ABSTRACT
The diagnosis of neuropathic pain is a clinical one and can be based on careful history taking and a basic clinical examination looking for negative and positive neurological signs. Nociceptive pain is the most common type of pain seen in the acute clinical setting. The diagnosis of neuropathic pain can usually be made on the basis of a complete history and basic physical examination. Patients will typically describe their pain as “strange” and different from “normal” wound pain. Neuropathic pain is most obvious when the pain occurs in an area of complete neurological deficit, for example, below the level of the lesion after spinal cord injury or in a flaccid arm after brachial plexus injury. Complex regional pain syndrome is not a straightforward manifestation of neuropathic pain, but excellently described as a “disease of neuronal systems”. The diagnosis is currently made according to the Budapest criteria. The patient has continuing pain disproportionate to an inciting event.
