Neuropathic pain is defined as a pain caused by primary lesion or damage to the central or peripheral nervous system. Neuropathy refers to disturbances or changes in one or more nerves.
Neuropathic pain is challenging to treat; even with optimized therapy, only 50% of patients achieve a 30–50% pain reduction, while the other half remain resistant to treatment.
Pathophysiological characteristics of neuropathic pain are:
- Central and peripheral nervous sensitization
- Non-neural cells hyperactivity
- Reduced activity of inflammation-controlling receptors
- Altered neurotransmitter activity
- Neuronal inflammation
- Dysfunctional pain modulation
- Altered neuronal structure and functions
- Altered neuroplasticity
A comprehensive approach to neuropathic pain management should address its above mentioned pathophysiological characteristics and complement first-line therapies.