Abstract
Pain is a leading symptom of numerous diseases across all clinical specialties. According to the current definition of the Neuropathic Pain Special Interest Group of the International Association for the Study of Pain, neuropathic pain is the direct consequence of damage to or disease of somatosensory nerve structures in the peripheral or central nervous system. According to the location of the lesion, a distinction is made between peripheral and central neuropathic pain, whereby mixed forms are not infrequently encountered in the chronic course of pain. From a pathophysiological point of view, it is also true that every pain condition – regardless of the cause – can result in structural and functional changes in pain-conducting, pain-processing and pain-controlling parts of the nervous system as a function of duration and intensity. These phenomena of peripheral and central sensitization are summarized as wind-up. The result is pain that becomes increasingly neuropathic over time and increasingly refractory to conventional therapies. Thus, neuropathic pain components can occur in any chronic pain process with corresponding negative consequences in terms of disease severity and treatability. This circumstance was taken into account with the introduction of the mixed pain concept, e.g. for chronic musculoskeletal pain conditions, and with a multiple revision of the definition and grading system of neuropathic pain, including secondary neuropathic pain conditions.
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Wille, C. (2023). Treatment Algorithm for Neuropathic Pain Syndrome. In: Jerosch, J. (eds) Minimally Invasive Spine Intervention. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63814-9_3
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