{"id":2879,"date":"2025-07-09T18:18:40","date_gmt":"2025-07-09T17:18:40","guid":{"rendered":"https:\/\/neuropsiquiatria.pt\/?p=2879"},"modified":"2025-07-20T02:05:11","modified_gmt":"2025-07-20T01:05:11","slug":"dor-neuropatica-o-guia-completo-2025","status":"publish","type":"post","link":"https:\/\/neuropsiquiatria.pt\/en\/dor-neuropatica-o-guia-completo-2025\/","title":{"rendered":"Neuropathic Pain: The Complete Guide (2025)"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"2879\" class=\"elementor elementor-2879\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6e7fab4 e-flex e-con-boxed e-con e-parent\" data-id=\"6e7fab4\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-56a615c elementor-widget elementor-widget-text-editor\" data-id=\"56a615c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">The Complete Guide to Understanding, Diagnosing and Treating<\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ce9b6b7 elementor-widget elementor-widget-text-editor\" data-id=\"ce9b6b7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>It is estimated that neuropathic pain affects 7-10% of the European population, but in Portugal many cases remain underdiagnosed. Is it just \"a stronger pain\"?<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-65a71a5 elementor-widget elementor-widget-post-info\" data-id=\"65a71a5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"post-info.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-inline-items elementor-icon-list-items elementor-post-info\">\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-repeater-item-87d2c88 elementor-inline-item\" itemprop=\"datePublished\">\n\t\t\t\t\t\t<a href=\"https:\/\/neuropsiquiatria.pt\/en\/2025\/07\/09\/\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-calendar\" viewbox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12 192h424c6.6 0 12 5.4 12 12v260c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V204c0-6.6 5.4-12 12-12zm436-44v-36c0-26.5-21.5-48-48-48h-48V12c0-6.6-5.4-12-12-12h-40c-6.6 0-12 5.4-12 12v52H160V12c0-6.6-5.4-12-12-12h-40c-6.6 0-12 5.4-12 12v52H48C21.5 64 0 85.5 0 112v36c0 6.6 5.4 12 12 12h424c6.6 0 12-5.4 12-12z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text elementor-post-info__item elementor-post-info__item--type-date\">\n\t\t\t\t\t\t\t\t\t\t<time>July 9, 2025<\/time>\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8e883a2 elementor-widget elementor-widget-text-editor\" data-id=\"8e883a2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone wp-image-2999 size-full\" title=\"Representative image of Neuropathic Pain\" src=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-5_07_2025-18_59_35.webp\" alt=\"Ilustra\u00e7\u00e3o de homem com dor neurop\u00e1tica no pesco\u00e7o e ombro, mostrando nervos inflamados com raios vermelhos indicando dor\" width=\"1536\" height=\"1024\" srcset=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-5_07_2025-18_59_35.webp 1536w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-5_07_2025-18_59_35-300x200.webp 300w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-5_07_2025-18_59_35-1024x683.webp 1024w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-5_07_2025-18_59_35-768x512.webp 768w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-5_07_2025-18_59_35-18x12.webp 18w\" sizes=\"(max-width: 1536px) 100vw, 1536px\" \/>Imagine waking up every morning with the feeling that<strong> thousands of needles run through your legs<\/strong>or that <strong>a hot iron is constantly pressed against your skin<\/strong>. It's not a pain that comes and goes - it's a constant presence, a <strong>burning that won't stop<\/strong> even when there is no visible wound.<\/div><div>\u00a0<\/div><div>For many people, trying to describe this experience to others becomes almost impossible: <strong>\"How can I be in so much pain when you can't see anything?\"<\/strong><\/div><div>\u00a0<\/div><div>For those living with neuropathic pain, it's not just a matter of \"putting up with it\" - it's a reality that completely transforms you. <strong>the way you move around the world, the way you sleep, the way you work and the way you relate to others.<\/strong>.<\/div><div><p><img decoding=\"async\" class=\"alignleft wp-image-2987\" title=\"Neuropathic Pain - Nervous System and Neural Structure\" src=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-01_20_29.webp\" alt=\"Dor neurop\u00e1tica - diagrama m\u00e9dico mostrando silhueta humana com sistema nervoso destacado e close-up de nervo danificado com inflama\u00e7\u00e3o\" width=\"780\" height=\"520\" srcset=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-01_20_29.webp 1536w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-01_20_29-300x200.webp 300w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-01_20_29-1024x683.webp 1024w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-01_20_29-768x512.webp 768w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-01_20_29-18x12.webp 18w\" sizes=\"(max-width: 780px) 100vw, 780px\" \/><\/p><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f600409 elementor-widget elementor-widget-html\" data-id=\"f600409\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"toc-manual\">\r\n    <h3>\ud83d\udd52 Table of Contents<\/h3>\r\n    <ul>\r\n        <li><a href=\"#o-que-e-dor-neuropatica\">1. \ud83e\udde0 What is Neuropathic Pain?<\/a>\r\n            <ul>\r\n                <li><a href=\"#definicao-medica\">1.1 \ud83d\udd2c Medical definition<\/a><\/li>\r\n            <\/ul>\r\n        <\/li>\r\n        <li><a href=\"#diferenca-dor-neuropatica-outras-dores\">2. \ud83d\udcca Difference between Neuropathic Pain and Other Pains<\/a><\/li>\r\n        <li><a href=\"#sintomas-mais-comuns-dor-neuropatica\">3. \ud83e\udd15 Most common symptoms of neuropathic pain<\/a><\/li>\r\n        <li><a href=\"#tipos-de-dor-neuropatica\">4. Types of Neuropathic Pain<\/a><\/li>\r\n        <li><a href=\"#causas-e-fatores-de-risco\">5. \u26a0\ufe0f Causes and risk factors<\/a><\/li>\r\n        <li><a href=\"#o-diagnostico-da-dor-neuropatica\">6. The Diagnosis of Neuropathic Pain?