Neuropathic pain in the lower limbs

According to the pathological mechanism of pain, chronic pain can be divided into nociceptive or inflammatory pain (appropriate response to pain stimuli) and neurological (pathological) pain (inappropriate response induced by neurological damage). The International Pain Research Association (IASP, 1994) defines neurogenic pain as "pain caused by primary or secondary damage to the peripheral or central nervous system or dysfunction or transient disorder"; neuropathic For pain (neuropathic pain), the words "transitory perturbation" are deleted; however, there is no obvious difference between the two in clinical practice and they can be used interchangeably. Neuropathic pain has been a difficult problem for the medical community: the pathogenesis is unclear, opioid treatment is not effective, and patients are very distressed. With the development of molecular biology and electrophysiology in recent years, people have gradually realized the complex pathological mechanism of neuropathic pain, and provided new ideas and methods for treatment. Neuropathic pain is a pain syndrome caused by a primary lesion or dysfunction of the central or peripheral nervous system. Can be caused by trauma or disease caused by peripheral nerves, spinal cord roots, spinal cord and some parts of the central nervous system damage caused by. According to the different causes, properties and degrees of nerve injury, it is clinically divided into two categories: central nerve pain and peripheral nerve pain caused by peripheral nerve injury. Central nervous pain, referred to as central pain, is the primary pain caused by damage or dysfunction in the pain pathways of the central nervous system. It is common in spinal cord trauma or cerebrovascular disease, multiple sclerosis and tumors. Peripheral nerve pain is caused by trauma, ischemia, compression, infection, inflammation, metabolism and other factors that damage peripheral nerves, such as phantom limb pain, postherpetic neuralgia, polyneuritis, and diabetic peripheral neuralgia. Characteristics of neuropathic pain: Symptoms unrelated to the stimulus (described by the patient): 1. Spontaneous pain (rest at rest, especially at night): persistent burning, intermittent tingling, electric shock, beating pain, etc. 2. Paresthesia: There is no objective cause on the skin. Abnormal sensation. 3. Dull feeling: Pain in the skin numbness is related to irritation (stimulus induction): 1. Allodynia-Pain in normal painless stimuli. Hyperalgesia-Increased irritability to pain or persistent severe pain. The above symptoms can be improved during the activity or during cold compresses, and can be aggravated after activity or fatigue; the symptoms worsen at rest, especially at night