Neuropathic Pain

Overview

Definition

Neuropathic pain is pain from hurt or poorly working nerves. It may also be from problems in how these nerves send signals to the nervous system.

Nervous System
CNS and PNS
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Causes

This pain may be caused by hurt nerve fibers that send pain signals to your brain. This can happen even when there is no event to start 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 from:

  • Physical damage
  • Chemicals
  • The nerve not getting the vital nutrients needed to work
  • Infection
  • The body’s immune system attacking the nerves

Sometimes the cause of the nerve pain is unknown.

Risk Factors

Certain health problems raise 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
  • Lack of vitamins
  • Spinal cord problem or injury
  • Cancer
  • Carpal tunnel syndrome
  • Health problems that are present at birth

It may also be raised due to:

  • Back surgery
  • Chemotherapy
  • Being around toxins or metals
  • Certain medicines

SymptomsandDiagnosis

Symptoms

Neuropathic pain may cause feelings of:

  • Burning
  • Stabbing
  • Electrical shock
  • Pins and needles/tingling
  • Numbness

This pain may be all the time or come and go during the day. The pain can get in the way of daily activities like sleep. In some cases, even the touch of a bed sheet can cause pain.

Diagnosis

Your doctor will ask about your symptoms and health history. A physical exam will be done.

You may be sent to a neurologist to be checked or treated.

You may also be referred to a special doctor who can help you take care of your pain.

Treatments

Treatment

Talk with your doctor about the best plan for you. You may have:

Medications

There are a number of medicines that can help treat neuropathic pain. Some of these were made to treat other health problems. They have also been found to be useful for treating nerve pain.

Medicines to treat symptoms of peripheral neuropathy:

  • Antiseizure medicine
  • Antidepressants
  • Opioid pain relievers
  • Over the counter pain relievers, such as ibuprofen
  • Topical creams put on the skin or patches, such as capsaicin cream

It may take a while for your doctor to find the right medicine for you. You may need to take more than one medicine.

Herbals

In recent years, some states have approved marijuana for certain health problems. Some studies support using it for spasticity. Talk to your doctor about whether it is right for you. Find out whether it is a legal option where you live.

Other Options

  • Ask your doctor to suggest a safe exercise program. Being active will help your health.
  • Work with a therapist to help cope with pain. Joining a support group may also be helpful.
  • Talk to your family and friends about your health problem. They can offer help and support.
  • Learn relaxation techniques , such as meditation, to lower stress.
  • If you have another health problem, like diabetes, be sure to get care for it.

Procedures

Your doctor may advise nerve decompression. If pressure on the nerve is causing pain, surgery can relieve it. This can help lower the pain or make it go away.

If you are still not feeling better, your doctor may advise:

  • A nerve block—An anesthetic is injected into the painful site to block pain.
  • Pain pump—A pain pump can be placed in your body to give you pain medicine.
  • Nerve stimulators—This device is attached to the nerve and gives electrical signals to control pain.
  • Surgery can be done to block the hurt nerves from sending signals.

Prevention

You can lower your chance of getting neuropathic pain by getting care for any health problems, such as diabetes.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Pain, Neuropathic; Nerve Pain; Pain, Nerve)

RESOURCES

American Chronic Pain Association https://theacpa.org 

National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov 

CANADIAN RESOURCES

Canadian Diabetes Association http://www.diabetes.ca 

Chronic Pain Association of Canada http://chronicpaincanada.com 

References

Botez SA, Herrmann DN. Sensory neuropathies, from symptoms to treatment. Curr Opin Neurol. 2010;23(5):502-508.

Causes. The Foundation for Peripheral Neuropathy website. Available at: https://www.foundationforpn.org/what-is-peripheral-neuropathy/causes. Accessed June 22, 2018.

Peripheral neuropathy. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T474253/Peripheral-neuropathy  . Updated December 18,2 017. Accessed June 22 2018.

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.

7/20/2015 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T901291/Medical-uses-of-cannabinoids  : Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015;313(24):2456-2473.