Caring for Face Pain and Sleep Apnea
Rich Hirschinger, DDS, MBA
Diplomate American Board of Orofacial Pain
9615 Brighton Way, Suite 323
Beverly Hills, CA 90210
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History of Neuropathic Pain

Neuropathic pain conditions have a long history of misdiagnosis as mechanisms are complex, often dependent on multiple factors, and are the result of causes that remain unclear. The healthcare establishment frequently dismissed some orofacial neuropathies as psychosomatic, or imagined conditions originating in the mind.

Atypical odontalgia, or phantom tooth pain, is an example of a condition that was often thought to be imagined pain. The mainstream healthcare community did not recognize phantom pain symptoms until the 1940's.

Complex regional pain syndrome has previously been known by the names "reflex sympathetic dystrophy syndrome" and "causalgia." During the Civil War, "causalgia" was coined describe the pain felt by war veterans long after wounds had healed.

Trigeminal neuralgia, a common orofacial neuropathic pain condition, has been recognized in medical literature dating back to the first century A.D. in the writings of ancient Greek physician Aretaeus. However, without an adequate understanding of the mechanisms behind the condition, early treatments included the application of poisons like arsenic, hemlock and animal venom. Nicolaus Andre, an 18th century French surgeon, coined the term "tic douloureux" to describe the condition. The phrase translates as "painful spasm." Other common neuropathies that affect the orofacial region have a much more recent history of recognition and research. The first medication to treat trigeminal neuralgia was not discovered until the 1940's.

Today, the National Institutes of Health conduct research into neuropathic pain conditions through its National Institute of Neurological Disorders and Stroke (NINDS). Through this national government organization, biomedical research of disorders of the nervous system and brain are uncovering insights into the mechanisms that cause and perpetuate chronic neuropathic pain. Better medical and surgical treatments for nerve pain disorders are a major goal of studies and research.