Neuropathic Pain

Overview

Definition

Neuropathic pain is pain from damage or disease of the nervous system.

Nervous System
CNS and PNS
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Causes

In some people, the cause of nerve pain is not known. In others, it may be caused by things like:

  • Trauma
  • Chemicals
  • The nerve not getting the nutrients needed to work
  • Infection, such as HIV
  • The body's immune system attacking the nerves

Risk Factors

Health problems that may raise the risk are:

  • Diabetes
  • Poor glucose tolerance
  • Shingles
  • HIV infection
  • Amputation
  • Alcohol use disorder
  • Lack of vitamins
  • Spinal cord problem or injury
  • Cancer
  • Carpal tunnel syndrome
  • Health problems that are present at birth

Other things that may raise the risk are:

  • Back surgery
  • Chemotherapy
  • Being around toxins or metals
  • Taking certain medicines

SymptomsandDiagnosis

Symptoms

The pain may be all the time or come and go during the day. Some problems may be:

  • Burning
  • Stabbing
  • Electrical shock
  • A feeling of pins and needles
  • Numbness

Diagnosis

You will be asked about your symptoms and health history. The doctor will ask what your pain is like and when it happens. A physical exam will be done. You may be sent to a doctor who treats the nervous system. You may also need to see a doctor who treats pain.

Tests that may be done are:

  • Blood tests to look for problems that may be causing the pain, such as a lack of certain vitamins and minerals
  • Nerve conduction tests to find out how well nerves are passing electrical signals
  • Electromyography (EMG) to measure the electrical activity in the nerves
  • A biopsy to look for problems that may be causing pain

Treatments

Treatment

Any underlying problems with need to be treated, such as diabetes.

The goal of treatment is to manage symptoms. Options are:

Medications

One or more of these medicines may be given to manage pain:

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

Some states allow residents to use medical marijuana for health problems. It may be helpful for people with neuropathic pain related to HIV.

Procedures

Nerve decompression surgery may be advised to ease pain. Other procedures that may be done are:

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

Prevention

The risk of neuropathic pain may be lowered by managing other 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

Barrell K, Smith AG. Peripheral Neuropathy. Med Clin North Am. 2019 Mar;103(2):383-397.

Causes. The Foundation for Peripheral Neuropathy website. Available at: https://www.foundationforpn.org/what-is-peripheral-neuropathy/causes. Accessed October 2, 2020.

Peripheral neuropathy. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/peripheral-neuropathy  . Accessed October 2, 2020.

7/20/2015 EBSCO DynaMed Systematic Literature Surveillance  https://www.dynamed.com/condition/peripheral-neuropathy  : Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015;313(24):2456-2473.