Monday, 25 July 2016

The Nature Of Neuropathic Pain

Today's excellent post from (see link below) looks at the nature of pain and its different sorts. I'm sure that while you've been researching your neuropathy, you've come across terms like 'nociceptive' and 'neuropathic' and have got the gist of what's being said without really understanding what they mean. This article explains why you feel the pain you have and how it relates to the nervous system. Well worth a read and don't forget to click on the 'full size image' links for a better view of the images. Don't forget also, that when it refers to 'diabetic' pain, it refers to all neuropathic pain (it's just that the vast majority of neuropathy sufferers are also diabetics.

The pain drain
David Holmes Nature 535,S2–S3(14 July 2016)doi:10.1038/535S2a Published online 13 July 2016

We can't live without it, but many of us struggle to live with it. Pain has an essential biological function, but too much — or the wrong sort — ruins lives and puts a sizeable dent in economic productivity.

Nociceptive pain

This type of pain is caused by the activation of nociceptors — specialized sensory neuronsthat are stimulated by noxious mechanical, thermal or chemical stimuli. Nociceptors transform these stimuli into electrical signals and relay them to the central nervous system. Nociceptive pain tends to be short-lived and associated with injury. But if it persists beyond 12 weeks, it becomes chronic pain — and its nature can change.

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Neuropathic pain

Unlike nociceptive pain, neuropathic pain is caused by damage to the somatosensory nervous system itself, as a result of trauma or disease. However, there is not always a clear link between disease states and neuropathic pain.

Diabetic neuropathy

Painful diabetic peripheral neuropathy is one of the most common forms of neuropathic pain, with its incidence set to increase as the obesity and diabetes epidemics continue to grow. Neuropathy is caused by metabolic factors as well as by damage to the microvasculature that supplies nerve fibres.

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Neuropathic pain incidence

Definitions of neuropathic pain vary across studies, leading researchers to call for a unified nomenclature. The best evidence on incidence comes from studies of neuropathic pain linked to specific conditions, but even then ranges can vary widely1.

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Price of pain

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Biggest burden

Around 100 million adults in the United States are aff¬ected by chronic pain in a single year. The annual total cost of pain, including direct costs, decreased wages and lost productivity, eclipses that of any other condition2.

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Growing pain

Health-care spending on back problems in the United States more than doubled between 1987 and 2000. Although treatment costs and population increases contributed, most of the $9.5-billion rise was due to an increase in the prevalence of back pain3.

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1. van Hecke, O. et al. Pain 155, 654–662 (2014).
2. Inst. Medicine Relieving Pain in America (National Academy of Sciences, 2011).
3. Thorpe, K. E. et al. Health Affairs (2004).

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Related links

Related links in NPG
Crosstalk between the nociceptive and immune systems in host defence and disease
Pain That Won't Quit
Focus on pain
Nature Insight: Precision Medicine
Related external links
The International Association for the Study of Pain

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