Neuropathic pain
Neuropathic pain is pain caused by injury, irritation or dysfunction of the nervous system. Unlike pain arising from muscles or joints, neuropathic pain occurs when nerves become damaged or abnormal pain signaling develops within the nervous system.
Neuropathic pain is often chronic and may significantly affect function, sleep, mobility and quality of life.
At the University of Kentucky Interventional Pain Medicine program, we provide comprehensive evaluation and treatment for a wide range of neuropathic pain conditions using a multidisciplinary and individualized approach.
Symptoms of neuropathic pain
Neuropathic pain is commonly described as:
- Burning pain
- Stabbing or shooting pain
- Electric shock-like sensations
- Tingling or pins-and-needles sensations
- Numbness
- Hypersensitivity to touch
- Pain from normally nonpainful stimuli (allodynia)
Symptoms may worsen with:
- Movement
- Pressure
- Weight-bearing
- Clothing contact
- Temperature changes
Conditions commonly treated
Neuropathic pain may develop from a variety of conditions affecting the peripheral or central nervous system.
Conditions commonly treated include:
- Complex regional pain syndrome (CRPS)
- Peripheral neuropathy
- Post-herpetic neuralgia (shingles-related pain)
- Failed back surgery syndrome
- Post-surgical nerve pain
- Post-thoracotomy pain
- Peripheral nerve injury
- Focal nerve entrapment syndromes
- Chronic neuropathic extremity pain
Treatment recommendations are individualized based on your symptoms, diagnosis, imaging findings and prior treatments.
Complex regional pain syndrome (CRPS)
Complex regional pain syndrome (CRPS), previously referred to as reflex sympathetic dystrophy or causalgia, is a chronic neuropathic pain condition that typically affects an arm or leg following injury, surgery or trauma.
Symptoms may include:
- Severe burning pain
- Increased sensitivity to touch
- Swelling
- Skin color or temperature changes
- Sweating abnormalities
- Joint stiffness
- Decreased range of motion
- Changes in hair or nail growth
CRPS is diagnosed clinically based on a combination of symptoms and physical examination findings.
Although there is currently no known cure for CRPS, treatment focuses on improving pain, restoring function, and improving quality of life.
Multidisciplinary neuropathic pain care
Neuropathic pain conditions often require a comprehensive multidisciplinary approach.
Treatment may include:
- Physical therapy
- Occupational therapy
- Medication management
- Cognitive behavioral therapy and psychological support
- Image-guided procedures
- Neuromodulation therapies
Our team works closely with rehabilitation specialists, psychologists, neurologists, surgeons and primary care providers to develop individualized treatment plans.
Interventional treatment options
Nerve blocks involve injection of local anesthetic with or without corticosteroid medication near targeted nerves or sympathetic nervous system structures.
These procedures may be used for:
- Diagnostic evaluation
- Temporary pain relief
- Reduction of inflammation
- Improvement in function and rehabilitation participation
Common procedures may include:
- Stellate ganglion blocks
- Lumbar sympathetic blocks
- Peripheral nerve blocks
Advanced neuromodulation therapies may be considered for patients with persistent neuropathic pain that has not responded adequately to conservative treatment.
Spinal cord stimulation (SCS)
Spinal cord stimulation delivers electrical impulses near the spinal cord to alter pain signaling before it reaches the brain.
Dorsal root ganglion (DRG) stimulation
DRG stimulation is a specialized neuromodulation therapy designed for focal neuropathic pain conditions.
This therapy may be particularly useful for:
- CRPS
- Groin pain
- Persistent knee pain
- Focal nerve-related pain syndromes
Peripheral nerve Stimulation (pNS)
Peripheral nerve stimulation uses small electrical leads placed near peripheral nerves to alter pain signaling in targeted regions of the body.
PNS may be considered for selected focal neuropathic pain conditions and peripheral nerve injuries.
Most neuromodulation therapies involve a trial phase prior to permanent implantation to evaluate treatment response and functional improvement.
What to expect
Evaluation for neuropathic pain typically includes:
- Detailed medical history
- Physical examination
- Imaging review when appropriate
- Neurologic assessment
- Review of prior treatments and response
Treatment plans are individualized based on the underlying condition, symptom severity and functional goals.
Advanced neuropathic pain care
The UK HealthCare’s Interventional Pain Medicine program offers advanced interventional and neuromodulation therapies for complex neuropathic pain conditions.
Our goal is to:
- Reduce pain
- Improve function
- Restore mobility
- Improve quality of life
- Minimize reliance on long-term medications whenever possible
