Clinical diagnostic criteria for neuropathic pain Neuropathic pain has many causes, complex mechanisms, and variable clinical manifestations; therefore, there are no uniform diagnostic criteria. Interrogation history, systematic review, specific symptoms and physical examination, neurological examination, quantitative sensory test, various questionnaires, neurophysiological and pathological examination and imaging examination are all indispensable parts of the diagnosis. Of these, history and neurological examination are key to the diagnosis. Pain is a subjective sensation, and if it is accompanied by neurosensory abnormalities in the area of pain, it suggests the possible presence of neuropathic factors. A history of nerve injury increases the likelihood of neuropathic pain and includes a history of trauma, surgery, and neurologic disease. If the site of neurologic injury is confirmed to coincide with its characteristic neurologic signs and symptoms, the diagnosis of neuropathic pain is clearly supported. However, if the site of injury cannot be demonstrated, existing diagnostic techniques do not exclude the possibility of neuropathic pain. The characteristics of the pain may also provide some diagnostic clues. Patients are asked to carefully describe the initial onset of pain and the pain experienced. Patients typically describe pain using language such as electric shock-like, crushing, burning, pins and needles, broken glass, cramp-like, and spasm-like pain. Burning or electric shock-like pain or electric shock pain compounded with a tingling sensation should be highly suspicious of neuropathic pain. If the site of pain is consistent with the level of nerve damage, the diagnosis of neuropathic pain is further supported. Physical examination should include sensory assessment, motor function, and anatomic signs to confirm or exclude the presumed site of nerve damage from the history. Concomitant abnormalities in nerve function may suggest the presence of a neuropathic pain syndrome, and therefore special attention should be given to the sensory nerve examination. The Neuropathic pain scale (NPS), which includes 10 pain descriptors (intense, sharp, burning, dull-like, cold, sensitive, uncomfortable, pruritic, deep, and somatic), provides clinicians with an accurate and valid assessment tool and can also be used to evaluate the effectiveness of treatment. Local anesthetic percutaneous peripheral nerve or nerve root blocks can assist in localizing peripheral neuropathies. Sympathetic nerve blocks help in the diagnosis of persistent sympathetic pain, but their specificity has been increasingly questioned in recent years. Although different neuropathic pain disorders can exhibit the same pain characteristics and different pain manifestations can coexist in the same neuropathic pain disorder, yet no single symptom or sign can be used to specifically diagnose neuropathic pain. The current level of knowledge about neuropathic pain is not able to reveal the exact mechanism of all clinical manifestations, and the existing classification methods such as etiologic, anatomic, and temporal classifications cannot meet the clinical needs, thus posing difficulties in establishing diagnostic criteria for neuropathic pain. However, it is not difficult to make a diagnosis of neuropathic pain in the clinical setting in the face of patients, and the following conditions should generally be met: 1. History History of peripheral or central nerve injury: including peripheral neuropathy due to HIV/AIDS, central or peripheral nerve injury due to tumor, radicular pain due to nerve compression by herniated disc, diabetic peripheral neuropathy, stroke due to cerebrovascular accident post-stroke pain, transverse myelitis, and herpes zoster, etc. Post-surgery: phantom limb pain after amputation, post-mastectomy pain syndrome, post-open-heart surgery pain syndrome, etc. History of trauma: brachial plexus injury, spinal cord injury, CRPS, etc. 2.Pain nature burning-like, lightning-like, shooting-like, pins-and-needles, spasm-like pain, etc. 3.Sensory abnormalities include pins and needles, numbness (paresthesia), sensory loss, nociceptive hypersensitivity and touch-evoked pain, etc. 4.The intensity and duration of pain are not proportional to the injury. 5, partial sensitivity to opioids or NSAIDs 6, enhanced pain assessment IV, common assessment scales Assessment of neuropathic pain is an extremely important first step in the management of neuropathic pain. Although pain is subjectively felt, quantitative assessment of pain intensity is necessary, in addition to comprehensive and dynamic assessment. Indeed the lack of adequate assessment of pain is a global problem. A thorough and comprehensive assessment of neuropathic pain must first be made prior to pain management. The assessment of pain should take into account the patient’s perception and presentation of pain in order to determine the degree of pain and to analyze the causes and mechanisms of pain occurrence. It is worth noting that clinicians only indirectly understand the patient’s perception of pain and analyze the pain condition through the patient’s presentation of pain, which is influenced by a variety of factors, including the patient’s emotions, cultural beliefs, and other factors. Therefore, effective assessment and treatment of pain requires a comprehensive understanding of the patient as a whole individual. As the condition progresses, patients may suddenly develop new pain and the level of pain may suddenly increase at any time, making it necessary to repeatedly assess the patient’s pain.