Last updated: Tue, Aug 13, 2024
The causes of neuropathies in general are those given at the beginning of the previous section—trauma, metabolic disorders, infections, toxins. Physiologically, a variety of different types of damage to the sensory neurons, such as severing of the axon or damage or loss of the myelin coating, cause changes in the types and quantities of membrane receptors. This causes some cells to spontaneously fire action potentials. It causes more cells to become excitable, and hence to fire more often and more vigorously. This in turn causes sensitization in the spinal cord and brain.
When sensory nerves are cut, sympathetic nervous system neurons inside the dorsal root ganglion sprout new branches and become more active, releasing chemicals that make the sensory neuron bodies in the ganglion more active and excitable.1
Despite the diversity of causes for peripheral nerve damage, the common physiology behind neuropathic pain means that treatments for the many varieties are similar. The treatment focuses on tricyclic antidepressants, anti-convulsant drugs, opioids, and NMDA receptor antagonists. In alcoholic and diabetic neuropathies, correcting the underlying metabolic and dietary problems is also an important part of therapy.