[Diagnosis and treatment of postoperative nerve damage. Chronic neuropathic pain]

Neuropathic pain is caused by lesions in the peripheral and/or central nervous system. Patients with pain due to nerve damage after operations are often misinterpreted and met with suspicion of malingering. Neuropathic pain typically presents with a characteristic set of sensory disorders independent of the cause. The sensory dysfunction may manifest itself as hypo- and/or hyperesthesia to one or more modalities, increased pain to painful stimuli (hyperalgesia) and/or pain to non-painful stimuli (allodynia). Conventional analgesics such as acetaminophen, non-steroidal anti-inflammatory drugs and opioids are often ineffective. Instead, antidepressants and anticonvulsants may be tried. The pain condition is unknown to most physicians. This may result in mistreated patients having undergone several unnecessary and ineffective investigations and treatments.