Neurotrophic influences on neuropathic pain.

Damage to peripheral nerves following trauma or disease has a number of consequences including the emergence of neuropathic pain. Commonly, neuropathic pain sufferers experience spontaneous burning pain in and radiating from the area innervated by the damaged nerves, and an exquisite sensitivity to light touch stimuli, which are now perceived as painful. These neuropathic pains are often refractory to conventional analgesic therapy, with most patients obtaining at best only partial relief. Unfortunately, neuropathic pains are frequently also very persistent and do not resolve with time. Thus, neuropathic pain is often an extremely debilitating condition with a bleak outlook. In this paper we review the pathophysiological mechanisms that underlie these neuropathic pain states with particular emphasis on the therapeutic role of neurotrophic factors.