(Pain, Neuropathic; Nerve Pain; Pain, Nerve)
From the Health Library by Rebecca J. Stahl, MA
DefinitionNeuropathic pain is a painful sensation that occurs due to damaged or poorly functioning nerves. The pain may be long-lasting.
© 2011 Nucleus Medical Media, Inc.
CausesThis condition is caused by damaged nerve fibers that send pain signals to your brain. This happens even when there is no event to trigger the pain. For example, a person with neuropathic pain may experience a feeling of pins and needles when putting on socks.
Nerve damage may be caused by:
- Physical damage
- The nerve not getting the vital nutrients needed to function
- The body’s immune system attacking the nerves
Sometimes the cause of the nerve pain is unknown.
- Diabetes ( diabetic neuropathy)
- Shingles ( post-herpetic neuralgia)
- HIV infection (HIV sensory neuropathy)
- Amputation ( phantom limb pain)
- Vitamin deficiency
- Spinal cord disorder or injury
- Carpal tunnel syndrome
- Congenital (present at birth) conditions
- Back surgery
- Exposure to toxins or metals
- Certain medicines
SymptomsNeuropathic pain may cause sensations of:
- Electrical shock
- Pins and needles/tingling
This pain may be constant or occur off and on throughout the day. The condition can interfere with daily activities, as well as sleep. In some cases, even the touch of a bed sheet can cause pain.
If you have any of these symptoms, talk to your doctor.
DiagnosisYour doctor will:
- Ask about your symptoms and medical history
- Do a physical exam
You may be referred to a neurologist. This is a doctor who specializes in disorders of the nervous system. This doctor will do a neurological exam and other tests.
Depending on your condition, you may also be referred to a pain specialist who can help you manage your pain.
TreatmentTalk with your doctor about the best treatment plan for you. Treatment options include:
ProceduresYour chiropractic doctor may recommend nerve decompression. If pressure on the nerve is causing pain, non surgical decompression can relieve it. This can help decrease the pain or make it go away completely.
If you are not getting relief from other treatments, your chiropractic doctor may recommend referral for:
- 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 medicine.
- 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.
MedicationsThere are a number of medicines that have limited effectiveness for treating neuropathic pain. Some of these, like antidepressants, were created to treat other conditions. They have also been found to be marginally useful for treating nerve pain.
Examples of medicines used to treat symptoms of peripheral neuropathy include:
- Opioid pain relievers
- Over-the-counter pain relievers (eg, acetaminophen, ibuprofen)
- Topical creams (applied to the skin) or patches (eg, capsaicin cream or a patch with lidocaine)
It may take a while for your doctor to find the right medicine for you. You may need to take a combination of medicines for pain relief.
- Ask your doctor to recommend a safe exercise program. Being active will help your overall health.
- Work with your chiropractor or a therapist to help you 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, like meditation, to reduce stress.
- If you have an underlying condition, like diabetes, be sure to get proper treatment for it.
PreventionYou can reduce your chance of developing neuropathic pain by getting proper treatment for any spine movement problems or chronic conditions, such as diabetes.
American Chronic Pain Association
National Pain Foundation
Canadian Diabetes Association
Canadian Pain Coalition
Botez SA, Herrmann DN. Sensory neuropathies, from symptoms to treatment. Curr Opin Neurol . 2010;23(5):502-508.
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Neuropathic pain. Merck Manuals Online Medical Library website. Available at: http://www.merckmanuals.com/professional/sec16/ch209/ch209c.html . Updated February 2007. Accessed February 3, 2011.
Types of neuropathic pain. The Neuropathy Association website. Available at: http://www.neuropa... . Accessed February 3, 2011.
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