The Understanding to Neuropathic (nerve) pain
By Neurosurgery Singapore
What is neuropathic pain?
Neuropathic pain is a pain condition that’s usually chronic. It’s usually caused by chronic, progressive nerve disease, and it can also occur as the result of injury or infection.
If you have chronic neuropathic pain, it can flare up at any time without an obvious pain-inducing event or factor. Acute neuropathic pain, while uncommon, can occur as well.
Typically, non-neuropathic pain (nociceptive pain) is due to an injury or illness. For example, if you drop a heavy book on your foot, your nervous system sends signals of pain immediately after the book hits.
With neuropathic pain, the pain isn’t typically triggered by an event or injury. Instead, the body just sends pain signals to your brain unprompted.
People with this pain condition may experience shooting, burning pain. The pain may be constant, or may occur intermittently. A feeling of numbness or a loss of sensation is common, too.
Neuropathic pain tends to get worse over time.
“Neuropathic unrelenting and severe, and sometimes it comes and goes. It often is the result of nerve damage or a malfunctioning nervous system. The impact of nerve damage is a change in nerve function both at the site of the injury and areas around it. “
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Symptoms for neuropathic pain?
Every nerve in your peripheral system has a specific function, so symptoms depend on the type of nerves affected. Nerves are classified into:
Sensory nerves that receive sensation, such as temperature, pain, vibration or touch, from the skin
- Motor nerves that control muscle movement
- Autonomic nerves that control functions such as blood pressure, heart rate, digestion and bladder
Signs and symptoms of peripheral neuropathy might include:
- Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms
- Sharp, jabbing, throbbing or burning pain like sciatica pain
- Extreme sensitivity to touch
- Pain during activities that shouldn’t cause pain, such as pain in your feet when putting weight on them or when they’re under a blanket
- Lack of coordination and falling
- Muscle weakness
- Feeling as if you’re wearing gloves or socks when you’re not
- Paralysis if motor nerves are affected
If autonomic nerves are affected, signs and symptoms might include:
- Heat intolerance
- Excessive sweating or not being able to sweat
- Bowel, bladder or digestive problems
- Changes in blood pressure, causing dizziness or lightheadedness
Carpal tunnel syndrome is an example of mononeuropathy. Most people with peripheral neuropathy have polyneuropathy.
What types of diagnosis?
The diagnosis of pain is based upon further assessment of a patient’s history. If underlying nerve damage is suspected, then evaluation of the nerves with testing may be warranted. The most common way to evaluate whether a nerve is injured is with electrodiagnostic medicine.
Clinical evaluation may reveal some evidence of loss of function, and can include assessment of light touch, the ability to distinguish sharp from dull, the ability to discern temperature, and assessment of vibration.
Possible treatment methods?
Some symptoms of neuropathy will ease over time. Treating or managing the underlying cause may help relieve symptoms of neuropathic pain.
People with chronic neuropathic pain may need treatment to relieve painful or debilitating symptoms.
Other medications that may help relieve nerve pain include:
- antiepileptic drugs
- capsaicin cream
- lidocaine patch
- injections or nerve blocks, which may be a combination of steroids, opioids, and anesthetics
Our doctor may also suggest treatment with a transcutaneous electrical nerve stimulation (TENS) machine. A TENS machine delivers a small electrical impulse to the area of pain through an electrode attached to the skin.
The impulse may stimulate specific nerves and block pain signals. This can help the muscles relax and ease painful symptoms.
Surgery can also provide relief from severe cases of some types of nerve damage, such as compression mononeuropathy.
Before embarking on any treatment, it is highly recommended to seek professional advice to determine the underlying issues.