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Updated: Jul 13, 2025

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What's New in Neuropathy?

Giustino Varrassi1, Stefano Tamburin2, Panagiotis Zis3

  • 1Department of Pain Medicine, Paolo Procacci Foundation, Rome, ITA.

Cureus
|October 11, 2023
PubMed
Summary

Neuropathic pain, often linked to voltage-gated sodium channel issues, presents diagnostic delays. Emerging research highlights gluten neuropathy as a key consideration, potentially managed with a gluten-free diet.

Keywords:
diagnosis of neuropathygluten neuropathyneuropathic painneuropathic pain registryneuropathy

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Area of Science:

  • Neurology
  • Pain Medicine
  • Neuroscience

Background:

  • Neuropathic pain poses significant diagnostic and treatment challenges, with aberrant nerve signaling causing sensory loss and pain.
  • Voltage-gated sodium channels are crucial in neuronal function; their dysregulation contributes to hyperexcitability and pain.
  • Despite available diagnostic tools, patients frequently face delays in identifying the cause of their neuropathy.

Purpose of the Study:

  • To review current understanding and challenges in diagnosing and treating neuropathic pain.
  • To highlight emerging concepts in neuropathy classification, including gluten neuropathy.
  • To present preliminary findings from a Greek neuropathic pain registry regarding patient demographics and treatment patterns.

Main Methods:

  • Literature review on neuropathic pain mechanisms, diagnosis, and emerging neuropathy types.
  • Discussion of diagnostic considerations for gluten neuropathy, including electrochemical testing.
  • Analysis of initial data from the Greek neuropathic pain registry (established 2014).

Main Results:

  • Neuropathic pain prevalence exceeds 50% in most neuropathy types, notably chronic idiopathic axonal polyneuropathy.
  • Gluten neuropathy is identified as a new diagnostic consideration in patients with gluten sensitivity or celiac disease.
  • Early registry data suggest suboptimal prescribing and underutilization of interventional procedures in Greek pain clinics.

Conclusions:

  • Further research is needed to fully elucidate neuropathic pain mechanisms and improve diagnosis.
  • Gluten neuropathy represents a treatable condition, potentially responsive to dietary changes.
  • The Greek neuropathic pain registry aims to improve real-world data collection and guide clinical practice improvements.