Addressing the Issue of Nerve Pain

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Addressing the Issue of Nerve Pain

• A Presentation from the Neuropathic Pain Network
  (NPN)
• INSERT NAME, TITLE, AFFILIATION

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What is Neuropathic Pain?

• Chronic pain caused by injury or disease of the
  nervous system
• Seems to have no cause and responds poorly to
  standard therapies
• Can last indefinitely and even increase over time
• Results in severe disability

Wall PD. Textbook of Pain. 4th ed. 1999 Dworkin
RH, et al. Arch of Neuro. 2003601524-1534
Belgrade MJ. Postgraduate Medicine.1999106(6)127
-140.
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How Neuropathic Pain Occurs

• Millions of nerves are linked throughout the body
• Nerves enable the brain and body to communicate
• If you accidentally grab a hot iron, nerves in
  your hand send a message to the brain that you
  are touching something hot. As a result, your
  hand feels a burning pain

Price SA. Pathophysiology Clinical Concepts of
Disease Processes. 5th ed 1997
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How Neuropathic Pain Happens

• When nerves become damaged or injured, they stop
  working properly
• May send the wrong signal to the brain
• Injured nerves might tell the brain that your
  foot is experiencing burning pain even when you
  arent stepping on something hot
• Nerves can be injured or damaged in a number of
  ways, including a spinal cord injury or a medical
  condition such as diabetes, shingles or a stroke

Price SA. Pathophysiology Clinical Concepts of
Disease Processes. 5th ed 1997
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What are the symptoms?

• Frequently results in a burning, tingling and
  shock-like sensation
• Experience of pain to things that are often
  non-painful, such as to bed sheets or socks
• Pain can persist even after the cause has been
  removed
• Abnormal sensations that are described as pins
  and needles
• The symptoms can be mild to incapacitating and
  are often progressive
• Symptoms often worse at night

Wall PD. Textbook of Pain. 4th ed. 1999.
Dworkin RH, et al. Arch of Neuro.
2003601524-1534 Jude EB. Clinics in Pod Med
and Surg. 19991681-97 Weiner RS. Pain
Management A Practical Guide for Clinicians. 6th
ed. 2002 Galer BS. Neurol. 199545(Suppl
9)S17-S25.
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Neuropathic Pain is Different from
Muscle/skeletal Pain
Wall PD. Textbook of Pain. 4th ed 1999 Jude EB.
Clin in Pod Med and Surg.19991681-97 Price SA.
Pathophysiology Clinical Concepts of Disease
Processes. 5th ed 1997 Goldman L. Cecil
Textbook of Medicine. 21st ed 2000
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Symptoms of Neuropathic Pain Characterized
Differently
Muscle/Skeletal Pain
Neuropathic Pain
Price SA. Pathophysiology Clinical Concepts of
Disease Processes. 5th ed 1997 Galer BS et al.
Diabetes Res Clin Pract. 200047123-128
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Incidence/Prevalence

• Up to 7.7 of people in Europe have neuropathic
  pain
• 3 million people, or 7.5 in the United Kingdom
• 2.5 million people, or 6.4 in France
• 3.5 million people, or 6.0 in Germany
• 2.1 million people, or 7.7 in Spain
• It often is under-diagnosed and under-treated

Bennett G. Hosp Pract. 199895-114 Patient Flow
Study. Mercer Management Consulting July 2,
2002 Dickinson T. Trends in Pharmacol Sci.
200324555-557.
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Emotional and Social Impact of Neuropathic Pain

• People with neuropathic pain report
• Difficulty sleeping
• A lack of energy
• Drowsiness
• Difficulty concentrating
• Strained relationships with family and friends
• An inability to work, walk, or even wear clothes
  as the contact with their skin can cause an
  unbearable burning pain

Meyer-Rosberg K. Euro J of Pain. 20015379-389
Berger A.. Pain. 20045(3)143-9
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What is the Neuropathic Pain Network?

• Mission
• The NPN is a coalition of organizations that
  exists to actively support people with
  neuropathic pain by enabling them to better cope
  with their pain, to obtain the best treatment
  and, ultimately, to improve the quality of their
  lives

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NPN Objectives

• To raise awareness and educate those
  organizations who have the ability to impact the
  treatment (by society and medical management) of
  people with neuropathic pain
• To help people with neuropathic pain access the
  most appropriate treatment and provide them the
  support to improve their lives

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NPN Steering Committee

• Harry Kletzko (German Pain League) Chair
• Raymond Berggren (Swedish Association for Pain)
• Penney Cowan (American Chronic Pain Association)
• Ian Semmons (UK Action on Pain)

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NPN Coalition Members
In 2005, the NPN Steering Committees goal was to
recruit an additional five members. By April
2005, this goal was exceeded and 10 new member
organizations joined the NPN. The NPN comprises
14 organizations to date. New
members include

• Canada Canadian Pain Coalition
• Chile Chile Diabetic Association
• Denmark Danish Chronic Pain Association
• Finland Finnish Pain Patient Association
• France French Association of Diabetes
• Italy Italian Neuropathy Association
• Mexico Mexican Association for the Study and
  Treatment of Pain
• Peru Patients of the Peruvian Diabetes
  Association
• Portugal Portuguese Association for the Study of
  Pain
• Spain European League of Diabetics

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NPN Milestones
NPN launches Web site
NPN Steering Committee Formed
NPN recruits new members hosts
firstAll-MemberMeeting
NPN hosts firstJournalist Press Briefing
1st face-to-face Steering Committee Meeting
2004
2005
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NPN Web Site

• First consumer Web site offering neuropathic pain
  educational information launched 15 October 2004
• Many of the visitors are from the U.S., U.K.,
  Sweden, Germany, Singapore, Turkey, Japan,
  Finland, South Korea and Canada

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www.neuropathicpainnetwork.org
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Future Activities of the NPN

• Support patients provide access to information
• Resource tools for patients and physicians