Abstract
Neuropathic pain is caused by damage to peripheral nerves, described here, or to selected CNS pain pathways. It has distinct qualities that differentiate it from other forms such as musculoskeletal pain. Chronic neuropathic pain may originate from ectopic, or unwanted generation of action potentials in damaged nerves. Abnormal excitability of damaged nerves, in turn, is caused by remodeled numbers and types of ion channels, changes in the local nerve environment or cross talk with CNS microglial cells. When prolonged, peripheral neuron damage initiates remodeling throughout the nervous system including dorsal root ganglia, dorsal horn of spinal cord, spinal cord pain pathways, thalamus and the cortex of the brain. The treatment of neuropathic pain is challenging and suboptimal with risks for addiction and other adverse effects.
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