Neuropathic pain — master index¶
Last curated: 2026-08-30 · status: audited
The condition in five sentences. Neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system, graded as possible, probable or definite according to history, neuroanatomy, sensory signs and confirmatory evidence (Finnerup 2016, PMID 27115670). Population studies suggest 6.9–10% prevalence when validated screening instruments are used, though case ascertainment varies (van Hecke 2014, PMID 24291734). Ectopic activity, altered ion channels, neuroimmune signaling, disinhibition and central sensitization produce heterogeneous combinations of burning, electric-shock pain, allodynia, numbness and evoked pain (Colloca 2017, PMID 28205574; Finnerup 2021, PMID 32584191). First-line medicines—tricyclic antidepressants, SNRIs, gabapentin and pregabalin—help only a minority, and topical therapies are useful for selected peripheral phenotypes (Finnerup 2015, PMID 25575710). The frontier is mechanism-based phenotyping and combination or neuromodulation strategies that improve modest responder rates without importing opioid or device harms (Petersen 2021, PMID 33818600).
Start here: overview.md. Diagnostic path: definition, grading and diagnosis → sensory phenotyping → biomarkers. Treatment path: pharmacology → topical/interventional → neuromodulation. Etiology path: diabetes, postherpetic/postsurgical, chemotherapy/toxic, and central pain. Frontier: OPEN-QUESTIONS.md.
Pages¶
| File | Scope | Status |
|---|---|---|
| overview.md | Definition, burden, mechanisms, phenotypes and treatment map | curated |
| definition-grading-and-diagnosis.md | Possible/probable/definite grading, examination and confirmatory tests | curated |
| epidemiology-and-burden.md | Population prevalence, disability and condition-specific burden | curated |
| peripheral-mechanisms.md | Ectopic firing, channels, neuroma, small fibers and immune interactions | curated |
| central-sensitization-and-plasticity.md | Spinal/cortical amplification, disinhibition and maintained pain | curated |
| sensory-phenotyping-and-qst.md | Bedside signs, QST, clusters and mechanism inference | curated |
| diabetic-neuropathic-pain.md | Distal symmetric neuropathy, metabolic injury and treatment | curated |
| postherpetic-and-postsurgical-pain.md | PHN, nerve injury, prevention and localized therapy | curated |
| chemotherapy-and-toxic-neuropathy.md | CIPN prevention, treatment and survivorship | curated |
| spinal-cord-and-central-neuropathic-pain.md | SCI, stroke, MS and central phenotypes | curated |
| pharmacologic-treatment.md | Antidepressants, gabapentinoids, sodium-channel drugs and combinations | curated |
| topical-and-interventional-treatment.md | Lidocaine, capsaicin, blocks, ablation and selection | curated |
| neuromodulation.md | SCS, DRG stimulation, non-invasive approaches and durability | curated |
| guidelines.md | NeuPSIG, EAN/EFIC and national recommendations | curated |
| biomarkers.md | QST, skin biopsy, imaging, electrophysiology and molecular candidates | curated |
| clinical-trials-landscape.md | Drugs, combinations, devices and mechanism-stratified trials | curated |
| patient-experience-and-advocacy.md | Sleep, function, disbelief, access and patient priorities | curated |
| red-flags-and-safety-concerns.md | Progressive deficit, myelopathy, cauda equina, toxicity and medication harms | curated |
Literature layer¶
| Artifact | Status |
|---|---|
| Bibliography | audited; 309 unique live-resolved PMIDs |
| Landmark notes | 6 notes |
| Guideline registry | deepened; >25 international/national documents and explicit disagreement map |
| Statistics | deepened; conflicting estimates, effect sizes and confidence intervals retained side by side |
| Patient voice | audited; organization URLs rechecked 2026-08-30 |
Curation state¶
This condition was audited on 2026-08-30. All 18 canonical pages passed the separate claim-to-source review and are curated; each remains within the 150–400-line target and carries 28–34 live-resolved PMID references. The trial landscape contains 16 live-reverified NCT records, and the full condition bibliography contains 309 unique PMIDs. No unresolved substantive citation issue or verification flag remains.