals relayed to and from the brain. This condition is called central pain
syndrome or, if the damage is in the thalamus (the brain's center for processing
bodily sensations), thalamic pain syndrome. It affects as many as 100,000
Americans with multiple sclerosis, Parkinson's disease, amputated limbs, spinal
cord injuries, and stroke. Their pain is severe and is extremely difficult to
treat effectively. A variety of medications, including analgesics, antidepressants,
anticonvulsants, and electrical stimulation, are options available to central
pain patients.
Vascular disease or injury-such as vasculitis or inflammation
of blood vessels, coronary artery disease, and circulatory problems-all have
the potential to cause pain. Vascular pain affects millions of Americans and
occurs when communication between blood vessels and nerves is interrupted. Ruptures,
spasms, constriction, or obstruction of blood vessels, as well as a condition
called ischemia in which blood supply to organs, tissues, or limbs is cut off,
can also result in pain.
Prepared by: Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD
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