Pain caused by the nervous system itself is called neuropathic pain. It may be due to damage to the nerves, or other changes in the nervous system. Damage does not always cause pain - it may just cause numbness. The nerves could be damaged by injury, disease or surgery. Also chronic pain can cause sensitization of the nervous system, so that pressure may be felt as pain. This is the most difficult type of pain to treat. The anti-epileptic drug gabapentin (Neurontin) can help some people with this type of pain.
Diagnosis
Neuropathic pain is normally diagnosed on the basis of the patient's history of possible nerve damage, and the nature of the symptoms. If the pain feels abnormal - for instance, touching the skin causes pain - then the pain may be neuropathic.
Treatment
Conventional painkillers, from aspirin to morphine, are not very effective at reducing neuropathic pain. Two types of drug that have been found to help with neuropathic pain are drugs that are normally used to treat epilepsy (anti-convulsants) or depression (tri-cyclic anti-depressants). But these drugs are not fully effective, and can have unpleasant side-effects. For more details, see the drugs page. Also spinal stimulation and nerve blocks are used to treat neuropathic pain.
Updated 2002-02-14