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Nat Rev Dis Primers. 2017 Feb 16;3:17002. doi: 10.1038/nrdp.2017.2.

Neuropathic pain.

Author information

1
Department of Pain and Translational Symptom Science, School of Nursing and Department of Anesthesiology School of Medicine, University of Maryland, 655 West Lombard Street, 21201 Baltimore, Maryland, USA.
2
INSERM, Unit 987, Ambroise Paré Hospital, UVSQ, Boulogne Billancourt, France.
3
Department of Neurology, Division of Neurological Pain Research and Therapy, Klinik fur Neurologie Christian-Albrechts-Universität Kiel, Kiel, Germany.
4
Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
5
Department of Neurology, Rambam Health Care Campus, Technion Faculty of Medicine, Haifa, Israel.
6
Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
7
Department of Neurology and Psychiatry, Sapienza University, Rome, Italy.
8
Pain Evaluation and Treatment Centre of Hôpital Ambroise Paré, Paris, France.
9
Department of Clinical Medicine - The Danish Pain Research Center, Aarhus University, Aarhus, Denmark.
10
Centre for Pain Research, University of Bath, Bath, UK.
11
Department of Clinical and Health Psychology, Ghent University, Ghent, Belgium.
12
Division of Pain Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
13
Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK.
14
Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.
15
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Abstract

Neuropathic pain is caused by a lesion or disease of the somatosensory system, including peripheral fibres (Aβ, Aδ and C fibres) and central neurons, and affects 7-10% of the general population. Multiple causes of neuropathic pain have been described and its incidence is likely to increase owing to the ageing global population, increased incidence of diabetes mellitus and improved survival from cancer after chemotherapy. Indeed, imbalances between excitatory and inhibitory somatosensory signalling, alterations in ion channels and variability in the way that pain messages are modulated in the central nervous system all have been implicated in neuropathic pain. The burden of chronic neuropathic pain seems to be related to the complexity of neuropathic symptoms, poor outcomes and difficult treatment decisions. Importantly, quality of life is impaired in patients with neuropathic pain owing to increased drug prescriptions and visits to health care providers, as well as the morbidity from the pain itself and the inciting disease. Despite challenges, progress in the understanding of the pathophysiology of neuropathic pain is spurring the development of new diagnostic procedures and personalized interventions, which emphasize the need for a multidisciplinary approach to the management of neuropathic pain.

PMID:
28205574
PMCID:
PMC5371025
DOI:
10.1038/nrdp.2017.2
[Indexed for MEDLINE]
Free PMC Article

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