Management of Peripheral Nerve Pain

Neuropathic pain is defined by the IASP (International Association for the Study of Pain), as a “pain caused by a lesion or disease of the somatosensory nervous system, " while peripheral neuropathic pain is specifically defined as “pain caused by a lesion or disease of the peripheral somatosensory nervous system” (https://www.iasp-pain.org/Education/Conten.aspx?ItemNumber=1698#Neuropathicpain). Chronic neuropathic pain is not an uncommon disorder and is a global public health concern. It has a prevalence ranging from 6.9% to 10% of the world’s population (Van Hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain. 2014;155:654-62). Neuropathic pain often causes major suffering and disability. Unfortunately, many therapeutic options provide less than satisfactory relief. Specific examples of painful peripheral nerve pain syndromes include peripheral neuropathies (painful diabetic neuropathy, chemotherapy-associated neuropathy, HIV-associated neuropathy, other polyneuropathies), pain after peripheral nerve injuries, and postherpetic neuralgia. While complex regional pain syndrome (CRPS) has been classified as a “nociplastic” pain disorder, due to the very neuropathic nature of this pain disorder and its predilection to affect an extremity, CRPS will also be discussed in this chapter.