ABSTRACT
Symptoms Nerve damage at any point of the sensory system may result in any of the following features: • spontaneous pain which may be paroxysmal • pain described as burning, shooting or numb • severe pain in response to a noxious stimulus (hyperalgesia) • severe pain in response to a stimulus which is not normally noxious (allo-
dynia) • severe pain in response to stimulation despite sensory impairment (hyper-
pathia). Similar clinical entities may produce different symptoms in different patients.
Principles of management Many treatment methods for chronic pain enjoy a brief vogue before fading from use because they ignore the multidimensional nature of the problem. No two pains are the same and individualisation of management, usually with a combination of therapies, produces the best results. The principles of management of neurogenic pain can be listed as: • prevention • remove cause • medication • neural blockade • stimulation-induced analgesia
