Post by Lαrα on Aug 22, 2013 11:34:22 GMT -8
Nerve pain is often referred to as neuropathic pain, this pain is due to damaged nerves. Many people who have Spinal Cord Injuries will suffer with nerve pain. The degree and type of nerve pain varies from individual to individual, even when two people share the same injury level they may suffer nerve pain differently.
Unlike pain that occurs in response to an injury, neuropathic pain occurs without any associated stimulation. At times, neuropathic pain may be associated with an exaggerated or heightened sensitivity to normal stimulation (such as a light touch or the sensation of clothing) and these sensations may be misinterpreted as pain.
Neuropathy is a dysfunction of nerves leading to loss of sensation. Although many people develop neuropathy, some of those people go on to experience pain associated with their symptoms. This condition is known as painful neuropathy, and the pain is described as neuropathic pain.
Neuropathic pain can be further divided into pain at the level or below the level of the injury. One-third of all patients develop below-level neuropathic pain following spinal cord injury, and this type appears to be the most severe pain and the most difficult to treat.
The specific reason that pain develops with neuropathy isn't known. Several theories have been proposed; one theory suggests that when nerve cells are unable to conduct sensory impulses or messages, spontaneous activity begins within the nerve cells that the brain interprets as pain.
Types of Nerve Pain
Neuropathic pain, commonly described as burning, stabbing, or sharp and painful hypersensitivity, is characterized as persistent and spontaneous pain, and as irregular responses of the nerves to stimuli.
Allodynia (pain is felt from normally non-painful stimuli) and hyperalgesia (or extreme pain is felt from normally painful stimuli) are common hyperactivities of the nervous system following spinal cord injury.
Neuropathic pain that presents soon after spinal cord injury, such as in the first 3 to 6 months, is a poor prognostic indicator of pain, as these patients typically experience worse pain and in longer durations.
Neuropathic pain following spinal cord injury can be described as 2 separate types: pain that occurs at the level of injury and pain that occurs below the level of injury.
Patients can have both types of pain, with both being chronic and difficult to treat. At-level pain, or radicular pain, which occurs in the same area as the injury, typically presents earlier than below-level pain.
This type of pain is thought to be due to injury to the nerve roots and dorsal gray matter.
Below-level pain likely develops from pathophysiologic changes that occur to the nerves in response to the spinal lesions from injury. This type tends to have a delayed onset after the spinal cord injury, thus the mechanism is thought to be different than at-level pain. Below-level pain occurs due to injury of spinothalamic tracts or deafferentation.