Neuropathic Pain

• Neuropathic Pain:

  • pain as a results of a lesion or disease of the somatosensory NS, can be located in the central or peripheral NS
  • 2 types of presentations:
  • Radicular signs and symptoms
  • Radiculopathy
• Neuropathic Pain - Radicular Signs & Symptoms:

  • describes pain/symptoms that spread down the lower limbs and usually a dermatological distributions and neuropathic in origin
  • Hyperactivity: Positive neural symptom, Sharp shooting, Burning, pins and needles
  • These symptoms are also referred to as radicular symptoms/pain
• Neuropathic Pain - Radiculopathy:

  • A diagnosis based on possible radicular signs and symptoms
  • Hypoactivity: Negative neural symptoms, Loss of sensation, Loss of strength/weakness
• Neuropathic Pain:

  • when theres suspected nerve involvement we need to make a decision if theres compromise to the neural tissue through examination of conduction of the nervous system - this is done by a neural integrity assessment
  • this can help us determine if the presentation is just radicular signs and symptoms or if the diagnosis is a radiculopathy as it includes motor loss and sensory loss
• Neuropathic Pain:

  • Pain/symptoms felt in a dermatomal distribution
  • If suspected radiculopathy - Loss of strength/weakness usually in myotomal distribution
• • Pain/symptoms felt in a dermatomal distribution = Neuropathic Presentations (pain due to disease/lesion in somatosensory NS)
  • 2 types of Neuropathic Presentations:
  • Radiculopathy:
  • Loss of strength/weakness usually in myotomal distribution
  • A diagnosis based on possible radicular signs and symptoms
  • and
  • Hypoactivity: Negative neural symptoms, anaesthesia, Loss of strength/weakness
  • Radicular Signs & Symptoms
  • Hyperactivity: Positive neural symptom Sharp shooting Burning, paraesthesia
  • These symptoms are also referred to as radicular symptoms/pain
• • Radiculopathy:
  • hypoactivity (e.g. anesthesia, loss of strength)
  • weakness usually in myotomal distribution
  • Radicular signs and symptoms:
  • hyperactivity (e.g. paraesthesia, sharp shooting, burning pain)
  • symptoms usually spread in dermatomal distribution