This condition can be mild or severe, and it can be persistent or come and go. It is called neuropathic pain, and it is often caused by the following health conditions. For example, shingles, diabetes, and central nervous system disorders, but it may also happen due to other diseases. In most cases, doctors prescribe a combination of treatments to treat neuropathic pain. These include medicines, physical therapy, psychological counseling, and surgery.
In other words, this condition is nerve pain that occurs due to damage to the nervous system. This pain may occur in different parts of the body, depending on where damage occurs. For example, the peripheral nerves, the spinal cord, and the brain. While the central nervous system includes the brain and spinal cord, the nerves from the rest of the body are called the peripheral nervous system.
The medical term “neuropathy” means a disturbance or functional changes in one or multiple nerves. For instance, approximately 30% of neuropathy cases happen due to diabetes. However, there are hundreds of other disorders that may also cause it. These include HIV/AIDS, alcohol use disorder, shingles, and others.
Symptoms
Usually, people with neuropathic pain experience the following symptoms. For example:
- Spontaneous pain (pain that occurs without an obvious reason) – This type of pain can be burning, stabbing, electric shock-like pain, numbness, or tingling.
- Allodynia – It occurs when cold, pressure, or brushing against the teeth causes pain. In other words, it is an extreme sensitivity to touch.
- Hyper- and hypoalgesia – These symptoms occur when painful stimuli cause extreme pain or reduced pain response.
- Dysesthesia – Unexpected sensations that feel strange, unpleasant, or painful.
- Insomnia – Sometimes, people with neuropathic pain may have sleep disturbances. They may also experience emotional stress.
Do not hesitate to visit a doctor if any of the previous symptoms occur without an obvious reason.
Causes
There are multiple causes of neuropathic pain. Check some of them below:
- Diabetes
- Facial nerve conditions
- HIV infection
- Alcohol use disorder
- Complex regional pain syndrome
- Shingles
- Central nervous system conditions (including stroke, multiple sclerosis, Parkinson’s disease, and others)
- Amputation (this procedure may cause phantom limb pain)
- Radiation therapy
- Chemotherapy drugs (such as Cisplatin, Paclitaxel, or Vincristine)
- Spinal nerve compression or inflammation
- Tumors that can put pressure on certain nerves in the body
- Surgeries or trauma that cause nerve damage
Complications
People with neuropathic pain may also experience some complications. Examples include:
- Sensory loss – People who do not feel pain may have unnoticed injuries, burns, and infections.
- Foot problems – These include foot ulcers, Charcot joint deformity, and gangrene.
- Muscle dysfunction – It includes weakness, atrophy, paralysis, poor coordination, and an increased fall risk.
- Autonomic problems – For example, abnormal heart rhythm, circulation issues, bladder or digestive dysfunction, and others.
- Mental health conditions – These include major depressive disorder, anxiety, and others.
- Cognitive impairment – Some people may experience memory problems and general malaise.
The previous list does not contain a complete list of complications. However, you can consult with your healthcare professional about measures to reduce the risk of the previous ones.
How to Prevent Neuropathic Pain?
It is not always possible to prevent this condition, but you can take some steps to reduce the risk. These include:
- Quit smoking – If you have problems with smoking cessation, discuss it with your physician.
- Physical exercise – Doctors often recommend aiming for 30 minutes of physical exercise per day, at least 5 days a week. It also helps get and maintain a healthy weight.
- Limit or avoid alcoholic drinks
- Manage chronic health conditions – For example, diabetes, high cholesterol, hypertension (high blood pressure), and others.
Diagnosis
Physicians usually diagnose this condition based on symptoms and a physical examination. During this examination, they will check for abnormalities linked to the condition. Once you are diagnosed with neuropathic pain, doctors may perform some tests to determine the underlying cause. For example, imaging tests, blood tests, and others.
Treatment
Healthcare professionals typically prescribe different treatments for individuals with this condition, as the treatment depends on the severity and underlying cause of the disease, age, overall health, and individual preferences. Generally, the treatment goal is to address the underlying condition, alleviate pain, maintain functionality, and enhance your quality of life. Mostly, doctors recommend a combination of the following treatments. Check some examples below:
- Over-the-counter (OTC) medicines – These are nonprescription medicines used to provide pain relief. Usually, they recommend Acetaminophen or Ibuprofen.
- Antiseizure medicines – Healthcare providers do not fully understand why this group of medicines works so well for some people with neuropathic pain.
- Antidepressants – These medications are often recommended to treat complications of neuropathic pain that may occur in some people. For example, depression, anxiety, and other mental health problems.
- Topical treatments – Doctors often recommend creams, ointments, or gels with Lidocaine or Capsaicin to ease pain caused by this condition. You should apply these medicines directly to the affected area.
- Nerve blocks – In some cases, doctors may prescribe injections to relieve pain.
- Physical therapy – During this therapy, doctors will teach you specific exercises to relieve soreness, stiffness, and discomfort caused by neuropathic pain.
- Surgery – In more severe cases or when the previous medicines do not work, doctors may recommend surgery to ease pain.
- Psychological counseling – This is an additional treatment that helps you cope with emotional stress.
When the previous treatments do not work, you may need spinal cord stimulation, peripheral nerve stimulation, or brain stimulation. In any case, you should consult with your doctor about the benefits and risks before choosing any of them.
Frequently Asked Questions
When should I go to the ER?
Immediately call 911 or go to the nearest emergency room (ER) if any of the following symptoms occur. For example:
- Severe numbness, weakness, or pain
- Dizziness
- Fainting
- Fast or irregular heart rhythm
- Difficulty urinating
What is the most common neuropathic pain?
In general, there are multiple causes of nerve pain, but the most common one is diabetes-related neuropathy. It accounts for about 30% of all diagnosed cases.
What vitamin deficiency causes nerve pain?
Some people may also develop this condition due to deficiencies in B vitamins (especially vitamin B12). However, for proper nerve function and repair, vitamins B1 (also known as Thiamine) and B6 are also important. If you have additional questions, ask your healthcare provider.
