neuropathic pain mechanisms and management

Pain signaled by a normal sensory system, sources of persistent pain may be nociceptive or neuropathic. Both utilize the same nerve pathways for transmission, but significant physiologic differences exist in mechanisms through which these painful stimuli are biologically processed and resolved. Nociceptive pain resulting from a known or obvious source is often easy to identify. Neuropathic pain initiated or caused by a primary lesion or dysfunction in nervous system and due to disordered peripheral or central nerves.Neuropathic pain may be classified as either peripheral or central in origin. In peripheral nervous system, neuropathic pain is caused by conditions affecting small nerve fibers, and in the central nervous system is caused by lesions of spinothalamic tract, thalamus, rarely by subcortical and cortical lesions. The clinical feature common to virtually all conditions leading to the development of neuropathic pain is the perception of pain in an area of sensory impairment, an apparently paradoxical situation.