Neuropathy and Neuropathic Pain

Symptoms of more than 150 different diseases that have injurious effects on normal neurological functioning. These conditions are typically treated by many types of medical professionals; neurologist, pain management, anesthesiologist, Rheumatologist, physical therapist and more. Each professional focuses on one or a few aspects of the contributory development like cancer or diabetes or peripheral neuropathies. Pain specialists must eventually deal with the common presentations of permanent neurological damage. Once the cellular damage occurs, reversing the disease state becomes almost impossible.

At the stage of Neuropathic pain diagnosis, analgesic treatment is often the only option. As the bio-mechanical make up of these conditions are found and documented new treatment modalities will improve the chances of eliminating of the pain and possibly the condition causing the pain. At this time effective treatment modalities are rare, but some patients are finding successes such as lower pain levels or even remission. The goal of treatments should be to understand the physiological system of the condition and then working to prevent permanent painful Neurological transformations.

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Toxic Neuropathy is typically the result of Chemo-radiation in the treatment of cancer. Other causes are found in tuberculosis patients who receive Isoniazid, a colorless crystalline compound, and thallium, a soft highly toxic white metallic element. Toxic exposure is generally a results in an abnormal and often inherited improper protein processing when a person is exposed to harmful chemicals. Whether it be from a purposeful exposure like Chemo or environmental exposures such as arsenic or lead.

Metabolic Dysfunction Neuropathy pain is typically seen in Diabetes patients. Other causes are Nutritional deficiencies. This can be low Vitamin B1 typically seen with alcohol induced Neuropathy in the case of diabetes and inhibiting of axonal, sodium, potassium and ATPase (an enzyme that aids in the breakdown of ATP into ADP with a release of energy) axonal transport producing nerve cell degeneration.

Trauma can result in phantom limb syndromes and/or Reflex Sympathetic Dystrophy Syndrome (RSD/CRPS). Amputee pain is thought to be a result of abrupt loss of sensory input from the limb to the brain. The pain is felt at discharges stemming from the nerve endings at the sight of the amputation that continue to send pain signals to the brain, making the brain think the limb is still there. Trauma or insults to the body, be it big or small, that do not heal correctly have been suggested as the cause of RSD , including dysfunctional processing throughout the entire nervous system involving peripheral, central and autonomic nerve systems.

Carpal tunnel syndrome and compartment syndromes are common entrapment injuries. The excessive external pressure on nerve axon (transmits impulses outward from the cell body) can cause an inadequate supply of blood to the part of the body or stretching changes. Prolonged injury results not only in pain but we see a resultant muscle atrophy in patients with this type of injury.

Autoimmune Neuropathic pain conditions include Polyneuropathy (the loss of the fatty covering myelin of the nerve fibers) and Vasculitic Neuropathy (relating to blood vessels). A patient may have an autoimmune antibodies involved in the disturbance of function that a disease causes in an organ, as distinct from any changes in structure that might be caused. These are usually modifiable with immune therapy (IVIG).

Viral conditions are known to result in long-standing Neuropathic pain. Conditions in this category are post-herpetic neuralgia, lyme disease, leprosy, HIV and post-infectious patients.

Inherited genetic diseases such as Fabry’s Disease and Charcot-Marie-Tooth Disease are good examples of peripheral Neuropathic pain associated with congenital abnormalities.

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