What is Nerve Pain?
Nerve pain also called neuropathic pain, is pain caused by injury or disease of the sensory nervous system. The sensory nervous system is associated with the senses of pressure, pain, touch, movement, vibration, temperature and position. You may experience a variety of symptoms ranging from pain to numbness in various parts of the body depending on the location of the nerve damage.
Causes of Nerve Pain
Nerve pain can be caused by injury to the central or peripheral nerves.
Central nerve pain: This is caused due to damage to the nerves of the central nervous system by the presence of lesions or diseases such as stroke, spinal cord injury or multiple sclerosis.
Peripheral nerve pain: This arises due to dysfunction or injury to the peripheral nerves (nerves that carry senses and motor signals from the brain and spinal cord to the entire body). Diabetes, trauma, vitamin deficiency, kidney disease, certain medications, and alcoholism can cause peripheral nerve pain.
Symptoms of Nerve Pain
Nerve pain can be differentiated from normal pain symptoms as follows:
- The normal symptoms of pain are altered and present as prickling or tingling sensations to a stabbing, shooting or burning pain, similar to an electric shock.
- Allodynia or pain that occurs from a stimulus that does not normally cause pain sensations.
- Hyperalgesia or increased pain caused by a stimulus that usually causes pain.
- Anaesthesia Dolorosa or pain that is felt in a region that is numb.
Neuropathic Pain Conditions
There are several conditions that can lead to nerve pain. Some of the most common include:
- Diabetic peripheral neuropathy: This is a common condition if you have diabetes and is characterized by a stabbing or burning pain and numbness in the legs and feet.
- Trigeminal neuralgia: This is a frequently occurring condition that arises due to multiple sclerosis or from a tumour compressing the trigeminal nerve, which carries signals of sensation to the face and motor functions such as chewing and biting. Typical symptoms include sudden facial pain lasting for several seconds to minutes and intense burning pain, usually accompanied by involuntary spasms or facial twitches.
- Chemotherapy-induced peripheral neuropathy: As the name indicates, this type of nerve pain is commonly seen while undergoing chemotherapy, due to sensory nerve damage in the dorsal root of the spinal nerves. Common symptoms include pain and numbness, which may aggravate as the therapy continues.
- HIV-associated sensory peripheral neuropathy (HIV-SN): This condition affects HIV patients either due to the attack of the HIV virus on the peripheral nerves or the effect of the medicine, which is neurotoxic. Advancing age, malnutrition, genetics and associated diseases such as diabetes further increase the risk of HIV-SN.
- Post-herpetic neuralgia: This condition occurs if you have previously suffered from herpes zoster infection. Reactivation of the herpes zoster virus where it resides in the dorsal root ganglion can lead to pain typically along the spine and around the eyes.
Diagnosis of Nerve Pain
Nerve pain is diagnosed with a detailed review of your medical history and a thorough physical examination. A grading system is used to determine the cause of pain as neuropathic.
What are the treatment options available for Nerve Pain?
- Ablative therapy
- Spinal Cord, Dorsal Root Ganglion Stimulation, and Peripheral Nerve Stimulation
Early treatment is important to manage nerve pain as nerve damage is progressive. Nerve damage cannot be cured completely. Treatment is centred around relieving symptoms.
The first line of treatment is to manage your underlying condition such as diabetes and changing medication that may be causing nerve damage. Surgery may be indicated to remove tumours.
Your doctor may prescribe anti-epileptic analgesic drugs, antidepressants, opioids or opioid-like drugs or topical anaesthetic and analgesic medications to relieve symptoms. Electrical nerve stimulation such as TENS may be performed to relieve pain.
Alternate treatments such as meditation, acupuncture, hypnosis, and biofeedback may be ordered to help you cope with pain.