<\/a>\r\n                        <ul>\r\n                <li><a href=\"#questionario-dn4\">6.1 \ud83d\udd2c DN4 questionnaire<\/a><\/li>\r\n            <\/ul>\r\n        <\/li>\r\n        <li><a href=\"#impacto-da-dor-neuropatica-na-vida-diaria\">7. \ud83d\udcc9 Impact of neuropathic pain on daily life<\/a><\/li>\r\n        <li><a href=\"#como-se-trata-a-dor-neuropatica\">8. \ud83d\udc8a How is neuropathic pain treated?<\/a>\r\n            <ul>\r\n                <li><a href=\"#medicamentos-utilizados-no-tratamento\">8.1 \ud83d\udc89 Medicines used for treatment<\/a><\/li>\r\n                <li><a href=\"#papel-da-neuroterapia-no-tratamento\">8.2 \ud83e\udde0\u26a1 Neurotherapy's role in treatment<\/a><\/li>\r\n            <\/ul>\r\n        <\/li>\r\n        <li><a href=\"#quando-procurar-ajuda-profissional\">9. When to seek professional help<\/a><\/li>\r\n        <li><a href=\"#como-lidar-com-a-dor-neuropatica-no-dia-a-dia\">10. \ud83e\uddd8\u200d\u2640\ufe0f How to deal with Neuropathic Pain in everyday life?<\/a><\/li>\r\n        <li><a href=\"#avancos-na-investigacao-cientifica\">11. \ud83d\udd2c\ud83d\ude80 Advances in scientific research<\/a>\r\n            <ul>\r\n                <li><a href=\"#cannabis-medicinal-no-tratamento\">11.1 \ud83c\udf3f Medical cannabis in treatment<\/a><\/li>\r\n                <li><a href=\"#neuromodulacao-e-novos-tratamentos\">11.2 \u26a1\ufe0f Neuromodulation and new treatments<\/a><\/li>\r\n            <\/ul>\r\n        <\/li>\r\n        <li><a href=\"#mitos-e-verdades-sobre-dor-neuropatica\">12. \ud83e\udd14 Myths and Truths about Neuropathic Pain<\/a><\/li>\r\n        <li><a href=\"#recursos-e-apoio-disponiveis-em-portugal\">13. \ud83c\uddf5\ud83c\uddf9\ud83e\udd1d Resources and support available in Portugal<\/a><\/li>\r\n        <li><a href=\"#conclusao-dor-neuropatica\">14. Conclusion<\/a><\/li>\r\n        <li><a href=\"#faqs-dor-neuropatica\">15. \u2753 FAQ's on Neuropathic Pain<\/a><\/li>\r\n    <\/ul>\r\n<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-72b5261 elementor-widget elementor-widget-text-editor\" data-id=\"72b5261\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2 id=\"o-que-e-dor-neuropatica\"><strong>What is Neuropathic Pain?<\/strong><\/h2><div><p class=\"whitespace-normal break-words\">Neuropathic pain is pain that <strong>results from a lesion or problem in the nervous system<\/strong>. It's very different from the common pain we all know.<\/p><p class=\"whitespace-normal break-words\">When you cut your finger or hit your knee, you feel pain. This is because the <strong>pain receptors<\/strong>Pain in the finger or knee sends alarm signals to the brain. We call this normal pain <strong>nociceptive<\/strong> - is a response that protects us, alerting us to danger.<\/p><p class=\"whitespace-normal break-words\">In <strong>neuropathic pain<\/strong>The nervous system itself is damaged. It's as if the body's \"alarm system\" has short-circuited. It sends out pain signals even when there is no real danger. The result is painful sensations that usually don't go away. They are often described as <strong>burning, electric shocks or intense tingling<\/strong>.<\/p><\/div><h3 id=\"definicao-medica\">Medical definition<\/h3><div><p class=\"whitespace-normal break-words\">According to <a href=\"https:\/\/www.iasp-pain.org\/advocacy\/global-year\/neuropathic-pain\/\">IASP<\/a> (International Association for the Study of Pain), is <strong>pain caused by injury or disease of the nerves responsible for sensation<\/strong>. It is also classified as such by <strong>WHO<\/strong>in the reference guide <a href=\"https:\/\/icd.who.int\/browse\/2025-01\/mms\/pt#1170330671\">ICD-11<\/a>. In short, the cause of the pain is internal to the nervous system, not external, such as a cut or a blow.<\/p><p class=\"whitespace-normal break-words\">A <strong>burning pain<\/strong>, for example, happens when <strong>the pain nerves become active for no reason<\/strong>. The feeling of shock comes from <strong>abnormal electrical signals in damaged nerves<\/strong>.<\/p><p class=\"whitespace-normal break-words\">This condition can affect any part of the body, manifesting itself in a wide variety of ways. For this reason, diagnosis is a challenge even for specialised professionals.<\/p><\/div><h2 id=\"diferenca-dor-neuropatica-outras-dores\"><strong>Difference Between Neuropathic Pain and Other Pains<\/strong><\/h2><div><div><p>To truly understand <strong>neuropathic pain<\/strong>It is essential to realise exactly how it differs from other types of pain, which can mean other problems:<\/p><\/div><\/div><div><table><tbody><tr><td><strong>Character.<\/strong><\/td><td><strong>Nociceptive pain<\/strong><\/td><td><strong>Neuropathic Pain<\/strong><\/td><\/tr><tr><td><strong>Cause<\/strong><\/td><td>Identifiable tissue damage<\/td><td>Nervous system dysfunction<\/td><\/tr><tr><td><strong>Type<\/strong><\/td><td>Stinging, aching<\/td><td>Burning, shocks, tingling<\/td><\/tr><tr><td><strong>Localisation<\/strong><\/td><td>Well located<\/td><td>Localised or diffuse<\/td><\/tr><tr><td><strong>Response to drugs<\/strong><\/td><td>Variable (good)<\/td><td>Limited response<\/td><\/tr><tr><td><strong>Duration<\/strong><\/td><td>Temporary<\/td><td>Undefined<\/td><\/tr><\/tbody><\/table><\/div><p><img decoding=\"async\" class=\"alignnone wp-image-2917 size-full\" title=\"Neuropathic Pain Symptoms - Data and Manifestations\" src=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Infografico-Dor-Neuropatica-1.webp\" alt=\"Infogr\u00e1fico com silhueta humana mostrando sintomas da dor neurop\u00e1tica: queima\u00e7\u00e3o, dorm\u00eancia, choques el\u00e9tricos e hipersensibilidade. Afeta 7-10% da popula\u00e7\u00e3o europeia\" width=\"1536\" height=\"1024\" srcset=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Infografico-Dor-Neuropatica-1.webp 1536w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Infografico-Dor-Neuropatica-1-300x200.webp 300w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Infografico-Dor-Neuropatica-1-1024x683.webp 1024w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Infografico-Dor-Neuropatica-1-768x512.webp 768w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Infografico-Dor-Neuropatica-1-18x12.webp 18w\" sizes=\"(max-width: 1536px) 100vw, 1536px\" \/><\/p><h2 id=\"sintomas-mais-comuns-dor-neuropatica\"><strong>Most common symptoms of neuropathic pain<\/strong><\/h2><div><div><p>Neuropathic pain manifests itself through various symptoms.