Despite the complex pathophysiology of neuropathic pain, diagnosis is usually straightforward, relying on negative and positive symptoms and signs in the presence of a condition that can damage the somatosensory system.
Neuropathic pain is a common cause of persistent pain in the general practice population. It is defined as ‘pain arising as a direct consequence of a lesion or disease affecting the somatosensory system’. This replaces the less strict definition used in the past – pain initiated or caused by a primary lesion or dysfunction in the nervous system.
In a significant proportion of patients, neuropathic pain arises when disease or trauma affects the sensory peripheral nerves or somatosensory regions of the spinal cord or brain. The most common causes of neuropathic pain and their prevalence are shown in the Table.