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  • Q&A with Australian Health Practitioners

    What is neuropathic pain?

    Related Topic
    Pain
    I have burning in my leg and the doctor says its neuropathic pain
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    Chronic Pain Australia

    Chronic Pain Australia incorporated in 2006 to become a strong voice for Australians experiencing chronic pain. Chronic Pain Australia was a lead organisation in developing … View Profile

    From http://www.nice.org.uk/nicemedia/live/12082/42367/42367.pdf

    Neuropathic pain is initiated or caused by nervous system damage or dysfunction. Neuropathic pain is difficult to manage because affected people often have a complex history with unclear or diverse causes and comorbidities. Neuropathic conditions include failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS). People with FBSS continue to have back and/or leg pain despite anatomically successful lumbar spine surgery. It is not easy to identify a specific cause of neuropathic pain and people with FBSS may experience mixed back and leg pain. CRPS may happen after a harmful event or period of immobilisation (type I) or nerve injury (type II). Pain and increased sensitivity to pain are the most significant symptoms and are present in almost all people with NICE technology appraisal guidance 159 2 CRPS. Other symptoms can include perceived temperature changes, weakness of movement and changes in skin appearance and condition.

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    Dr Stephen Leow

    HealthShare Member

    The burning in the leg, if it is neuropathic in origin, would come from a malfunction of the sensory nerve supplying that region of the body. It may come from damage to the nerve from direct or indirect trauma, such as nerve compression in the lumbar spine or from dseases that directly sffect the nerve, such as diabetes or even from alcohol toxicity. It may also be from a dietary deficiency of vitamins (B Group, in particular)  It is important to determine the cause of the neuropathic pain, so that it can be addressed.

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  • Neil Synnott

    Exercise Physiologist, Physiotherapist

    I am qualified as a PHYSIOTHERAPIST and ACCREDITED EXERCISE PHYSIOLOGIST.I primarily use the McKENZIE METHOD for assessment and management of musculoskeletal pain disorders. The McKENZIE … View Profile

    Hi all,

    Neuropathic pain relates to pain from dysfunction within the nervous system.

    With the burning leg pain you are experiencing, while it may be true neuropathic pain, as Dr Leow mentioned, the nerve dysfunction may be secondary to another problem. A few quick scenarios may exist:

    • Compression of the nerve as it leaves your lumbar spine or in the buttock
    • Entrapment of the nerve along its course (this often occurs around joints or in muscle bellies)
    • With other disease ( like diabetes) 
    If the nerve dysfunction is due to compression or entrapment, this scenario can certainly improve. The nerves throughout our body can move quite a bit - more than 6cm in some instances. With completing the correct stretching regime and following posture advise, the burning nerve pain can be significantly improved!

    Ask yout doctor for a referral to a reputable physiotherapist in your area.

    All the best!

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  • Dr Terry Stewart

    Osteopath

    I am an Osteopath and massage therapist. I am a sole practitioner in my practice and I treat neuromusculoskeletal pain and dysfunction with a combination … View Profile

    Hi everybody,

    Neuropathic pain is pain arising from a primary lesion in the somatosensory nervous system. It is usually a combination nerve trunk and dyststhetic pain. Nerve trunk pain reults from hyperecitability of the nervi nervorum in the connective tissues of the nerve sheath and is dull, cramping and thobbing/toothache like pain. The underlying cause is usually compression or trauma which creates ischemia and hypoxia which leads to inflammation and neurogenic inflammation. Once this occurs the whole nerve trunk can be sensitised and patients will ususally describe pain provoked by movement and neurodynaic tests.

    Dystesthetic pain is the searing, sharp, burning, skin crawling sensations that arise from direct injury to the axons of the nerves themselves. This creates abnormal impulse generating sites that become hyperexctiable and pain can be provoked on movement, in the presnece of inflammation or it can be sponatneous due to the incresed insertion of ion channels in the regions of damaged axon, partuicularly the regions that are demyelinated. A very important factor here is the dorsal root ganglion that can enhance sensory conduction and be subjected to sympathetic efferent fibre sprouting. This now means adrenaline and noradrenaline can excite the DRG. Weakness and decreased sensation indicates conductive loss due to afferent fibre compression.

    These sensations will be described as unfamiliar; this is a very important descriptor. Remenber the brain; central sensitisation can underlie all types of pain.

    Cheers Terry.

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    Dr Terry Stewart

    Osteopath

    I am an Osteopath and massage therapist. I am a sole practitioner in my practice and I treat neuromusculoskeletal pain and dysfunction with a combination … View Profile

    Sorry guys as someone has already stated neuropathic pain is as result of a primary leison and/or dysfunction in the somatosensory system. Left dysfunction out before.
    Cheers Terry.

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