All About Neuropathy And Chronic Back Pain

By: Ralph F. Rashbaum, MD
June 27, 2001

Understanding chronic back pain and neuropathy

Chronic pain that results from damage to or pathological changes of the peripheral or central nervous system is called neuropathy. Peripheral neuropathic pain has also been referred to as painful neuropathy, nerve pain, sensory peripheral neuropathy, or peripheral neuritis. Patients with neuropathy often describe it as unlike any pain that they have felt before.

It is important to note that with neuropathy the chronic pain is not a symptom of injury, but rather the pain is itself the disease process. Neuropathy is not associated with the healing process. Rather than communicating that there is an injury somewhere, the nerves themselves malfunction and become the cause of pain.

Characteristics of neuropathy and chronic back pain

Back pain or other pain that is caused by neuropathy is typically described as:

• Severe, sharp, electric shock-like, shooting, lightening-like, or lancinating

• Deep, burning or cold

• Persistent numbness, tingling, or weakness

• Traveling along the nerve path into the arms, hands, or legs or feet

Further, neuropathy may be characterized by pain resulting from light touch or other stimulus that does not typically cause pain, as well as special hypersensitivity to a normally painful stimulus (e.g. a pinprick).

Neuropathy can result from any type of pain that compresses or impinges on a nerve. Examples of neuropathic pain originating from the back or spine can include:

• Chronic pain that radiates down the leg (radiculopathy, or sciatica)

• Chronic pain that radiates down the arm (radiculopathy)

• Pain after back surgery that starts gradually and persists, which is commonly referred to as failed back surgery syndrome.

Other common causes of neuropathy include diabetes, phantom limb pain, or regional pain syndrome (RPS).

As with all forms of chronic back pain, if neuropathy is not appropriately treated, there can be a number of associated problems that lead to a downward cycle for the patient, including depression, sleeplessness, feelings of fear and anxiety, limited social interaction and inability to perform normal daily activities or work.