Neurogenic pain syndromes and their management

Neurogenic pain is defined as pain due to dysfunction of the peripheral or central nervous system, in the absence of nociceptor (nerve terminal) stimulation by trauma or disease. Other terms used to describe some (but not all) forms of neurogenic pain include neuropathic pain, deafferentation pain, and central pain; all these terms are subsumed into the wider expression 'neurogenic pain'. The clinical syndromes representing this type of disorder make up at least 25% of the patients attending most pain clinics. This is undoubtedly proportionately greater than its incidence in chronic pain as a whole, and is a measure of its intractability and of the therapeutic dilemma which it presents. However, neurogenic pain syndromes are much commoner than is perhaps generally recognized: when all categories are taken into account, there are probably more than 550,000 cases in the UK population of 56 million at any one time, i.e. a prevalence of about 1%.