Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment
Abstract
Neuropathic pain develops as a result of lesions or disease affecting the somatosensory nervous system either in the periphery or centrally. Examples of neuropathic pain include painful polyneuropathy, postherpetic neuralgia, trigeminal neuralgia, and post-stroke pain. Clinically, neuropathic pain is characterised by spontaneous ongoing or shooting pain and evoked amplified pain responses after noxious or non-noxious stimuli. Methods such as questionnaires for screening and assessment focus on the presence and quality of neuropathic pain. Basic research is enabling the identification of different pathophysiological mechanisms, and clinical assessment of symptoms and signs can help to determine which mechanisms are involved in specific neuropathic pain disorders. Management of neuropathic pain requires an interdisciplinary approach, centred around pharmacological treatment. A better understanding of neuropathic pain and, in particular, of the translation of pathophysiological mechanisms into sensory signs will lead to a more effective and specific mechanism-based treatment approach.
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Sensitization, particularly central sensitization, may serve as a common mechanistic link between the pathogenesis of nociplastic pain and that of neuropathic pain and/or nociceptive pain.
“Sensitization, particularly central sensitization, may serve as a common mechanistic link between the pathogenesis of NPP and that of NP and/or) NCP.”
From Nociplastic pain: the prominent role of non-neuronal cells in central and peripheral sensitization (2026) · cites this paper as [9]
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“NPP often overlaps with the neuropathic pain due to shared underlying pathological mechanisms, especially central sensitization (9).”
- Authors
- Baron, R., Binder, A., & Wasner, G.
- Affiliations
- University Hospital Schleswig-Holstein (DE)
- Corresponding author
- Baron, Ralf
- Venue
- The Lancet Neurology
- Publisher
- Elsevier BV
- Published
- 2010-08
- Volume
- 9
- Issue
- 8
- Pages
- 807-819
- ISSN
- 1474-4422 (ISSN-L)
- OpenAlex
- W2113154361
- Cited by
- 1,816
- References
- 6
- Citations by year
- 2026: 104 · 2025: 151 · 2024: 157 · 2023: 127 · 2022: 167 · 2021: 105 · 2020: 122 · 2019: 97 · 2018: 104 · 2017: 100 · 2016: 99 · 2015: 122 · 2014: 106 · 2013: 99 · 2012: 77
- FWCI
- 8.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Dairy Farmers of Nova Scotia (01EM05/04, C2 0315449B)
- Bundesministerium für Bildung und Forschung
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- neuropathic pain, painful polyneuropathy, postherpetic neuralgia, trigeminal neuralgia, post-stroke pain, pathophysiological mechanisms, somatosensory system, pharmacotherapy, central sensitization
- MeSH terms
- Humans, Neuralgia, Pain, Pain Measurement, Polyneuropathies, Treatment Outcome, Pain Management
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