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Understanding Neuropathic Chronic Pain: An In-Depth Analysis 2024

Key takeaways

  • Neuropathic chronic pain is pain from damage to the nervous system and can be mild, moderate or severe
  • Neuropathic pain is often described as sharp, shooting or electric
  • Neuropathic pain also includes sensations of tingling or numbness or ‘pins and needles’
  • Neuropathic chronic pain is commonly associated with disease of the nervous system and nerve compression disorders

What is Neuropathic Chronic Pain?

Neuropathic chronic pain—a type of pain that’s distinct from nociceptive chronic pain and nociplastic chronic pain —poses significant challenges to those who experience it and the professionals who endeavour to treat it. This blog post seeks to offer comprehensive insight into the nature of neuropathic chronic pain, address its symptoms and diagnosis, explore the spectrum of treatments available, and finally, discuss the lifestyle changes that can help manage it effectively.

Neuropathic chronic pain arises from damage or disease affecting the somatosensory nervous system. Unlike nociceptive pain, which is triggered by noxious stimuli – think a cut or a burn – neuropathic pain occurs when there is damage to the nervous system and the nerves themselves.

Neuropathic pain is often called ‘nerve pain’ and it can be mild, moderate or severe.

Definition of Neuropathic Pain

The IASP defines neuropathic pain as : “…pain that arises as a direct consequence of a lesion or diseases affecting the somatosensory system.”

neuropathic chronic pain
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Symptoms of Neuropathic Chronic Pain

Symptoms of neuropathic chronic pain can vary widely among individuals but often include one or more of the following:

  • Sensations of tingling or numbness
  • Sharp, shooting, or intense stabbing pains
  • Heightened sensitivity to touch or cold temperatures
  • Pain from stimuli that wouldn’t normally cause pain, such as a light brush against the skin (allodynia)
  • An exaggerated pain response to a painful stimulus (hyperalgesia) or a diminished ability to feel pain from a typically painful stimulus (hypoalgesia)
  • Unexplained spontaneous pain, which may manifest as burning, stabbing, or sensations akin to an electric shock, along with tingling, numbness, or a “pins and needles” feeling
  • A tendency for nerve pain to intensify during the night.

Adding to the challenge, neuropathic pain frequently exists alongside other pain types, complicating its diagnosis and management.

Diagnosis of Neuropathic Pain

The process for diagnosing neuropathic chronic pain involves an in-depth review of the patient’s medical history, a comprehensive physical examination, and targeted diagnostic tests.

Clinicians may conduct a series of blood tests to uncover potential causes of nerve damage, such as elevated blood glucose levels, onset of diabetes, or nutritional deficiencies.

Imaging tests like CT or MRI scans are often recommended to identify any structural causes of nerve damage, including herniated discs or other abnormalities.

Additionally, nerve conduction studies, such as an Electromyogram (EMG), are utilized to assess the extent of damage through the application of electrical impulses to measure nerve function.


The treatment landscape for neuropathic chronic pain is diverse, aiming to alleviate discomfort and improve quality of life for sufferers. Treatment must be indivudulalised and depends on the underlying cause of the neuropathic pain. And will include both non-pharmacological strategies, such as physical therapy and psychological support, and pharmacological treatments, including specific medications tailored to address the unique characteristics of nerve pain.


Non-pharmacological treatments for neuropathic pain are diverse and can include:

  • Physical therapy and a regular exercise regimen.
  • Psychotherapy, such as cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT)
  • Transcutaneous electrical nerve stimulation (TENS)
  • Acupuncture
  • Biofeedback techniques

These interventions can help patients manage pain, improve function, and enhance their quality of life.


Pharmacological treatments typically include:

  • Anticonvulsants, which are commonly first-line treatments
  • Antidepressants, namely tricyclic antidepressants and serotonin-noradrenaline reuptake inhibitors
  • Topical treatments, including lidocaine or capsaicin cream
  • Opioids, which are generally considered last-line due to their potential for dependency and abuse

Researchers continue to explore new pharmacological avenues to expand the options available for effectively managing neuropathic pain.

Lifestyle Changes

In conjunction with medical treatments, certain lifestyle changes can be beneficial:

  • Regular low-impact exercise
  • Good nutrition and eating a healthy diet
  • Stress management techniques
  • Quitting smoking, as nicotine can worsen chronic neuropathic pain

Adopting healthier habits not only can mitigate the intensity of pain but can also improve overall well-being.

Diseases Commonly Associated With Neuropathic Pain

A range of diseases can be associated with the development of neuropathic pain, including:

  • Diabetes (diabetic neuropathy)
  • Central nervous system disorders like stroke, Parkinson’s disease and multiple sclerosis (MS).
  • Peripheral nervous system diseases like CIDP, Guillain Barre, Lupus, RA and vasculitis
  • Shingles (postherpetic neuralgia)
  • Cancer
  • Complex Regional Pain Syndrome
  • HIV

Other common causes of neuropathic pain include:

  • Chemotherapy medications
  • Radiation therapy
  • Amputation which can cause phantom limb pain
  • Spinal nerve root compression or inflammation
  • Trauma or surgeries with resulting nerve damage
  • Tumours that press on nerves

Prevalence of Neuropathic Pain

While the exact prevalence of neuropathic pain is difficult to ascertain due to diagnostic challenges, estimates suggest that 1 in 20 Australians are affected by neuropathic pain, with varying degrees of severity.


Neuropathic pain significantly impacts an individual’s quality of life, but understanding its complexities can lead to better management strategies. Both non-pharmacological and pharmacological treatments, along with lifestyle changes, play an essential role in comprehensive care.


Q: Is neuropathic pain permanent?

A: The permanency of neuropathic pain can vary depending on its cause. Some patients find relief through treatment, while for others, it may be a chronic condition to manage.

Q: Can neuropathic pain go away on its own?

A: Occasionally, if nerve damage heals, neuropathic pain may improve on its own. However, in many cases, intervention is necessary to relieve symptoms.

Q: How can I differentiate neuropathic pain from other types of pain?

A: It’s characterized by a unique set of symptoms, such as a burning sensation, tingling, or increased sensitivity. A healthcare provider can help determine the type of pain through a thorough evaluation.


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