Neuropathic pain in children

What is neuropathic pain in children?

Neuropathic pain – or pain arising from a disease, lesion or injury affecting the sensory nerves – is much more common in adults than children due to complications of diabetes, stroke, and other conditions.

However, some neuropathic conditions are becoming increasingly recognized in children and adolescents, including complex regional pain syndrome (CRPS), phantom limb pain, spinal cord injury, trauma and postoperative neuropathic pain, autoimmune and degenerative neuropathies (such as Guillain-Barre syndrome and Charcot-Marie-Tooth disease) and the effects of cancer disease processes and treatment.

Phantom limb pain is relatively common in children who have undergone amputation because of a congenital deformity, trauma or infection, or cancer. Some cases of neuropathic pain have been reported in children who’ve recently undergone surgery or been involved in a traumatic event – such as a car accident. Certain rare autoimmune diseases – like Guillain-Barre syndrome – cause the body to attack the peripheral nervous system, which, in turn can lead to pain. Additionally, certain metabolic diseases can also lead to nerve pain.

What are the signs and symptoms of neuropathic pain in children?

If your child is experiencing neuropathic pain, he or she may complain of chronic (ongoing) pain that’s sharp, stabbing or shooting. Even a light touch, such as that from clothing or sheets, may provoke pain.

How is neuropathic pain in children diagnosed?

• Physical exam - Your child’s provider will conduct a complete physical examination and take a thorough medical history of your child to determine the cause of his or her neuropathic pain. The provider may also test your child’s reflexes, muscle strength and tone, ability to feel certain sensations, posture and coordination.

• Imaging - The provider may order imaging tests – like X-rays, CT scans, or MRIs – to check for injuries, anatomical problems and other conditions that could be affecting your child’s nerves.

• Nerve conduction test - Your child's provider may also order a nerve conduction test to measure signals from sensory nerves.

• Other test and referrals - If your provider suspects your child may have an underlying autoimmune condition, metabolic disease or connective tissue disorder, he or she may order additional blood tests and/or refer your child to a rheumatologist, endocrinologist or geneticist.

How is neuropathic pain in children treated?

In some cases, neuropathic pain is relieved when the underlying illness or injury is treated. For more stubborn cases – or to manage pain while your child awaits or undergoes treatment – the Pediatric Pain Management Center at Children’s Health can help.

Your child may receive one, or a combination of several treatments, including:

• Pain relievers – over-the-counter or prescription

• Anti-seizure or anti-depressant medications, which can ease  neuropathic pain

• Topical creams or patches

• Physical therapy

• Occupational therapy

• Desensitization therapy

• Exercise

• Psychological counseling

• Electrode nerve stimulation

• Lifestyle changes, such as weight loss or activity modifications

• Massage therapy

• Acupuncture

• Nerve blocks

• Surgery