There is a kind of pain that is not the same as ordinary pain, did you know that? Although you have not been cut, stabbed with a needle, electrocuted, or burned by fire, you can experience the same pain sensation, which often causes excruciating pain, and this is neuropathic pain. The International Society for the Study of Pain defines neuropathic pain as pain that is stimulated or caused by primary damage and dysfunction of the nervous system. The recommended diagnostic criteria are: ① pain located in a clear neuroanatomical range; ② history suggests the presence of relevant damage or disease in the peripheral or central sensory system; ③ at least l auxiliary examination confirms that the pain is consistent with the neuroanatomical range; ④ at least 1 auxiliary examination confirms the presence of relevant damage or disease. Trauma, metabolic disorders, infection, poisoning, vascular lesions, nutritional disorders, tumors, nerve compression, immunity and genetics and other etiological factors can lead to nerve damage and neuropathic pain. Common causes include: diabetes, herpes zoster virus infection, spinal cord injury, stroke, multiple sclerosis, cancer, HIV infection, lumbar or cervical radiculopathy and trauma or postoperative nerve damage. There are currently about 90 million patients with neuropathic pain in China. Although there is no systematic research data on the survival quality of neuropathic pain patients in China, the impact of neuropathic pain on patients’ quality of life is obvious. Chronic pain not only affects the patient’s ability to sleep, work and live, but also increases the incidence of emotional disorders such as depression and anxiety. Some studies have shown that the quality of life score of patients with postherpetic neuralgia is about 1/2 of that of the normal population. The clinical manifestations of neuropathic pain are complex and varied, with their own unique nature and characteristics, including self-perceived symptoms and triggering symptoms. The main manifestation is the long duration of the disease, mostly more than 3 months. Usually, the site of pain is consistent with the damaged area. Most of the original pain-causing causes have been eliminated or controlled but the pain still exists, seriously affecting the patient’s work and life, often accompanied by emotional disorders. The characteristics of pain are as follows: 1, spontaneous pain: in the absence of any trauma, injurious stimulation, local or regional pain. 2, the pain site may be caused by a slight injury, but the pain site may be affected by a slight injury. 2.Painful areas can be induced by slight touch, such as contact with clothes or bed sheets, or small changes in temperature, for pain caused by non-injurious stimuli. 3.Nociceptive allergy: refers to the pain response to the normal pain-causing stimulus is enhanced. 4, the nature of pain: the nature of the patient’s pain is not all the same, to pull-like pain, electric shock-like pain, pins and needles, tear-like pain, burning pain, heavy pressure pain, swelling pain and numbness-like pain is more common. 5.Sensory abnormalities: there may be sensory abnormalities, dullness of sensation, itching or some other uncomfortable sensations. Does your pain belong to neuropathic pain? Common ones are: herpes zoster-related neuralgia; post-stroke pain; diabetic peripheral neuropathy; spinal cord cavernous pain; trigeminal neuralgia; ischemic myelopathy pain; liguopharyngeal neuralgia; certain cervical spondylopathies; post-traumatic neuralgia; multiple sclerosis pain; post-chemotherapy neuropathy; post-radiotherapy neuropathy; phantom limb pain; residual limb pain; spinal cord inflammation pain; and neuropathy caused by tumor compression or infiltration; Alcoholic polyneuropathy; Syphilitic neuropathy; HIV neuropathy; Nutritional disorders neuropathy; Toxic exposure neuropathy; Immunologic neuropathy. Neuropathic pain is also characterized by the fact that common painkillers such as ibuprofen are ineffective. First-line medications recommended for the treatment of neuropathic pain by the 2010 World Society for the Study of Pain and the latest edition of the European Federation of Neurological Societies guidelines include calcium channel modulators (e.g., pregabalin, gabapentin), tricyclic antidepressants (e.g., amitriptyline), and 5-hydroxytryptophan and norepinephrine reuptake inhibitors. In addition, topical lidocaine can be used as a first-line treatment for postherpetic neuralgia (PHN) and carbamazepine can be used as a first-line agent for trigeminal neuralgia. Second-line medications include opioid analgesics and tramadol. Other medications include other antiepileptic drugs (e.g., lamotrigine, topiramate), NMDA receptor antagonists, and topical capsaicin. In addition, neuromodulation techniques are often effective. They mainly include electrical (magnetic) stimulation techniques and intrathecal drug infusion techniques. The commonly used clinical methods include transcutaneous electrical nerve stimulation, spinal cord electrical stimulation, and transcranial magnetic stimulation. Spinal cord electrical stimulation is mainly applied to failed back surgery syndrome, complex regional pain syndrome, adhesive arachnoiditis, peripheral neuropathic pain, residual limb pain, and angina pectoris that cannot be immediately operated on if standardized medication is ineffective or the side effects of the medication cannot be tolerated. Intrathecal drug infusion therapy is through the drug infusion pump buried in the patient’s body, the drug in the pump is infused into the patient’s subarachnoid space, acting on the corresponding sites in the spinal cord or the center, blocking the transmission of pain signals to the center, so that the pain signals can’t reach the cerebral cortex, so as to achieve the purpose of controlling pain. There are also techniques such as nerve block, radiofrequency therapy and neurodestruction. To date, neuropathic pain remains the world’s most intractable and persistent pain problem. But if your pain happens to be it, don’t worry too much, we’ve got quite a few good methods.