Neuropathic pain is pain caused by injury or damage to nerves.
Neuropathic pain can be caused by:
Neuropathic pain feels different from most other types of pain. It is often described as sharp, stabbing, or burning. It may feel like an electric shock. It may be worse at night. The pain may be constant after a stroke or if you have diabetic neuropathy of the feet and legs. The pain may come and go if you have trigeminal neuralgia (nerve pain in the face, teeth, mouth, or nasal cavity) or sciatic pain (a form of low back pain that runs down your leg, causing pain, numbness, or tingling in the leg).
Kinds of neuropathic pain include:
Neuropathic pain can come from just one nerve. The kind of pain and where you feel it depends on what nerves are affected. Some of the more common pain problems are:
Your healthcare provider will ask about your symptoms and medical history. He or she will examine you. Tests such as X-rays, blood tests, scans, and nerve conduction tests may be done to try to find the specific cause of the pain. Your healthcare provider may also refer you to a neurologist, neurosurgeon, or physiatrist for additional testing.
Nonprescription and prescription pain medicines sometimes work well for neuropathic pain. If these medicines do not work well for you, your healthcare provider may prescribe antidepressants or antiseizure medicines that interfere with pain signals to the brain. They may be used alone or with other drugs. These medicines take days or weeks to work, so you must take the medicine every day on a set schedule to reduce the pain. These medicines rarely take away the pain completely, but they can help reduce it to a level you can tolerate.
Other treatments may include:
Your primary care provider will probably first recommend trying basic pain medicines and nonmedical treatments like heat or ice. He or she may refer you for physical therapy, massage, or manipulations. Biofeedback or use of a TENS device may be prescribed. If these things do not help your pain, your provider will most likely refer you to a pain specialist or pain clinic.
A pain specialist usually is needed if you are going to have nerves blocked by anesthetic shots or if you might have any type of nerve surgery. Shots of drugs into or around the nerve can deaden the nerve, providing pain relief that is sometimes temporary and sometimes permanent. If the pain relief is good but temporary, sometimes a permanent nerve block can be done using electrosurgery or radiowave surgery. This may result in numbness in the area where the pain used to be.
Studies have not yet shown that herbal medicine treatments work well in the treatment of pain. Acupuncture or acupressure have also been studied and don’t work very well. Some people might get wonderful relief, but that is not common. Capsaicin cream does work better than placebo creams, but the relief is not total.
Some chronic pain problems do not go away. Other problems hurt for awhile, and then the pain mostly goes away. Often the pain goes away because the nerve is so damaged that it stops working altogether. When this happens, the pain starts to feel like cold or numbness.
Neuropathic pain is a long-term, frustrating problem. You can help yourself by acknowledging that you will have some good days and some bad days. Going up and down with medicines or other treatments can be distracting and not very helpful with pain management. Often, your goal needs to be getting some pain relief and focusing on getting back to the things you enjoy or need to do.
Try hard to avoid narcotic pain medicines for neuropathic pain. The development of tolerance and the need for higher and higher doses can become a serious long-term problem if you start using narcotic (opioid) drugs as treatment for a chronic pain condition. If you do start narcotic pain medicine, your healthcare provider may ask you to sign an agreement about how you will and won’t use these addictive medicines.