<\/p><\/div><div><p>Patients often <strong>describe their experiences in very specific ways<\/strong>:<\/p><\/div><\/div><div><h3 data-start=\"4605\" data-end=\"4616\"><strong>Burning sensations<\/strong><\/h3><ul><li data-start=\"4620\" data-end=\"4653\"><p data-start=\"4622\" data-end=\"4653\">\"As if I had acid on my skin\"<\/p><\/li><li data-start=\"4657\" data-end=\"4693\"><p data-start=\"4659\" data-end=\"4693\">\"A constantly leaning hot iron\"<\/p><\/li><li data-start=\"4697\" data-end=\"4728\"><p data-start=\"4699\" data-end=\"4728\">\"Skin burning from the inside\"<\/p><\/li><\/ul><h3 data-start=\"4699\" data-end=\"4728\"><strong>Electric shocks<\/strong><\/h3><ul><li data-start=\"4767\" data-end=\"4803\"><p data-start=\"4769\" data-end=\"4803\">\"Discharges that go through the body\"<\/p><\/li><li data-start=\"4807\" data-end=\"4845\"><p data-start=\"4809\" data-end=\"4845\">\"Constant shocks\"<\/p><\/li><li data-start=\"4849\" data-end=\"4885\"><p data-start=\"4851\" data-end=\"4885\">\"Sudden and intense needles\"<\/p><\/li><\/ul><h3 data-start=\"4907\" data-end=\"4924\"><strong>Tingling or Numbness (Paresthesia)<\/strong><\/h3><ul><li data-start=\"4928\" data-end=\"4966\"><p data-start=\"4930\" data-end=\"4966\">\"Persistent tingling or numbness\"<\/p><\/li><li data-start=\"4970\" data-end=\"4995\"><p data-start=\"4972\" data-end=\"4995\">\"Thousands of needles pricking\"<\/p><\/li><li data-start=\"4999\" data-end=\"5019\"><p data-start=\"5001\" data-end=\"5019\">\"Numbness with burning\" (dysaesthesia)<\/p><\/li><\/ul><h3 data-start=\"4907\" data-end=\"4924\"><b>Hypersensitivity to touch (Mechanical Allodynia)<\/b><\/h3><ul><li>Pain caused by normally non-painful stimuli<\/li><li>A gentle touch or rubbing of clothing can cause intense pain<\/li><\/ul><h3 data-start=\"1206\" data-end=\"1248\">Reduced sensitivity (Hypoaesthesia)<\/h3><ul data-start=\"1408\" data-end=\"1549\"><li data-start=\"1408\" data-end=\"1467\"><p data-start=\"1410\" data-end=\"1467\">\"My skin feels like it's covered in a film\"<\/p><\/li><li data-start=\"1468\" data-end=\"1512\"><p data-start=\"1470\" data-end=\"1512\">\"I don't perceive heat or cold as I used to\"<\/p><\/li><li data-start=\"1513\" data-end=\"1549\"><p data-start=\"1515\" data-end=\"1549\">\"The area seems disconnected from the body\"<\/p><\/li><\/ul><\/div><h3 data-start=\"4907\" data-end=\"4924\"><b>Increased pain (Hyperalgesia)<\/b><\/h3><ul><li>Exaggerated response to painful stimuli<\/li><li>A little pinch can feel like a cut<\/li><\/ul><div><p data-start=\"5041\" data-end=\"5059\"><strong>Other common symptoms:<\/strong><\/p><ul><li data-start=\"5093\" data-end=\"5114\"><p data-start=\"5095\" data-end=\"5114\">Pain that gets worse at night<\/p><\/li><li data-start=\"5118\" data-end=\"5152\"><p data-start=\"5120\" data-end=\"5152\">Feeling of \"dead\" or strange skin<\/p><\/li><li data-start=\"5156\" data-end=\"5188\"><p data-start=\"5158\" data-end=\"5188\">Difficulty distinguishing temperatures<\/p><\/li><li data-start=\"5192\" data-end=\"5223\"><p data-start=\"5194\" data-end=\"5223\">Pain that spreads to areas not initially affected<\/p><\/li><\/ul><\/div><p>Neuropathic pain can cause <strong data-start=\"1633\" data-end=\"1653\">extra sensations<\/strong> (hyperaesthesia), but also <strong data-start=\"1690\" data-end=\"1711\">fewer sensations <\/strong>(hypoaesthesia). Both phenomena indicate that there are changes in the functioning of the nerves.<\/p><div><div class=\"aviso-importante\"><p><span class=\"titulo-aviso\">Important Note:<\/span>The presence of these symptoms does not automatically confirm <strong>neuropathic pain<\/strong>. The diagnosis should always be made by a specialised professional who can assess the whole picture.<\/p><\/div><p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-2983\" title=\"Symptoms of burning in the legs and feet\" src=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Design-sem-nome-20.webp\" alt=\"Pessoa com \u00e1rea vermelha destacada, perna e p\u00e9, indicando dor neurop\u00e1tica e sensa\u00e7\u00e3o de queima\u00e7\u00e3o\" width=\"720\" height=\"504\" srcset=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Design-sem-nome-20.webp 1280w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Design-sem-nome-20-300x210.webp 300w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Design-sem-nome-20-1024x717.webp 1024w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Design-sem-nome-20-768x538.webp 768w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/Design-sem-nome-20-18x12.webp 18w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><\/p><h2 id=\"tipos-de-dor-neuropatica\"><strong>Types of Neuropathic Pain<\/strong><\/h2><div><div><p>Neuropathic pain can be categorised in various ways, helping to guide treatment:<\/p><\/div><\/div><h3>Peripheral or Central<\/h3><p>The nervous system is divided into the central nervous system and the peripheral nervous system.<\/p><div><ul><li><strong>Peripheral Neuropathic Pain<\/strong><ul><li>It develops after an injury or illness that affects only the <strong>peripheral somatosensory nervous system<\/strong> - responsible for receiving and processing sensory information from the body, such as touch, temperature, pain and proprioception (spatial awareness of the body's position). Examples include diabetic neuropathy, post-herpetic neuralgia, or the severing of a nerve.<\/li><\/ul><\/li><\/ul><\/div><div><ul><li><strong>Central Neuropathic Pain<\/strong><ul><li>It results from an injury or disease of the central nervous system (CNS), and often occurs after a stroke, spinal cord injury or demyelinating plaque from multiple sclerosis.<\/li><\/ul><\/li><\/ul><\/div><h3>Localisation of the lesion<\/h3><div><ul><li><strong>Mononeuropathy<\/strong><ul><li>Only one nerve pathway is compromised. The pain is well localised.<\/li><\/ul><\/li><\/ul><\/div><div><ul><li><strong>Polyneuropathy<\/strong><ul><li>When several nerves are altered, the pain is generalised and can appear in the trunk, arms and legs simultaneously.