Patients & Visitors

Pain Clinic

A17

Chronic Pain

fire Pain can be thought of as nociceptive (arising from, or seeming to arise from, tissue damage) or neuropathic. Neuropathic pain seems to arise from nerve damage, although this ‘damage’ may have no obvious cause. Neuropathic pain tends to be of a burning nature, with sufferers disliking touch over the affected area. Often they may describe efforts to stay out of draughts, or away from the sun, out of normal proportion. Their clothing may be very uncomfortable against their skin.

There are many well-recognised causes of neuropathic pain. These include post-herpetic neuralgia, trigeminal neuralgia and sciatica. Early treatment with neuromodulatory drugs may be effective or helpful, and there are also non-drug treatments that may be useful. In the particular case of post-herpetic neuralgia, very early treatment with an anti-viral drug may lessen symptoms later on.

After a person has suffered pain for a period of time (usually considered to be about three months), the pain becomes chronic pain. While the sufferer experiences no change in their pain, alterations are beginning to occur in their central nervous system. The effect of these changes tends to cause maintenance of the pain; this effect means that the pain may persist after the original cause has gone. This is probably one reason why the pain of post-herpetic neuralgia can persist long after the rash of shingles has faded.

Where early treatment has not been effective in reducing or removing pain, patients seem to do best with a clear and consistent explanation within the environment of a multi-disciplinary Pain Clinic. It is of the utmost importance that patients are believed at this stage of their pain journey, as they may have experienced demoralising disbelief from immediate family and friends.


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