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Neuropathy is medically characterized as a form of chronic pain which may commonly result from damage to or pathological changes of the central or peripheral nervous system. Peripheral neuropathic pain has also been previously referred to as painful neuropathy, nerve pain, sensory peripheral neuropathy or peripheral neuritis. Individual’s affected by neuropathy generally describe its symptoms to be unlike any others they’ve ever experienced before. When it comes to neuropathy however, it’s fundamental to understand that chronic pain is not a symptom of injury but rather, the pain is itself the process of the disease. Neuropathy is not associated with the healing process either, instead of a specific injury in the body, the nerves themselves malfunction and are the source of the pain.

Characteristics of Neuropathy

The back pain or other type of painful symptom characteristic of neuropathy can usually be described in several ways. These can be specified as: severe, sharp, electric shock-like, shooting, lightning-like, or lancinating; deep, burning or cold; with persistent numbness, tingling or weakness; and/or trailing along the nerve path into the arms, hands, legs or feet. Furthermore, symptoms of neuropathy can be characterized by pain and discomfort from a light touch or other stimulus which generally shouldn’t cause pain, as well as hypersensitivity to a normally painful stimulus.

Symptoms of neuropathy can manifest as a result of any form of pain which impinges or compresses a nerve. Examples of neuropathic pain which generate from the region of the spine include: chronic pain which trails down the length of the leg, also known as radiculopathy or sciatica; chronic pain that radiates along the arm, also referred to as cervical radiculopathy; and gradual or persistent pain following a back surgical procedure, commonly associated with failed back surgery syndrome. Other well-known causes of neuropathy are: diabetes; phantom limb pain or regional pain syndrome, also referred to as RPS. If an individual’s neuropathy is not treated appropriately, numerous complications such as depression, sleeplessness, feelings of fear and anxiety, limited social interaction and an inability to perform normal daily activities or work have been described as frequent issues affecting those who suffer with chronic pain associated with neuropathy and its other symptoms.

Types of Back Pain

When it comes to neuropathic symptoms, it’s essential to have a general understanding of the major different types of back pain, most importantly because effectively determining these types of symptoms can guide people to receive the best treatment plan.

Nociceptive Pain and Neuropathy

Healthcare providers and professionals in the medical field typically classify pain in one of two general categories: neuropathic pain and nociceptive, or somatic, pain.

Nociceptive pain is felt by the nociceptor sensory fibers after there’s been damage or injury to a structure in the body, such as the muscles, ligaments, tendons, bones, joints or other organs. Nociceptive pain is commonly identified as a deep aching, throbbing, gnawing or sore sensation. Prevalent instances of nociceptive pain associated with back symptoms of pain and discomfort include: pain after direct trauma from an automobile accident or other personal injury case; pain after a back surgical procedure; and arthritis pain. Nociceptive pain is generally localized and can improve with healing treatments. Neuropathic pain, or neuropathy, results when there’s damage or injury to nerve tissue. Neuropathy is often identified as burning, severe shooting pains and/or a persistent numbness or tingling sensation. Prevalent instances of neuropathic pain associated with back symptoms of pain and discomfort include: sciatica, pain that travels from the spine down the arm, pain that persists after back surgery.

It is believed that in several cases, extended nociceptive pain may lead to neuropathy and an individual may subsequently experience both neuropathic pain and nociceptive pain simultaneously.  

Acute Pain and Chronic Pain

It’s also fundamental to recognize the differences between acute pain and chronic pain as these two forms of pain can be very distinct in structure and function.

With acute pain for example, the level of severity can directly correspond with the grade of tissue damage or injury. This provides individuals with a protective reflex, such as the reflex to move a limb immediately after touching a sharp object. Acute pain can be identified as a symptom of damaged or diseased tissue, where if the underlying complication is cured, the pain will subside as well. Acute pain is a form of nociceptive pain. With chronic pain for example, the pain doesn’t have the same structure and function as it does with acute pain. In other words, it does not serve a protective or other biological action. Instead, the nerves continue to send pain signals to the brain regardless if there’s no ongoing tissue damage. Neuropathy is a form of chronic pain.

Anatomy of Nerve Pain

The spinal cord functions as the primary part of the body’s central nervous system which transmits messages directly from the brain and spreads these out to the nerves throughout the body. Nerves can be found traveling to all parts of the body, entering and exiting the spinal cord alongside its entire length.

How Nerve Pain Works

There are 31 pairs of spinal nerves which can be found exiting the spinal cord between openings separating each vertebrae. The nerve root, or the point where the nerve exits the spinal cord, branches out into many smaller nerves which control distinct regions of the body, best referred to as the peripheral nerves. For instance, a nerve that exits the lower back will have peripheral branches that travel all the way down to the toes. Peripheral nerves make up the peripheral nervous system. The peripheral nerves are comprised of both motor nerves and sensory nerves. Sensory nerves receive sensory stimuli, such as how something physically feels and whether it is painful or not. These consist of nerve fibers known as sensory fibers. Additionally, mechanoreceptor fibers sense body movement and pressure placed against the body while nociceptor fibers sense tissue injury. Motor nerves travel throughout the muscles and stimulate their movements. These consist of nerve fibers known as motor fibers.

Nerve Injury and Neuropathy Pain

Although there is no sufficient research or evidence to support the following theory, it is believed that damage or injury to any of the above types of nerve tissues may be a possible reason which could lead to the development of neuropathic pain or neuropathy. Generally, the area of the nerve cell that is damaged by neuropathy is medically defined as the axon, which is the inner information pathway of the nerve cell, and/or its myelin covering, which is identified as the fatty outer sheath which protects the nerve cell and helps transfer information throughout the nervous system. When neuropathy pain occurs due to damage or injury to the above mentioned structures, neuropathy is sustained by abnormal processing of sensory input by the central nervous system and the peripheral nervous system.

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For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .

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