<\/li><\/ul><\/li><\/ul><\/div><h3>Time pattern<\/h3><div><ul><li><strong>Spontaneous pain<\/strong><ul><li>Continuous (persistent burning)<\/li><li>Paroxysmal (sudden electric shocks)<\/li><\/ul><\/li><\/ul><\/div><div><ul><li><strong>Evoked pain<\/strong><ul><li>Pain caused by normally non-painful stimuli (allodynia)<\/li><li>Exaggerated pain to painful stimuli (hyperalgesia)<\/li><\/ul><\/li><\/ul><\/div><\/div><h2 id=\"causas-e-fatores-de-risco\"><strong>Causes and risk factors<\/strong><\/h2><div><div><p>Neuropathic pain can result from various conditions that affect the <strong>nervous system<\/strong>:<\/p><\/div><\/div><div><h3><strong>Diabetes<\/strong><\/h3><p>The most common type of peripheral neuropathic pain is <strong>painful diabetic peripheral neuropathy<\/strong>which affects 60-70% of people with diabetes. High blood sugar progressively damages the peripheral nerves.<\/p><\/div><div><h3><strong>Viral infections<\/strong><\/h3><ul><li>Viruses like <strong>Herpes zoster<\/strong> (zone) can cause post-herpetic neuralgia<\/li><li><strong>33% of patients with HIV\/AIDS infection<\/strong> develop neuropathic pain<\/li><\/ul><\/div><div><h3><strong>Trauma and surgery<\/strong><\/h3><p>Accidents, fractures or surgery can cause nerve damage that leads to acute, high intensity pain. The pain can persist long after the tissues have healed.<\/p><\/div><div><h3><strong>Chemotherapy<\/strong><\/h3><p><strong>30-40% of cancer patients undergoing chemotherapy<\/strong> develop neuropathic pain due to the toxic effects of drugs on the nerves.<\/p><\/div><div><h3><strong>Autoimmune diseases<\/strong><\/h3><ul><li>Multiple sclerosis<\/li><li>Rheumatoid arthritis<\/li><li><a href=\"https:\/\/www.msdmanuals.com\/pt\/casa\/dist%C3%BArbios-%C3%B3sseos-articulares-e-musculares\/doen%C3%A7as-reum%C3%A1ticas-sist%C3%AAmicas\/s%C3%ADndrome-de-sj%C3%B6gren\">Sj\u00f6gren's syndrome<\/a><\/li><\/ul><\/div><div><h3><strong>Other factors:<\/strong><\/h3><ul><li>Alcoholism and nutritional deficiencies<\/li><li>Nerve compression (herniated discs...)<\/li><li>Degenerative neurological diseases<\/li><li>Certain medicines<\/li><\/ul><\/div><h3>Risk factors<\/h3><div><p>Some factors increase the <strong>probability<\/strong> of developing neuropathic pain:<\/p><ul><li>Older age<\/li><li>Poorly controlled diabetes<\/li><li>Family history of neuropathies<\/li><li>Excessive alcohol consumption<\/li><li>Vitamin deficiencies (especially B12)<\/li><li>Exposure to toxins<\/li><\/ul><\/div><p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-2994\" title=\"Doctor&#039;s surgery - illustration\" src=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-16_17_01.webp\" alt=\"Ilustra\u00e7\u00e3o de consult\u00f3rio m\u00e9dico com cadeira de exame, mesa com documentos e estetosc\u00f3pio, representando ambiente de tratamento m\u00e9dico\" width=\"720\" height=\"480\" srcset=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-16_17_01.webp 1536w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-16_17_01-300x200.webp 300w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-16_17_01-1024x683.webp 1024w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-16_17_01-768x512.webp 768w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/ChatGPT-Image-9_07_2025-16_17_01-18x12.webp 18w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><\/p><h2 id=\"o-diagnostico-da-dor-neuropatica\"><strong>The Diagnosis of Neuropathic Pain<\/strong><\/h2><div><p class=\"whitespace-normal break-words\">The clinical examination is very important for correctly diagnosing the type of pain. It includes talking to the patient and carrying out physical examinations of the nerves.<\/p><p class=\"whitespace-normal break-words\">The diagnosis of neuropathic pain is mainly made through <strong>analysing symptoms <\/strong>e<strong> neurological physical examinations<\/strong>feedback analysis. <strong>There is no single test to confirm the condition.<\/strong><\/p><\/div><p>The diagnostic process includes:<\/p><div><h3><strong>Detailed medical history<\/strong><\/h3><ul><li>Analysing the clinical history<\/li><li>Precise description of pain and symptoms<\/li><li>Onset and evolution of symptoms<\/li><\/ul><\/div><div><h3><strong>Neurological physical examination<\/strong><\/h3><ul><li>Sensitivity assessment<\/li><li>Reflex tests<\/li><li>Muscle strength assessment<\/li><li>Specific tests for allodynia and hyperalgesia<\/li><\/ul><\/div><div><p><strong>There are also tools such as standardised questionnaires,<\/strong> like the questionnaire <a href=\"https:\/\/aped-dor.org\/socios\/material_bibliografico\/diversos_QuestEspecificoRastreioDorNeuropatica-DN4.pdf\">DN4<\/a> or the LANSS scale, which help to identify neuropathic pain characteristics.<\/p><h3 id=\"questionario-dn4\"><strong>DN4 Questionnaire<\/strong><\/h3><p data-start=\"652\" data-end=\"716\">DN4 evaluates <strong data-start=\"665\" data-end=\"689\">10 signs and symptoms<\/strong>divided into two parts:<\/p><p data-start=\"718\" data-end=\"773\"><strong data-start=\"722\" data-end=\"771\">1. Symptoms reported by the patient (7 items)<\/strong><\/p><p data-start=\"774\" data-end=\"794\">(Answers: Yes\/No)<\/p><ul data-start=\"795\" data-end=\"1030\"><li data-start=\"795\" data-end=\"824\"><p data-start=\"797\" data-end=\"824\">Feeling of <strong data-start=\"809\" data-end=\"822\">burning<\/strong><\/p><\/li><li data-start=\"825\" data-end=\"862\"><p data-start=\"827\" data-end=\"862\">Feeling of <strong data-start=\"839\" data-end=\"860\">electric shocks<\/strong><\/p><\/li><li data-start=\"863\" data-end=\"894\"><p data-start=\"865\" data-end=\"894\">Feeling of <strong data-start=\"877\" data-end=\"892\">anthill<\/strong><\/p><\/li><li data-start=\"895\" data-end=\"934\"><p data-start=\"897\" data-end=\"934\">Feeling of <strong data-start=\"909\" data-end=\"932\">pinpricks<\/strong><\/p><\/li><li data-start=\"935\" data-end=\"952\"><p data-start=\"937\" data-end=\"952\"><strong data-start=\"937\" data-end=\"950\">Numbness<\/strong><\/p><\/li><li data-start=\"953\" data-end=\"977\"><p data-start=\"955\" data-end=\"977\"><strong data-start=\"955\" data-end=\"975\">Itching\/pruritus<\/strong><\/p><\/li><li data-start=\"978\" data-end=\"1030\"><p data-start=\"980\" data-end=\"1030\">The pain is caused by a <strong data-start=\"1005\" data-end=\"1019\">light touch<\/strong> (allodynia)<\/p><\/li><\/ul><p data-start=\"1032\" data-end=\"1103\"><strong data-start=\"1036\" data-end=\"1101\">2. Clinical signs assessed during the physical examination (3 