What is Neuropathic Pain?

Neuropathic pain is a complex, chronic pain condition resulting from damage or dysfunction in the nervous system, either peripheral nerves or the central nervous system . Neuropathic pain originates from abnormal nerve signaling and can cause burning, shooting, or electric shock-like sensations. Common causes include diabetes, shingles, multiple sclerosis, spinal cord injury, and nerve compression. Patients may also experience tingling, numbness, and hypersensitivity to stimuli that are normally not painful.

pain clinic referrals

Treatment Approaches

Neuropathic pain is often difficult to treat and typically requires a multidisciplinary intervention:

Medications

First-line medications include anticonvulsants, antidepressants, and topical agents.

Non-pharmacological therapies

Such as physical therapy, cognitive-behavioral therapy, and transcutaneous electrical nerve stimulation (TENS).

Interventional procedures

Nerve blocks or spinal cord stimulation may be considered for refractory cases.

Ketamine and Neuropathic Pain

Ketamine, an NMDA receptor antagonist, can treat neuropathic pain by blocking excitatory glutamate signalling involved in central sensitization. This is a a condition where the central nervous system (brain and spinal cord) becomes “stuck” in a state of high reactivity, acting like a broken, oversensitive alarm system. This is common in patients with chronic pain. Ketamine infusions can reduce the pain intensity in patients who don’t respond to conventional treatments.