(Pain, Neuropathic; Nerve Pain; Pain, Nerve)
Definition
Definition
Neuropathic pain is a painful sensation that occurs due to damaged or abnormally working nerves. It may also occur because of abnormalities in the central nervous system’s interpretation of the signals it is receiving from these nerves. The pain may be long-lasting.
Nervous SystemCopyright © Nucleus Medical Media, Inc.
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Causes
Causes
This condition may caused by damaged nerve fibers that send pain signals to your brain. This can happen even when there is no event to trigger the pain. For example, a person with neuropathic pain may have a feeling of pins and needles when putting on socks.
Nerve damage may be caused by:
- Physical damage
- Chemicals
- The nerve not getting the vital nutrients needed to function
- Infection
- The body’s immune system attacking the nerves
Sometimes the cause of the nerve pain is unknown.
Risk Factors
Risk Factors
Certain conditions increase your risk of getting neuropathic pain, such as:
- Diabetes— diabetic neuropathy
- Poor glucose tolerance
- Shingles— post-herpetic neuralgia
- HIV infection —HIV sensory neuropathy
- Amputation — phantom limb pain
- Alcohol use disorder
- Vitamin deficiency
- Spinal cord disorder or injury
- Cancer
- Carpal tunnel syndrome
- Conditions that are present at birth
Other risk factors include:
- Back surgery
- Chemotherapy
- Exposure to toxins or metals
- Certain medications
Symptoms
Symptoms
Neuropathic pain may cause sensations of:
- Burning
- Stabbing
- Electrical shock
- Pins and needles/tingling
- Numbness
This pain may be constant or occur off and on during the day. The condition can get in the way of daily activities, including sleep. In some cases, even the touch of a bed sheet can cause pain.
Diagnosis
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
You may be referred to a neurologist for further evaluation or treatment.
Depending on your condition, you may also be referred to a pain specialist who can help you manage your pain.
Treatment
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include:
Medications
There are a number of medications that are effective for treating neuropathic pain. Some of these, like antidepressants, were created to treat other conditions. They have also been found to be useful for treating nerve pain.
Examples of medications used to treat symptoms of peripheral neuropathy include:
- Anticonvulsants
- Antidepressants
- Opioid pain relievers
- Over-the-counter pain relievers, such as acetaminophen and ibuprofen
- Topical creams applied to the skin or patches, such as capsaicin cream or a patch with lidocaine
It may take a while for your doctor to find the right medication for you. You may need to take a combination of medications for pain relief.
Herbals
In recent years, some states have approved the use of medical marijuana for certain conditions. Some studies support the use of medical marijuana for chronic pain. Talk to your doctor about whether this treatment option is right for you and if it is legally available where you live.
Other Options
- Ask your doctor to recommend a safe exercise program. Being active will help your overall health.
- Work with a therapist to help cope with chronic pain. Joining a support group may also be helpful.
- Talk to your family and friends about your condition. They can offer help and understanding.
- Learn relaxation techniques, such as meditation, to reduce stress.
- If you have an underlying condition, like diabetes, be sure to get proper treatment for it.
Procedures
Your doctor may advise nerve decompression. If pressure on the nerve is causing pain, surgery can relieve it. This can help decrease the pain or make it go away.
If you are not getting relief from other treatments, your doctor may recommend:
- An injection of a nerve block—An anesthetic is injected into the painful area to block pain signals.
- Pain pump installation—A pain pump can be implanted into your body to deliver pain medication.
- Nerve stimulators—This device is attached to the nerve and delivers electrical signals to control pain.
- Surgery can be done to block the damaged nerves from sending signals.
Prevention
Prevention
You can reduce your chance of developing neuropathic pain by getting proper treatment for any chronic conditions, such as diabetes.
RESOURCES:
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov
CANADIAN RESOURCES:
Canadian Pain Coalition http://www.canadianpaincoalition.ca
References:
Rezania K, Soliven B, Rezai KA, Roos RP. Impaired glucose tolerance and metabolic syndrome in idiopathic polyneuropathy: The role of pain and depression. Med Hypotheses. 2011;76(4):538-542.
Types of neuropathic pain. The Neuropathy Association website. Available at:
http://www.neuropathy.org/site/News2?news_iv_ctrl=-1&page=NewsArticle&id=7775
Accessed May 30, 2014.
Understanding nerve pain. American Chronic Pain Association website. Available at:
http://www.theacpa.org/uploads/Final_Brochure.pdf
Accessed May 30, 2014.
7/20/2015 DynaMed’s Systematic Literature Surveillance
http://www.ebscohost.com/dynamed:
Whiting PF, Wolff RF, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015 Jun 23-30;313(24):2456-2473.
Last Updated: 7/20/2015