items)<\/strong><\/p><p data-start=\"1104\" data-end=\"1124\">(Answers: Yes\/No)<\/p><ul data-start=\"1125\" data-end=\"1350\"><li data-start=\"1125\" data-end=\"1192\"><p data-start=\"1127\" data-end=\"1192\">Hypoaesthesia to touch (sensation <strong data-start=\"1158\" data-end=\"1170\">reduced<\/strong> to the touch with cotton)<\/p><\/li><li data-start=\"1193\" data-end=\"1259\"><p data-start=\"1195\" data-end=\"1259\">Hypoaesthesia to the bite (sensation <strong data-start=\"1226\" data-end=\"1238\">reduced<\/strong> when pricking with a needle)<\/p><\/li><li data-start=\"1260\" data-end=\"1350\"><p data-start=\"1262\" data-end=\"1350\">The pain is caused by <strong data-start=\"1285\" data-end=\"1294\">rub<\/strong> of a light object (e.g. cotton) - <strong data-start=\"1332\" data-end=\"1350\">tactile allodynia<\/strong><\/p><\/li><\/ul><p data-start=\"1357\" data-end=\"1391\"><strong>Interpretation of results<\/strong><\/p><ul data-start=\"1393\" data-end=\"1576\"><li data-start=\"1393\" data-end=\"1431\"><p data-start=\"1395\" data-end=\"1431\">Every \"Yes\" answer is worth <strong data-start=\"1420\" data-end=\"1431\">1 point<\/strong><\/p><\/li><li data-start=\"1432\" data-end=\"1458\"><p data-start=\"1434\" data-end=\"1458\"><strong data-start=\"1461\" data-end=\"1478\">A score \u2265 4 (equal to or greater than 4)<\/strong>\u00a0indicates <strong data-start=\"1486\" data-end=\"1527\">high probability of neuropathic pain<\/strong><\/p><\/li><\/ul><\/div><h3 id=\"criterios-diagnosticos-atualizados\">Additional diagnostic criteria<\/h3><div><p>To be considered neuropathic pain, <strong>must be present<\/strong>:<\/p><ol><li><strong>Plausible neuroanatomical distribution<\/strong>:<br \/>pain must follow the distribution pattern of specific nerves<\/li><li><strong>History suggestive of nerve damage<\/strong>:<br \/>there must be evidence of disease or injury affecting the nervous system<\/li><li><strong>Confirmation tests<\/strong>:<br \/>tests such as electroneuromyography can confirm nerve dysfunction<\/li><\/ol><\/div><div><p><strong>Complementary examinations when necessary:<\/strong><\/p><ul><li><a href=\"https:\/\/www.hospitaldaluz.pt\/pt\/exames\/eletromiograma-emg-#tabp-0\">Electroneuromyography<\/a><\/li><li>Magnetic resonance imaging<\/li><li><a href=\"https:\/\/www.tuasaude.com\/biopsia-de-pele\/\">Skin biopsy<\/a> (specific cases)<\/li><li>Nerve function tests<\/li><\/ul><\/div><div><div class=\"aviso-importante\"><p><span class=\"titulo-aviso\">Important Note:<\/span>A <strong data-start=\"10762\" data-end=\"10777\">neuropathic pain<\/strong> is difficult to recognise and is therefore a health condition that is considered underdiagnosed. It is essential to seek out professionals with experience in this area.<\/p><\/div><h2 id=\"impacto-da-dor-neuropatica-na-vida-diaria\"><strong>Impact of Neuropathic Pain on Daily Life<\/strong><\/h2><div><div><p>Neuropathic pain is a reason for <strong>suffering<\/strong> e <strong>disability<\/strong> for many patients, constituting a public health problem.<\/p><\/div><div><p>The impact goes far beyond physical pain, affecting <strong>multiple dimensions of life<\/strong>:<\/p><\/div><\/div><h3>Physical impact<\/h3><div><ul><li data-start=\"13596\" data-end=\"13719\"><p data-start=\"13598\" data-end=\"13719\">Reluctance to move the painful part of the body, resulting in muscle atrophy, joint ankylosis (stiffness) and limited movement<\/p><\/li><li data-start=\"13723\" data-end=\"13763\"><p data-start=\"13725\" data-end=\"13763\">Sleep disorders due to nocturnal pain<\/p><\/li><li data-start=\"13767\" data-end=\"13791\"><p data-start=\"13769\" data-end=\"13791\">Chronic fatigue<\/p><\/li><li data-start=\"13795\" data-end=\"13825\"><p data-start=\"13797\" data-end=\"13825\">Reduced general functional capacity<\/p><\/li><\/ul><\/div><h3>Psychological impact<\/h3><div><p>Pain, and especially chronic pain, is often accompanied by symptoms of depression and anxiety. Nature <strong>\"invisible\"<\/strong> neuropathic pain can aggravate psychological suffering.<\/p><ul><li>Constant anxiety<\/li><li>Reactive depression<\/li><li>Frustration and irritability<\/li><li>Loss of self-esteem<\/li><li>Feeling misunderstood<\/li><\/ul><\/div><h3>Social and family impact<\/h3><div><ul><li>Significant consequences for families and the social environment<\/li><li>Social isolation<\/li><li>Difficulties in the marital relationship<\/li><li>Overburdened carers<\/li><li>Misunderstanding by others<\/li><\/ul><\/div><h3>Professional impact<\/h3><div><ul><li>Time off work<\/li><li>Reduced productivity<\/li><li>Frequent absences<\/li><li>Early retirement due to disability<\/li><\/ul><p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-487 size-full\" title=\"Medicines - Weekly Organisation\" src=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2024\/03\/artigo-8-imagem-11.webp\" alt=\"Organizador semanal de medicamentos com comprimidos coloridos, representando um tratamento farmacol\u00f3gico\" width=\"1000\" height=\"667\" srcset=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2024\/03\/artigo-8-imagem-11.webp 1000w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2024\/03\/artigo-8-imagem-11-300x200.webp 300w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2024\/03\/artigo-8-imagem-11-768x512.webp 768w\" sizes=\"(max-width: 1000px) 100vw, 1000px\" \/><\/p><\/div><h2 id=\"como-se-trata-a-dor-neuropatica\"><strong>How is Neuropathic Pain treated?<\/strong><\/h2><div><div><p>Various classes of drugs have some efficacy, but complete relief is <strong>unlikely<\/strong>It is important to set realistic expectations regarding medication. The aim of pharmacological treatment is to reduce neuropathic pain, so that it can be reduced. <strong>less debilitating<\/strong> and therefore, <strong>hardly helps to treat the \"root\" causing the pain<\/strong>.