Management and Recognition of Neuropathic Pain

This article discusses the impact of neuropathic pain on quality of life, types of pain, recognition of neuropathic pain, and management of neuropathic pain. It also highlights the recommended medications for the management of neuropathic pain.

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Management and Recognition of Neuropathic Pain
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Introduction
The neuropathic pain is a chronic pain that results due to the nerve damage or by a cancer
tumor which presses on a nerve or several nerves of the nervous system. Neuropathic pain is
experienced as stabbing pain especially at the middle of the night when someone is asleep. It is
hard for a person experiencing the neuropathic pain to bear such a severe painful situation. If the
appropriate management and treatment are engaged, the nerve pain can be sufficiently
controlled.
Impact of pain on quality of life
Pain causes the reduction in the physical activities of a patient. Several studies that have
been carried out shows that there is a high correlation between pain and reduction in physical
activities. Duration, location or intensity of pain have a substantial influence on the physical
performance of a patient. It diminishes their physical activity which in turn influences negatively
other aspects of the patient's daily life like walking, performing domestic chores, and
participation in social activities [1].
Pain influences the ability of a patient to carry out essential activities. Since patients who
experience pain seem to be unconscious the ability to carry out necessary activities is negatively
distracted. Crucial activities like sitting down and getting up are affected undesirably by pain.
Pain hurts the mental state of an individual. The adverse impact of pain on the mental
wellness of an individual causes deteriorating effects on the quality of life. Pain causes anxiety
and depression which affects the mental wellness of a patient.
Sleep disturbance is another common effect of pain. Individuals who are experiencing
pain often portray difficulties in sleeping. Sleep disorder may result to an increase in stress,

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stress makes an individual experience difficulty in performing simple tasks and even damage
their cognitive ability which may, in turn, affect their activities at home and in the workplace [2].
Types of pain
The different types of pain include;
Chronic pain is a long-lasting pain condition which does not decline even with treatments. It is
mainly linked to conditions like fibromyalgia and osteoarthritis.
Acute pain arises unexpectedly, but it is temporarily. It is mainly related to emotional stress and
anxiety and heals after the injury heals.
Nociceptive pain is a type of pain that arises from an injury in tissues; it includes damage to bone
or muscle of the body. It is mainly caused by fractures, cancer, burn, bruises, surgery and cuts.
Nociceptive pain mainly reduces when an injury heals.
Neuropathic pain is a kind of pain that arises due to damages of the nervous system; it can be
peripheral or central. Neuropathic pain is mainly caused by pinching, injury or disease.
Neuropathic pain can last for an extended period even when the injury has healed.
Psychogenic pain is a type of pain that arises due to psychological factors, tissue damage or
nerve damage. It is prolonged by conditions like fear, stress, depression or anxiety.
Pain is also classified by the body part involved or the kind of tissues affected. For example,
muscular pain, soft tissue pain and bone pain.
Some types of pain are also classified based on the syndromes. For instance, myofascial pain
syndrome is pain experienced in the body muscles [3].
Recognition of neuropathic pain

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Some of the signs of the neuropathic in the body peripheral includes; steady
commencement of numbness, tingling and pricking of the victim's hands or feet. These body
changes can spread to the upper body parts such as arms and legs. The person having
neuropathic pain experiences jabbing, sharp, freezing, throbbing and burning pain throughout the
body. The patient has extreme sensitivity to touch and lack of body coordination balance which
sometimes leads to falling [4].
When someone is experiencing such serious symptoms, it is advisable to seek health
professionals for treatment. The neuropathic pain results from damage of the nerves in the
nervous system either in the central or in the peripheral. Neuropathy is a chronic pain which is
not necessarily designating an underlying injury, but the pain itself is considered a disease. It is
essential for such symptoms assessed as nerve problems themselves of which they are the source
of pain. The most common cause of neuropathic pain is known from the spine disorders. As the
neuropathic pain affects the peripheral, it is easier to recognize because of its function in the vast
communication network of coordinating signals between the central nervous system and all body
parts. Thus, when the peripheral nerves are disrupted there is nervous malfunctioning, and
complex functions could lead to a stop [5].
Management of the neuropathic pain
The of nerve pain is challenging even with it being most focused on by the extensive
research. In a study to evaluate the effectiveness of the clinical practice guidelines, the
management neuropathy pain assists physicians to select the appropriate management
recommendations. The neuropathic pain is a chronic pain known to affect the quality of lives of
many people [6]. The estimated prevalence of the neuropathic pain is about 1% to 5% of a
country's general population according to the result of systemic and meta-analysis review. In

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facilitating the treatment and assessment of the neuropathic pain the regional and international
professional association published the practice guidelines to handle it. In examining the effect of
numerous treatments of the neuropathic pain several double-blind types of research were
conducted in oral and topical medications [7]. Regarding the analysis of the studies by a number
of authors, the first-line recommended for the neuropathic pain management medication were:
The tricyclic antidepressant (TCA) specifically the amitriptyline; serotonin-noradrenaline and
reuptake inhibitors (SNRIs) which include duloxetine; calcium alpha2delta ligands which
includes the pregabalin and gabapentin. The second-line drugs for neuropathy are tramadol,
strong opioids and caspsaicin. Th the tricyclic, antidepressant e researchers proposed that the
lidocaine patches are useful for the second line therapy [8]. In management of neuropathy pain the
clinical physician has to choose the specific and appropriate drug while considering the
particular related issues to the patient and to the drug. Proper choices are very crucial within the
first-line medication. The pregabalin and gabapentin are the first-line medications which have
pharmacokinetic characteristics with a recommended dosage of (300mg/ day). The TCA in the
first-line medication which may results to side effect to the elderly patients such as dizziness, dry
mouth and orthostatic hypotension which may later result to withdrawal. The duloxetine, a first-
class medication is given to the diabetic neuropathy patient requires a dose of 60 mg daily. The
tramadol and weak opioid which is second-line medication are used for rescue therapy are
associated with effects like high rates of withdrawals compared to other treatments. Though, the
researchers recommended more evidence-based updates concerning the treatment of neuropathic
pain management [9].
Conclusion

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The neuropathic pain disease affects the somatosensory nerves and cells of the brain. The
nerve pain is regarded to be associated with the peripheral nerve problems like neuropathy due to
diabetes, brain and spinal cord injuries which leads to severe chronic pain. Neuropathic pain is
accompanied by abnormal sensation known as dysesthesia which is the pain that occurs from the
actual non-painful stimuli, and it may happen in episodic or continuous components. It is
essential for a person experiencing the severe pain in the body to seek medical consultation from
a health professional for easier recognition and to determine the type of pain he/ she is
experiencing. The primary medication that is recommended for the management of the
neuropathic pain include amitriptyline, pregabalin duloxetine and gabapentin; they treat different
specific pain within the body.

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