IASP defines neuropathic pain as the pain resulting from a primary lesion or dysfunction of the nervous system, usually involving an element of sensory dysfunction 1. Whereas in nociceptive (inflammatory) pain an adequate stimulus is needed to activate the nociceptors, neuropathic pain results from sensitisation of the nervous system, even in the absence of nociceptive input. Neuropathic pain also has a character of non responsiveness to the conventional analgesics, specially the opioids. But does it give an easy way to label every chronic pain, difficult to treat as neuropathic? The answer is surely NO. Though manifestations of both nociceptive and neuropathic pains may be similar but certain cellular mechanisms differ which inturn specify and determine the correct treatment. It seems clinically useful to distinguish neuropathic pain in which nerve lesions can be demonstrated or inferred from a typical clinical presentation from situations in which nerve lesions are not tangible. The later conditions may include complex regional painful syndrome (CRPS) 2.
Key words: Painful syndrome, neuropathic pain, opioids
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