<\/p><\/div><div><p>Treatment of neuropathic pain<strong data-start=\"15907\" data-end=\"15922\">for the best possible expectation of improvement<\/strong>, requires an approach <strong>integrated multidisciplinary approach, combining different therapeutic strategies<\/strong>:<\/p><\/div><\/div><h3 id=\"medicamentos-utilizados-no-tratamento\">Medicines used for treatment<\/h3><div><p><strong>Gabapentinoids (first line)<\/strong><\/p><ul><li>Pregabalin<\/li><li>Gabapentin<\/li><\/ul><\/div><div><p><strong>Antidepressants<\/strong><\/p><ul><li><strong>Tricyclics<\/strong>amitriptyline, nortriptyline<\/li><li><strong>Duals<\/strong>duloxetine, venlafaxine<\/li><\/ul><\/div><div><p><strong>Topical medicines (ointments, gels)<\/strong><\/p><ul><li>Lidocaine<\/li><li>Capsaicin in high concentration<\/li><\/ul><\/div><div><div class=\"aviso-importante\"><p><span class=\"titulo-aviso\">Important Note:<\/span><\/p><p><a href=\"https:\/\/www.msdmanuals.com\/pt\/casa\/assuntos-especiais\/entorpecentes-e-intoxicantes\/opioides\">Opioid analgesics<\/a> can provide some relief, but are generally less effective than for <strong>acute nociceptive pain<\/strong> and are associated with the risk of addiction.<\/p><\/div><\/div><h3 id=\"papel-da-neuroterapia-no-tratamento\">Neurotherapy's role in treatment<\/h3><div><div><p>A <a href=\"https:\/\/neuropsiquiatria.pt\/en\/centro-de-neuroterapia\/\">Neurotherapy<\/a> represents an effective approach to treating neuropathic pain:<\/p><\/div><\/div><div><ul><li><strong>Transcranial Magnetic Stimulation (<a href=\"https:\/\/neuropsiquiatria.pt\/en\/estimulacao-magnetica-transcraniana\/\"><u>EMT<\/u><\/a>)<\/strong><br \/>EMT modulates the prefrontal cortex, which stimulates other regions of the brain, helping to restore the pain-free condition.<ul><li>No significant side effects<\/li><li>Acts to modulate pain perception<\/li><li>Studies show changes in neuronal activity in regions involved in pain regulation<\/li><\/ul><\/li><\/ul><\/div><div><ul><li><strong>Neurofeedback <span style=\"text-decoration: underline;\">(<a href=\"https:\/\/neuropsiquiatria.pt\/en\/neurofeedback-e-qeeg\/\">NF\/qEEG<\/a>)<\/span><\/strong><ul><li>Trains the brain to better process pain signals<\/li><li>Improves neuronal self-regulation<\/li><li>Effectively complements other treatments<\/li><\/ul><\/li><\/ul><\/div><div><ul><li><strong>Transcranial Direct Current Stimulation (<a href=\"https:\/\/neuropsiquiatria.pt\/en\/estimulacao-eletrica-transcraniana\/\"><u>tDCS<\/u><\/a>)<\/strong><ul><li>Shows promising results in modulating pain and mood<\/li><li>Safe and well-tolerated technique<\/li><\/ul><\/li><\/ul><p>In <strong>NeuroPsyque<\/strong>We use an integrated approach that combines advanced neurotherapy with <a href=\"https:\/\/neuropsiquiatria.pt\/en\/neurologia\/\">specialised neurological care<\/a>Our services are tailored to the specific needs of each patient. Our focus is to offer the <strong>best possible expectation of improvement<\/strong>using state-of-the-art technologies with a safety profile superior to conventional pharmacological treatments.<\/p><\/div><p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-2995 size-full\" title=\"Electromyography\" src=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/eletroneuromiografia.webp\" alt=\"Representa\u00e7\u00e3o de uma eletromiografia\" width=\"1024\" height=\"473\" srcset=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/eletroneuromiografia.webp 1024w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/eletroneuromiografia-300x139.webp 300w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/eletroneuromiografia-768x355.webp 768w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/eletroneuromiografia-18x8.webp 18w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/p><h2 id=\"quando-procurar-ajuda-profissional\"><strong>When to seek professional help<\/strong><\/h2><div><div><p>It is essential to seek specialised assessment when:<\/p><\/div><\/div><div><ul><li>Identify various symptoms listed in the test <a href=\"https:\/\/aped-dor.org\/socios\/material_bibliografico\/diversos_QuestEspecificoRastreioDorNeuropatica-DN4.pdf\">DN4<\/a>explained above<\/li><li>Pain doesn't improve with conventional painkillers<\/li><li>The pain gets progressively worse\/worse<\/li><li>Symptoms persist for more than 3 months<\/li><\/ul><\/div><div><p>Early diagnosis and appropriate treatment can prevent the condition from worsening and significantly improve quality of life.<\/p><\/div><h2 id=\"como-lidar-com-a-dor-neuropatica-no-dia-a-dia\"><strong>How to deal with Neuropathic Pain in everyday life?<\/strong><\/h2><div><div><p>In addition to specialised medical care, there are strategies that can improve quality of life:<\/p><\/div><\/div><h3 id=\"gestao-dor\">Pain management<\/h3><div><ul><li>Relaxation and deep breathing techniques<\/li><li>Application of heat or cold (according to tolerance)<\/li><li>Gentle massage on non-hypersensitive areas<\/li><li>Meditation and mindfulness<\/li><\/ul><\/div><h3 id=\"cuidados-sono\">Sleep care<\/h3><div><ul><li>Keeping regular hours<\/li><li>Create a comfortable environment<\/li><li>Avoid caffeine and screens before going to bed<\/li><li>Consider positions that reduce pressure on painful areas<\/li><\/ul><\/div><h3 id=\"atividade-fisica-adaptada\">Adapted physical activity<\/h3><div><ul><li>Low-impact physical exercise, prescribed by the Physiotherapist<\/li><li>Hydrotherapy<\/li><li>Gentle stretches<\/li><\/ul><\/div><h3 id=\"gestao-stress\">Stress management<\/h3><div><ul><li>Maintaining hobbies and pleasurable activities<\/li><li>Participation in support groups<\/li><li>Talking about the condition with family and close friends<\/li><\/ul><\/div><h3 id=\"cuidados-gerais\">General care<\/h3><div><ul><li>Protection of hypersensitive areas<\/li><li>Wear soft, non-tight clothing<\/li><li>Special care with temperature<\/li><li>Proper nutrition - B vitamins are important<\/li><\/ul><p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-454\" title=\"Anxiety talk\" src=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2024\/03\/imagem-9-artigo-6.webp\" alt=\"A ansiedade e os seus familiares diretos - Neuropsiquiatria\" width=\"720\" height=\"480\" srcset=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2024\/03\/imagem-9-artigo-6.webp 1000w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2024\/03\/imagem-9-artigo-6-300x200.webp 300w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2024\/03\/imagem-9-artigo-6-768x512.webp 768w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><\/p><\/div><h2 id=\"avancos-na-investigacao-cientifica\"><strong>Advances in scientific research<\/strong><\/h2><div><div><p>Research into neuropathic pain is constantly evolving, bringing <strong>new hopes<\/strong> for patients. <strong>Here are some of the most promising advances<\/strong>:<\/p><\/div><\/div><h3 id=\"cannabis-medicinal-no-tratamento\">Medical cannabis in treatment<\/h3><div><p>A <strong data-start=\"25660\" data-end=\"25677\">cannabis<\/strong> represents a promising therapeutic approach for the treatment of neuropathic pain, a condition often resistant to conventional treatments.