Neuropathic pain can arise from conditions such as diabetes, autoimmune disorders, infections, stretch injuries, nutritional disorders including deficiencies of vitamins or toxicity from vitamins, AIDS/HIV infections, alcoholism, and heavy metal toxicities. Ketamine and calcium channel blockers are potential treatments. When these modalities don’t work, the use of diagnostic and therapeutic blocks of the sympathetic chain should be considered since these conditions overlap with other sympathetic mediated pain. Some studies have shown certain states of different types of pain called allodynia may be mediated by a separate spinal cord receptor system. Ketamine has been shown to diminish components of this type of pain. If these treatments do not work, spinal cord stimulator/neuromodulation should be considered for a more permanent relief of pain.