Nociceptive versus Neuropathic Pain

The receipts behind Chapter 20

Her knee replacement was a surgical success, and the pain was worse than before the operation. The knee was never the problem: a nerve cut during the operation had become a generator, and for two years it was treated in a language it does not speak. In Chapter 20 I show how to tell a working alarm from a broken one, why the wrong drug keeps winning in the prescribing record, and why the examination that sorts them takes ninety seconds.

The book makes the argument. This Deep Dive shows the evidence, claim by claim: the study, who was in it, the number and where it sits in the paper, what it does not show — and the questions to bring to your own physician. It is written to be handed to your doctor.

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Frequently asked questions

What is the difference between nociceptive and neuropathic pain?

Nociceptive pain is a working alarm: tissue such as a joint is signaling a real problem. Neuropathic pain comes from a nerve that has itself become the generator, a broken alarm, and it needs different treatment. Treating one as the other means treating the pain in a language it does not speak, the mistake Chapter 20 of The Pained Brain is written to prevent.

Can a knee replacement cause nerve pain?

It can. In Chapter 20, a woman’s knee replacement was a surgical success, and the pain was worse than before the operation. The knee was never the problem: a nerve cut during the operation had become a generator, and for two years it was treated in a language it does not speak. The chapter shows how to tell a working alarm from a broken one.

How long does it take to tell nerve pain from joint pain?

Ninety seconds. That is how long the examination that sorts nociceptive pain from neuropathic pain takes. Chapter 20 also shows why the wrong drug keeps winning in the prescribing record. The Deep Dive gives the evidence behind the chapter, 41 pages and 107 verified references, written to be handed to your doctor.

Educational material. Not medical advice. If you are in the St. Louis area and want this looked at properly, that is what the Padda Institute is for.