Neuropathic pain Which implies literally a ‘nerve abnormality’  is a condition which occurs typically after injury to a nerve through pressure, bruising or inflammation. In normal recovery, the injured nerve returns to normal function and the ‘normal’ pain signals reduce. The pain settles and the injury stops hurting. If there are changes in the normal function or the structure of the damaged nerve, or due to progressive inflammatory messages within the nerve fibres there is damage the special ‘control cells’ which support the nerve’s activity, the pattern of control fails. The result of this loss of control function is that increased pain sensation is transmitted to the spinal cord, which then changes its own activity to be more responsive to the pain signals. This process is known as spinal cord ‘wind up’ or sensitization and causes the typical symptoms of neuropathic pain. Symptoms of persistent pain, often of a burning or ‘shooting’ character may last long after the original injury or surgery has healed or settled completely. The painful area frequently expands to increase the area of burning pain or sensitivity to neighbouring areas of skin which in turn become increasingly sensitive to touch, heat, cold and on movement. The degree of pain and disability may become limiting in terms of normal daily activities or work and sleep may be badly affected. Typical examples of neuropathic pain conditions include phantom limb pain, trigeminal or post herpetic neuralgia (shingles), diabetic neuropathy, multiple sclerosis and HIV. Treatment is usually based on medications which reduce the abnormally amplified  pain signals, skin preparations to decrease the skin sensitivity and, in limited cases, the surgical ablation or destruction of the affected nerve.   
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