Prevalence, Pathophysiology and Symptoms of Neuropathic Cancer PAIN – Hong Kong review

PAIN can be a persistent and incapacitating symptom of cancer. Although reports indicate only 15% of patients with nonmetastatic disease experience tumour-associated PAIN at the time of diagnosis, PAIN becomes more pervasive as disease progresses.1 In patients with recurrent or metastatic cancer, 67% complain of PAIN and 41% experience PAIN directly attributable to the disease. PAIN may be

chronic or acute, and patients with chronic PAIN commonly experience acute flares of PAIN.

One half to two thirds of patients with well-controlled chronic PAIN experience transitory ‘breakthrough’ PAIN. Cancer-associated PAIN may be secondary to antineoplastic therapy or an unrelated comorbid condition, but is commonly due to direct tumor involvement (ie, infiltration or compression of adjacent local structures, such as bone, soft tissue, nerves or the gastrointestinal tract).1,4 Hence, cancer PAIN syndromes can be somatic, visceral or neuropathic in origin.3 Understanding and recognizing these syndromes can help identify PAIN etiology and the need for additional evaluation, and target therapy more appropriately.

Reference source: http://www.neuropainhk.org, www.brainspione.com.hk

The above information is for educations only, if you have any related disease, please consult your neurosurgeon for more information. 

Easing Back Pain Once It Starts

Reference: www.back.com, http://www.brain-spine.com.hk/

If you are experiencing pregnancy-related back pain, consult with your doctor and follow his or her suggestions as to what's right for you. In addition to the above preventive measures, commonly prescribed therapies for easing pregnancy-related back pain can include:

·         Hot or cold therapy, in the form of a warm bath, a hot water bottle, or an ice pack.

·         Physical therapy specifically designed to address the needs of your changing body as your pregnancy progresses.

·         Anti-inflammatory/analgesic medications, as recommended by your doctor. Acetaminophen has been shown to be safe for pregnant women; others, including aspirin and ibuprofen, are not.

·         Complementary treatments such as chiropractic care, massage therapy, and acupuncture. Although these therapies have not been proven effective for treating low back pain, they may provide some relief for pregnancy-related discomfort, and perhaps some stress relief as well. Consult with your doctor first, however, to ensure there is no underlying spinal condition causing the pain.

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult your neurosurgeon.

Neuropathic Pain Syndromes

Postherpetic neuralgia

      - occurs following an acute attack of herpes zoster (shingles). It is defined as pain persisting for more than 3 months after the active herpes zoster lesions have healed, and involves constant aching, burning or itching with intermittent, severe, lancinating pain. Allodynia and hyperalgesia may also occur.

Peripheral or painful diabetic neuropathy

      - a peripheral, autonomic or cranial nerve disorder associated with diabetes mellitus. These conditions usually result from diabetic microvascular injury involving small blood vessels that supply nerves. It is estimated that over 50% of diabetic patients may experience a neuropathy during their lifetime, although not all neuropathies are painful. Painful neuropathy is generally described as superficial and affects the feet and hands. Burning, tingling and allodynia are typically reported.

Trigeminal neuralgia

-          affects any of the 3 trigeminal nerves that supply either side of the face, and can sometimes affect 2 branches at once. The 1-sided pain of trigeminal neuralgia may extend through the cheek, mouth, nose and/or jaw muscles. This condition is characterized by a lancinating, shooting, electric-like sensation that can last from a few seconds to several minutes. Pain may be initiated by stimulating trigger points on the face, lips or gums, or by facial muscle movement, such as chewing.

Reference: http://www.neuropainhk.org

The information provided aims to provide educational purpose, if you have the described conditions as above, please consult a neurosurgeon.

Prevalence, Pathophysiology and Symptoms of Neuropathic Cancer PAIN – Hong Kong review

PAIN can be a persistent and incapacitating symptom of cancer. Although reports indicate only 15% of patients with nonmetastatic disease experience tumour-associated PAIN at the time of diagnosis, PAIN becomes more pervasive as disease progresses.1 In patients with recurrent or metastatic cancer, 67% complain of PAIN and 41% experience PAIN directly attributable to the disease. PAIN may be

chronic or acute, and patients with chronic PAIN commonly experience acute flares of PAIN. One half to two thirds of patients with well-controlled chronic PAIN experience transitory ‘breakthrough’ PAIN. Cancer-associated PAIN may be secondary to antineoplastic therapy or an unrelated comorbid condition, but is commonly due to direct tumor involvement (ie, infiltration or compression of adjacent local structures, such as bone, soft tissue, nerves or the gastrointestinal tract).1,4 Hence, cancer PAIN syndromes can be somatic, visceral or neuropathic in origin.3 Understanding and recognizing these

syndromes can help identify PAIN etiology and the need for additional evaluation, and target therapy

more appropriately.

Reference source: http://www.neuroPAINhk.org, www.brain-spine.com.hk

The above information is for educations only, if you have any related disease, please consult your neurosurgeon for more information.

Introduction of Neuropathic Pain?

Neuropathic pain is an inappropriate physiological response caused by a lesion or dysfunction in the peripheral nervous system or central nervous system. Unlike nociceptive pain, which is an appropriate physiological response to a painful stimulus, neuropathic pain can be either stimulus-independent or stimulus-evoked.

Assessment of Neuropathic Pain

The assessment of neuropathic pain can be challenging, as the aetiology and symptomatology of each neuropathic pain syndrome can vary greatly. Some conditions may also involve both neuropathic and nociceptive pain. Patient descriptions of neuropathic pain symptoms may include:

1. Continuous, burning pain
2. Dysaesthesia (abnormal and unpleasant sensations caused by spontaneous ectopic discharges along Aß fibres. Such sensations may be spontuneous or evoked)
3. Shooting or lancinating pain/sharp, tearing pain
4. Hyperalgesia (an increased response to a stimulus that is normally painful)
5. Allodynia (pain from a stimulus that is not always painful)
6. Paraesthesia (abnormal, but not unpleasant, sensations caused by spontaneous ectopic discharge along Aß fibres. Such sensations may occur in the absence of external stimuli)
7. Electric, shock-like pain

Patients with the same neuropathic pain syndrome often present with different symptoms and respond to the same therapy with varying degrees of success, thus complicating disease management. It has become clear that physicians should adopt a more symptom- and disease mechanism-based approach to selecting therapy.

Reference information: http://www.spineuniverse.com

The information above is used for educational purpose only, for any enquiries, please consult the neurosurgeon for medical advices.