Neurol. praxi. 2015;16(5):253-256

Neuropathic component of back pain

prof. MUDr. Josef Bednařík, CSc.

Neurologická klinika LF MU a FN, Brno

Back pain is probably the most prevalent clinical syndrome at all – lifetime prevalence is thought to be approximately >70% and currently about 30% of the population have this condition. Presently, chronic lumbar radicular pain is the most common neuropathic pain syndrome at all. Neuropathic component is present in at least 1/5 patients suffering from back pain. The pathophysiology of back pain is complex. Nociceptive – and neuropathic pain–generating mechanisms are thought to be involved, which established the term mixed pain syndrome. Radicular syndromes serve as typical examples of neuropathic pain. Neuropathic component, however, is also present in pseudoradicular and local types of back pain. Practical diagnostics of neuropathic back pain is based on the same diagnostic tools and principles as diagnosis of neuropathic pain in general. Current knowledge on the optimum therapy of neuropathic back pain is not sufficient to formulate unequivocal recommendations. Combined therapy utilising drugs focused to both nociceptive and neuropathic pain represents probably the best choice with respect to presumed pathophysiology of back pain in most patients.

Keywords: neuropathic pain, nociceptive pain, mixed pain, back pain

Published: October 1, 2015  Show citation