Neurol. praxi. 2022;23(1):63-68 | DOI: 10.36290/neu.2021.062

Chronic pain after peripheral nerve injury

MUDr. Dana Vondráčková1, 2, MUDr. Helena Vorlíková1
1 Ambulance pro léčbu bolesti, Neurochirurgická a neuroonkologická klinika ÚVN Praha Střešovice
2 Subkatedra algeziologie IPVZ, Praha

The article provides an overview of the pathophysiological mechanisms responsible for the development of chronic pain after nerve injury and especially of the strategies for its treatment. Special attention is given to the complex regional pain syndrome (CRPS) and phantom pain. Chronic pain is a very unpleasant consequence of peripheral nerve injury. The pain is not only the result of the injury itself but is maintained and even augmented by the mechanisms of peripheral and central sensitization. Therefore, adequate pain therapy must be started already in the acute stage of the injury. Correctly indicated and performed surgical procedure is essential for the treatment of nerve injuries. In the management of pain, various methods are combined, from pharmacotherapy - following the guidelines for the treatment of neuropathic pain - through rehabilitation to invasive methods including neurostimulation.

Keywords: chronic pain, neuropathic pain, nerve injury, complex regional pain syndrome, pain treatment.

Received: July 21, 2021; Revised: August 6, 2021; Accepted: August 28, 2021; Prepublished online: August 28, 2021; Published: March 14, 2022  Show citation

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Vondráčková D, Vorlíková H. Chronic pain after peripheral nerve injury. Neurol. praxi. 2022;23(1):63-68. doi: 10.36290/neu.2021.062.
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References

  1. Ambler Z. Poruchy periferních nervů. Praha: Triton 2013; s.48 a s. 444-446.
  2. Antoniadis G, Kretschmer T, Pedro MT, et al. Iatrogenic Nerve Injuries. Dtsch Arztebl Int. 2014;111(16):273-279. Go to original source... Go to PubMed...
  3. Bednařík J, Ambler Z, Opavský J, et al. Klinický standard pro farmakoterapii neuropatické bolesti. Cesk Slov Neurol N. 2012;75/108(1):93-101.
  4. Burnett MG, Zager EL. Pathophysiology of peripheral nerve injury: a brief review. Neurosurg Focus. 2004;16(5):1-7. Go to original source... Go to PubMed...
  5. Ciaramitaro P, Padua L, Devigili G, et al. Prevalence of Neuropathic Pain in Patients with Traumatic Brachial Plexus Injury: A Multicenter Prospective Hospital-Based Study. Pain Med. 2017;18(12):2428-2432. Go to original source... Go to PubMed...
  6. Cutts S, Gangoo S, Srinivasan SH, et al. Complex regional Syndrome: An evolving perspective. Postgrad Med J. 2021;97:250-255. Go to original source... Go to PubMed...
  7. Foster CH, Karsy M, Jensen MR, et al. Trends and Cost-Analysis of Lower Extremity Nerve Injury Using the National Inpatient Sample. Neurosurgery. 2019;85(2):250-256. Go to original source... Go to PubMed...
  8. Freynhagen R, Bennett MI. Diagnosis and management of neuropathic pain. BMJ. 2009;339:b3002. Go to original source... Go to PubMed...
  9. Goebel A, Barker C, Birklein F, et al. Standards for the diag­nosis and management of complex regional pain syndrome: Results of a European Pain Federation task force. Eur J Pain. 2019;23(4):641-651. Go to original source... Go to PubMed...
  10. Habib KR. Estimation of Carpal Tunnel Syndrome (CTS) Prevalence in Adult Population in Western European Countries: A Systematic Review. Eur J Clin Biomed Sci. 2017;3(1):13. Go to original source...
  11. Huckhagel T, Nüchtern J, Regelsberger J, et al. Nerve trauma of the lower extremity: evaluation of 60,422 leg injured patients from the TraumaRegister DGU® between 2002 and 2015. Scand J Trauma Resusc Emerg Med. 2018;26(1):40. Go to original source... Go to PubMed...
  12. Huckhagel T, Nüchtern J, Regelsberger J, et al. Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the Trauma Register DGU® between 2002 and 2015. Scand J Trauma Resusc Emerg Med. 2018;26(1):76. Go to original source... Go to PubMed...
  13. Kaiser R. Chirurgie hlavových a periferních nervů s atlasem přístupů. Praha: Grada Publishing. 2016;232.
  14. Karsy M, Watkins R, Jensen MR, et al. Trends and Cost Analysis of Upper Extremity Nerve Injury Using the National (Nationwide) Inpatient Sample. World Neurosurg. 2019;123:e488-e500. Go to original source... Go to PubMed...
  15. Lee G, Grovey B, Furnish T, et al. Medical Cannabis for Neuropathic Pain. Curr Pain Headache Rep. 2018;22(1):8. Go to original source... Go to PubMed...
  16. Lejčko J. Opomíjený syndrom chronické bolesti - fantomová bolest. Bolest. 2021;24(1):32-36.
  17. Mertz K, Trunzter J, Wu E, et al. National Trends in the Diagnosis of CRPS after Open and Endoscopic Carpal Tunnel Release. J Wrist Surg. 2019;8(3):209-214. Go to original source... Go to PubMed...
  18. Metodické pokyny pro farmakoterapii bolesti. Bolest. 2016; 19(Suppl. 1):19-21.
  19. Miclescu A, Straatmann A, Gkatziani P, et al. Chronic neuropathic pain after traumatic peripheral nerve injuries in the upper extremity: prevalence, demographic and surgical determinants, impact on health and on pain medication. Scand J Pain. 2019;20(1):95-108. Go to original source... Go to PubMed...
  20. Opavský J, Rokyta R. Patofyziologie periferních a centrálních bolestí. In: Rokyta R, Kršiak M, Kozák J. Bolest. Praha: Tigis. 2012;258-262.
  21. Vondráčková D, Masopust V. Bolestivé syndromy nervů a neuromodulace. In: Kaiser R, a kol. Chirurgie hlavových a periferních nervů s atlasem přístupů. Praha: Grada Publishing. 2016;61-67.
  22. Wang ML, Rivlin M, Graham JG, et al. Peripheral nerve injury, scarring, and recovery. Connect Tissue Res. 2019;60(1): 3-9. Go to original source... Go to PubMed...
  23. Yang S, Chang MC. Effect of Repetitive Transcranial Magnetic Stimulation on Pain Management: A Systematic Narrative Review. Front Neurol. 2020;11. Go to original source... Go to PubMed...




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