<\/p><\/div><h3 id=\"neuromodulacao-e-novos-tratamentos\">Neuromodulation and new treatments<\/h3><div><ul><li><strong>Advanced stimulation techniques<\/strong><ul><li>Stimulation of peripheral nerves can interrupt pain signals travelling through the nerves, providing relief to patients with <strong>localised neuropathic pain<\/strong> <strong><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7828608\/\">(study)<\/a><\/strong><\/li><\/ul><\/li><\/ul><\/div><div><ul><li><strong>Recent developments<\/strong><ul><li>High frequency stimulation <strong><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11571607\">(study)<\/a><\/strong><\/li><li>Burst stimulation <strong><a href=\"https:\/\/www.mdpi.com\/2227-9059\/12\/5\/930\">(study)<\/a><\/strong><\/li><li>Closed systems with biofeedback <strong><a href=\"https:\/\/bioelecmed.biomedcentral.com\/articles\/10.1186\/s42234-024-00163-4\">(study)<\/a><\/strong><\/li><\/ul><\/li><\/ul><\/div><div><h3>Biomarkers and personalised medicine <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9130475\">(study)<\/a><\/h3><ul><li>Identification of genetic profiles<\/li><li>Biomarkers of response to treatment<\/li><li>Targeted therapies based on pain phenotype (type)<\/li><\/ul><\/div><div><h3>Regenerative therapies <a href=\"https:\/\/ej-med.org\/index.php\/ejmed\/article\/view\/2030\/1473\">(study)<\/a><\/h3><ul><li>Neural growth factors<\/li><li>Stem cell therapy<\/li><li>Regenerative medicine for peripheral nerves<\/li><\/ul><h2><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-2982\" title=\"Genetic Discovery and Biomarkers - Neuropathic Pain Research\" src=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/image-10.webp\" alt=\"Ilustra\u00e7\u00e3o cient\u00edfica mostrando laborat\u00f3rio de pesquisa com microsc\u00f3pio e an\u00e1lise celular de danos neurais e biomarcadores gen\u00e9ticos\" width=\"726\" height=\"508\" srcset=\"https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/image-10.webp 1280w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/image-10-300x210.webp 300w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/image-10-1024x717.webp 1024w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/image-10-768x538.webp 768w, https:\/\/neuropsiquiatria.pt\/wp-content\/uploads\/2025\/07\/image-10-18x12.webp 18w\" sizes=\"(max-width: 726px) 100vw, 726px\" \/><\/h2><h2><strong>Myths and Truths about Neuropathic Pain<\/strong><\/h2><\/div><p>It is essential to clear up misconceptions about this condition:<\/p><div><table><tbody><tr><td><strong>Myth<\/strong><\/td><td><strong>Truth<\/strong><\/td><\/tr><tr><td><strong>\"The pain is only in the head\"<\/strong><\/td><td>Neuropathic pain has a real neurobiological basis and can be measured through specific tests.<\/td><\/tr><tr><td><strong>\"Pain medication solves the problem\"<\/strong><\/td><td>Conventional analgesics and anti-inflammatories have limited efficacy in neuropathic pain, and specific treatments are needed.<\/td><\/tr><tr><td><strong>\"It's a rare condition\"<\/strong><\/td><td>It affects 7-10% of the European population and is more common than you might think.<\/td><\/tr><\/tbody><\/table><\/div><h2 id=\"recursos-e-apoio-disponiveis-em-portugal\"><strong>Resources and support available in Portugal<\/strong><\/h2><div><div><p>Portugal has several <strong>organisations and resources to support people with neuropathic pain<\/strong>:<\/p><\/div><\/div><div><table><tbody><tr><td><strong>Resource<\/strong><\/td><td><strong>Description<\/strong><\/td><\/tr><tr><td><a href=\"https:\/\/www.aped-dor.org\/\"><strong>APED - Portuguese Association for the Study of Pain<\/strong><\/a><\/td><td>Leading organisation in promoting knowledge about pain in Portugal<\/td><\/tr><tr><td><a href=\"https:\/\/sip-pt.pt\/noticias\/\"><strong>SIP Portugal<\/strong><\/a><\/td><td>Platform that brings together health professionals and patient organisations<\/td><\/tr><tr><td><strong>SNS 24 line<\/strong><\/td><td>24-hour telephone support: 808 24 24 24<\/td><\/tr><tr><td><strong>Hospital Pain Units<\/strong><\/td><td>22 specialised units throughout the country<\/td><\/tr><tr><td><strong><a href=\"https:\/\/www.dor.com.pt\/\">DOR.com<\/a><\/strong><\/td><td>Site dedicated to Pain<\/td><\/tr><\/tbody><\/table><\/div><div><div><p>In <strong>NeuroPsyque<\/strong>We are part of a network of specialised care, offering a response that combines <a href=\"https:\/\/neuropsiquiatria.pt\/en\/neurologia\/\">Neurology<\/a>, <a href=\"https:\/\/neuropsiquiatria.pt\/en\/centro-de-neuroterapia\/\">Neurotherapy<\/a> e <a href=\"https:\/\/neuropsiquiatria.pt\/en\/fisioterapia\/\">Physiotherapy<\/a>. Our commitment is, as always, to provide you with the greatest possible expectation of improvement.<\/p><\/div><div><p>We have <a href=\"https:\/\/neuropsiquiatria.pt\/en\/estimulacao-magnetica-transcraniana\/\" data-start=\"33538\" data-end=\"33572\">Transcranial Magnetic Stimulation<\/a>, <a href=\"https:\/\/neuropsiquiatria.pt\/en\/neurofeedback-e-qeeg\/\">Neurofeedback<\/a> e <a href=\"https:\/\/neuropsiquiatria.pt\/en\/estimulacao-eletrica-transcraniana\/\" data-start=\"33613\" data-end=\"33657\">Transcranial Direct Current Stimulation<\/a>which have proved important in the treatment of <strong data-start=\"33769\" data-end=\"33784\">neuropathic pain<\/strong>. <strong><a href=\"https:\/\/neuropsiquiatria.pt\/en\/contactoselocalizacao\/\">Book your appointment with us!<\/a><\/strong><\/p><\/div><\/div><h2 id=\"conclusao-dor-neuropatica\"><strong>Conclusion<\/strong><\/h2><div><div><p>A <strong data-start=\"34211\" data-end=\"34226\">neuropathic pain<\/strong> is a complex condition that affects millions of people worldwide, including <strong>hundreds of thousands in Portugal<\/strong>. Although it represents a significant challenge, it is important to emphasise that <strong>it's not a sentence of permanent suffering<\/strong>.