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Best Neuropathic Pain
Treatment in Hyderabad

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  • I was suffering with severe neck pain since last 7years , hav all type of physiotherapy and massages and chiropractor but no relief then I met Dr Sudheer and Dr minal at this center…

    Dava Ramesh

  • Very good doctor. Suffering from knee pain from last 4 years and didn’t want to get a surgery. They treated my knee pain with out surgery with stem cell therapy. I am very happy with the results.

    Meghana Reddy

  • By far the best pain management specialists in town. After consulting several places with no effect, Epione made sure that they treated my mother’s delicate pain condition with patience…

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  • I am very thankful to doctors in Epione pain management center. My neck pain has gone which I was fighting since last 4 years . Dr sudhir Dara and dr minal have helped me come out…

    Sanjana Tirkey

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  • I finally got relief from my back pain thanks to Epione

    Mrs. Aswathi Subramanyan

    Back Pain Treatment
  • Dr Sudheer cured me from knee pain due to arthritis

    Mrs. Padmaja

    Knee Pain Treatment
  • I suffered from foot pain for 5 years but finally found pain relief at Epione

    Mr. BVS Prasad

    Foot and Ankle Pain Treatment
  • I can’t believe I got relieved of my back pain in a single day

    Mr. Sreekanth

    Back Pain Treatment

Neuropathic Pain
Treatment in Hyderabad

arising as a direct consequence of a lesion or disease affecting the somatosensory system

Signs and symptoms

  • Patients typically have symptoms of pain as
  • electric shock,
  • burning,
  • shooting,
  • pin and needles.
  • atypical sensations like worms crawling,
  • loss of sensation,decreased sensation,
  • pain at the area of decreased sensation,
  • numbness,
  • hyperalgesia
  • allodynia..

Types of Neuropthaic Pain

Site of Injury

Peripheral

  • CRPS I/CRPS II (involvement of Sympathetic nervous system)
  • Painful Polyneuropathy
  • Lancinating Neuralgias
  • Phantom Pain (+/- involvement of Sympathetic nervous system)
  • Nerve Compression
  • Neuroma Formation

Mixed

  • Avulsion of Plexus (+/- involvement of Sympathetic nervous system)
  • Postherpetic Neuralgia (+/- involvement of Sympathetic nervous system)

Central

  • Central Pain (+/- involvement of Sympathetic nervous system)

Predominating pain mechanism

Predominating “central” pain generator

  • Deafferentiation Pain (response to either peripheral or CN system injury)
  • Sympathetically Maintained Pain (associated with focal autonomic dysfunction)

Predominating “Peripheral” pain generator

  • Painful polyneuropathies (multiple mechanisms probably involved)
  • Painful mononeuropathies
    1. Lancinating Neuralgias
    2. Nerve Compression or Inflammation Nerve Transection

CAUSES:

Polyneuropathy

  • Diabetes (IDDM & NIDDM)
  • Alcoholism
  • Human Immunodeficiency virus
  • Hypothyroidism
  • Renal failure
  • Chemotherapy induced (vincristine, cisplatinum, paclitaxel, metronidazole)
  • Anti-HIV drugs
  • B12 and folate deficiencies

Mononeuropathy

  • Entrapment syndromes
  • Traumatic injury
  • Diabetes

Plexopathy

  • Diabetes
  • Avulsion
  • Tumour

Root syndromes and radiculopathy

  • Compressive lesions
  • Inflammatory
  • Diabetes

Post-herpetic neuralgia

Trigeminal neuralgia

Phantom limb pain

RSD/causalgia/CRPS

Management

Pharmacotherapy

Non-pharmacotherapy

Interventions

Pharmacotherapy

  • Tricyclic antidepressants & SSRNI’s/SSRI’s
  • Anticonvulsants
  • Opioids
  • Topical agents
  • NMDA Antagonists
  • Other drugs

Non Pharmacological treatment

  • Physical Therapy
  • TENS Therapy
  • Occupational Therapy
  • Cognitive Behaviour Therapy

Interventions

  • Neural blockade– nerve blocks have been used by physicians for generations for the treatment of neuropathic pain,
  • Implanted Neural Stimulator or spinal cord stimulators– implanted stimulators of the dorsal column of the spinal cord or of the injured peripheral nerve
  • Implanted Intrathecal Infusion Pumps
    Evidence for the efficacy of pumps administering morphine, hydromorphone, and Baclofen
  • Decompressive Neurosurgery
    Select patients with well-defined lesions may benefit from surgical exploration and decompressionWell accepted for carpal tunnel syndrome, but unfortunately underutilized for patients with painful nerve compressions elsewhere
  • Ablative Neurosurgery
    Procedures are rarely indicated, and are performed far less frequently now than in the past. Cutting nerves usually relieves pain only temporarily, if at all.

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