Neuropathic Pain (cont.)

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What are the signs and symptoms of neuropathic pain?

Chronic pain is the most common complaint of patients with neuropathic pain. Although many people experience pain in their feet, legs and upper extremities can also be involved. There is no obvious cause for the pain and often the pain has been present for many weeks to months before patients will seek evaluation. The quality of pain may be unique for every person; burning, stabbing, prickling, or tingling are words commonly used to describe the symptoms that people are experiencing. Because the entire hands and feet are commonly affected, the symptoms are often described as being in a "stocking-glove distribution."

How is neuropathic pain diagnosed?

No objective test for pain has been developed; as such, when patients present with complaints of neuropathic pain, testing for evidence or causes of neuropathy is performed. Physical examination may reveal decreased ability of a patient to sense temperature or light pinpricks. Strength and reflexes are usually normal. Patients may be unable to identify if someone is moving their foot or toe and may be unable to sense a vibrating tuning fork. If there is evidence of neuropathy on a physical examination, a nerve conduction study with electromyography (NCS and EMG) may be ordered. This test is used to determine the severity of the neuropathy, and may offer additional clues as to the cause of the neuropathy. Blood tests can be used to identify vitamin deficiencies or other metabolic abnormality which is contributing or causing the neuropathy. In some cases, MRI or CT scans may be needed to further define possible causes of the neuropathy; skin or nerve biopsies are done infrequently but can provide further information in some situations.

Once the neuropathy is defined, further evaluation of the discomfort that the patient is experiencing may be done. Visual analog scales (VAS) are often used to gauge the severity of the pain that patients are experiencing.

Visual Analog Scale (VAS) for Pain
Visual analog scale (VAS) for pain.
Medically Reviewed by a Doctor on 6/24/2013

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