<\/p><\/div><div><p>Scientific advances in recent years have brought new treatment prospects - from more effective drugs to neuromodulation, the therapeutic options continue to expand. The expansion of knowledge about genetics brings promising possibilities, and the <a href=\"https:\/\/neuropsiquiatria.pt\/en\/estimulacao-magnetica-transcraniana\/\" data-start=\"34861\" data-end=\"34895\">Transcranial Magnetic Stimulation<\/a> shows efficacy in modulating pain perception.<\/p><\/div><div><p>The key to success lies in <strong>early diagnosis and specialised treatment<\/strong>. Each person is unique, and finding the ideal therapeutic combination may take time and adjustments, but it's worth persevering.<\/p><\/div><div><p>If you live with symptoms that might suggest <strong data-start=\"35467\" data-end=\"35482\">neuropathic pain<\/strong>don't hesitate to seek specialised help. Silent suffering has no place. <strong><a href=\"https:\/\/neuropsiquiatria.pt\/en\/contactoselocalizacao\/\">Book your appointment with us!<\/a><\/strong><\/p><\/div><\/div><h2 id=\"faqs-dor-neuropatica\"><strong>FAQ's on Neuropathic Pain<\/strong><\/h2><div><div><h3>1. Can neuropathic pain be cured?<\/h3><p>Although there is no definitive \"cure\" for all forms of <strong data-start=\"36545\" data-end=\"36560\">neuropathic pain<\/strong>The symptoms can be very well controlled with appropriate treatment. The aim is to reduce the pain so that it is less debilitating, allowing for a normal and productive life.<\/p><\/div><div><h3>2. What are the most characteristic symptoms?<\/h3><p>The most common are continuous burning pain, shock sensations and mechanical allodynia. Patients often describe sensations of a \"hot iron\", \"electric shocks\" or \"thousands of needles\".<\/p><\/div><div><h3>3. How is the diagnosis made?<\/h3><p>Diagnosis is based mainly on anamnesis and neurological physical examination. There is no specific test, but questionnaires such as the <a href=\"https:\/\/aped-dor.org\/socios\/material_bibliografico\/diversos_QuestEspecificoRastreioDorNeuropatica-DN4.pdf\" data-start=\"37397\" data-end=\"37401\">DN4<\/a> and complementary tests (<a href=\"https:\/\/www.hospitaldaluz.pt\/pt\/exames\/eletromiograma-emg-#tabp-0\" data-start=\"37429\" data-end=\"37449\">electroneuromyography<\/a>magnetic resonance imaging) can support the diagnosis.<\/p><\/div><div><h3>4. Is neurotherapy effective for neuropathic pain?<\/h3><p>Yes, techniques such as <a href=\"https:\/\/neuropsiquiatria.pt\/en\/estimulacao-magnetica-transcraniana\/\" data-start=\"37699\" data-end=\"37733\">Transcranial Magnetic Stimulation<\/a> have shown promising results in modulating pain perception. Neurotherapy represents a lower risk alternative to pharmacological treatments, acting on the <a title=\"Neuroplasticity: The Brain&#039;s Superpower\" href=\"https:\/\/neuropsiquiatria.pt\/en\/neuroplasticidade-o-superpoder-do-cerebro\/\" data-start=\"37953\" data-end=\"37969\">neuroplasticity<\/a>.<\/p><\/div><div><h3>5. How long does the treatment take?<\/h3><p>The time varies according to the individual case. Medications can take 6-12 weeks to show full effect. Neurotherapy can show benefits more quickly, but requires regular sessions for lasting results.<\/p><\/div><div><h3>6. Can I work with neuropathic pain?<\/h3><p>With appropriate treatment and possible adaptations in the workplace, many people are able to maintain their professional activity. The important thing is to seek specialised support to optimise symptom control.<\/p><\/div><div><h3>7. Can neuropathic pain get worse over time?<\/h3><p>Without proper treatment, symptoms can intensify. However, with specialised monitoring and appropriate treatment, it is possible to stabilise or even improve the condition.<\/p><\/div><div><h3>8. Are there support groups in Portugal?<\/h3><p>Yes, there are various associations and support groups for sharing experiences about chronic pain. Some resources are listed above!<\/p><\/div><h3>9. How do I explain the condition to my family?<\/h3><p>Show them this article! It's important to educate family members about the reality of neuropathic pain, emphasising that pain is real even without visible external signs. Educational materials and participation in consultations can help with understanding.<\/p><div><h3>10. Does physical exercise help or harm?<\/h3><p>Adapted and gradual exercise can be beneficial, but it should be guided or prescribed by a specialised physiotherapist. Physical activity helps to prevent muscle atrophy and maintain range of movement, but must respect individual limits.<\/p><\/div><div><h3>11. What are the side effects of the medicines?<\/h3><p>Gabapentinoids (pregabalin, gabapentin) can cause drowsiness, dizziness, weight gain and oedema. Antidepressants can affect sleep and appetite.<\/p><\/div><div>\u00a0<\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>O Guia Completo para Compreender, Diagnosticar e Tratar Estima-se que a dor neurop\u00e1tica afete 7-10% da popula\u00e7\u00e3o europeia, mas em Portugal muitos casos permanecem subdiagnosticados. Ser\u00e1 apenas &#8220;uma dor mais forte&#8221;? Imagine acordar todas as manh\u00e3s com a sensa\u00e7\u00e3o de que milhares de agulhas percorrem as suas pernas, ou que um ferro quente est\u00e1 constantemente [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":2999,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2879","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-geral"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/posts\/2879","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/comments?post=2879"}],"version-history":[{"count":85,"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/posts\/2879\/revisions"}],"predecessor-version":[{"id":3231,"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/posts\/2879\/revisions\/3231"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/media\/2999"}],"wp:attachment":[{"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/media?parent=2879"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/categories?post=2879"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neuropsiquiatria.pt\/en\/wp-json\/wp\/v2\/tags?post=2879"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}