Nerve pain (neuropathic pain) is a long-term condition causing pain such as a shooting or burning sensation. The pain is typically triggered by chronic, progressive nerve disease, an injury or infection.
Pain can be persistent, or may occur irregularly. Untreated nerve pain can be unbearable; however, with treatment, it can often be controlled. Understanding the cause can help find better treatments to prevent the pain from getting worse.
The nervous system is involved in everything your body does such as regulating your breathing to sensing hot or cold or controlling your muscles. There are 3 types of nerves in the body:
Autonomic nerves
The autonomic nerves control the involuntary functions of your body, such as heart rate, blood pressure, digestion, and temperature regulation.
Motor nerves
Motor nerves control your actions by transmitting information from your brain and spinal cord to your muscles.
Sensory nerves
The sensory nerves spread information from your skin and muscles back to your spinal cord and brain. The information is then managed to allow you to feel pain and other sensations.
As nerves are vital to all you do, nerve pain and damage can dramatically affect your quality of life.
Symptoms
Nerve damage can cause a number of symptoms and people can experience the pain differently. Symptoms depend on the location and type of nerves that are affected. Damage can occur to nerves in your brain and spinal cord. It can also happen in the peripheral nerves, which are situated throughout the rest of the body.
Each person’s symptoms of neuropathic pain may vary slightly, but the below are common:
- Shooting, burning, or stabbing pain
- Tingling, prickling and numbness, or a pins and needles sensation
- Sudden pain, or pain that occurs without a trigger
- Weakness
- Sexual dysfunction
- Pain caused by things that are usually not painful such as brushing your hair
- Trouble sleeping or resting
- Excess sweating or sweating too little
- Emotional problems caused by lasting pain and loss of sleep
In some cases, people with nerve damage will experience symptoms that indicate damage to 2 or 3 different types of nerves.
Cause
There are over 100 different types of nerve damage. The various types may trigger different symptoms and may require different types of treatment.
There are 4 main causes for neuropathic pain: disease, injury, infection, and loss of limb.
Disease
Neuropathic pain can be a symptom or complication of several diseases and medical conditions such as multiple sclerosis, multiple myeloma, and other forms of cancer. Not everyone with these conditions will have neuropathic pain.
Diabetes can affect how your nerves function. People with diabetes commonly experience loss of sensation and numbness, followed by pain, burning, and stinging in their limbs and figures.
Excessive alcohol intake over a long period can trigger many complications, including chronic neuropathic pain. Damage to nerves due to chronic alcohol use can cause long-term and painful effects.
Trigeminal neuralgia (a chronic pain condition that affects the nerve that carries sensation from your face to your brain) is a painful condition with severe neuropathic pain on one side of the face. It is one of the more common causes of neuropathic pain and it can develop without an obvious cause.
Cancer treatment can cause neuropathic pain. Chemotherapy and radiation can both effect the nervous system and cause irregular pain signals.
Injuries
Injuries or damage to tissue, muscles and joints, as well as back, leg and hip problems or injuries are an uncommon cause of neuropathic pain. The injury may heal; however, the damage to the nervous system may not. This can cause you to experience persistent pain for many years following the injury.
Accidents or injuries that affect the spine such as herniated discs and spinal cord decompression can also trigger neuropathic pain and cause damage to the nerve fibres around your spine.
Infection
Infections are rarely the cause neuropathic pain. Shingles, which is caused by recurrence of the chicken pox virus, can result in several weeks of neuropathic pain. Postherpetic neuralgia is a rare complication of shingles, causing persistent neuropathic pain.
A syphilis infection can also cause a burning, stinging, unexplained pain.
Loss of limb
An uncommon form of neuropathic pain known as phantom limb syndrome can develop when an arm or leg has been amputated. Despite the loss of the limb, your brain still thinks it is receiving pain signals from the amputated body part. In fact, this occurs because the nerves near the amputation are sending faulty signals to your brain.
Other causes of neuropathic pain include:
- Vitamin B deficiency
- Carpal tunnel syndrome
- Thyroid problems
- Arthritis in the spine
Diagnosis
Your doctor will begin by asking you about your symptoms and medical history. They will then carry out a physical examination. They will assess your nerves by testing the strength of your muscles, checking reflexes and assessing your sensitivity to touch.
To confirm the diagnosis, your doctor may request further tests such as:
- Blood tests to gauge your overall health and check for underlying conditions
- Nerve conduction studies that measure how quickly your nerves carry electrical signals
- CT or MRI scans to inspect for anything that could be pressing on a nerve
Treatment
In many cases, nerve damage cannot be cured completely. However, there are a number of treatments that can improve pain and quality of life. Nerve damage is often progressive. To reduce the chance of permanent damage, it is important to go and see your doctor when you first notice symptoms.
Nerve pain can be tricky to treat, although conditions such as diabetes and vitamin B12 deficiency can be managed relatively easily. Treatments aim to directly ease the pain. Painkillers and medication can help, as well as non-drug treatments such as exercise, acupuncture and relaxation techniques.
Medication
In some cases, nerve pain can be managed with over the counter pain relief such as aspirin, paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs). Stronger painkillers such as opioids are occasionally used, but these have significant side effects that can cause long-term damage and can be addictive.
Epidural steroid injections can be very helpful in treating nerve pain caused by bones or discs in your back.
Many other medications can be effective against nerve pain. They include medicines originally used to treat depression and seizures.
Alternative Approaches
Non-medicine treatments can help people to understand and deal with the pain. They include:
- Exercise
- Acupuncture
- Relaxation techniques such as meditation
- Psychological treatments to help you feel in control of your pain and decrease distress
- Transcutaneous electrical nerve stimulation (TENS) to block the transmission of pain sensations to your brain
Outlook
Neuropathic pain can negatively affect your life if you do not take steps to treat it and prevent symptoms from getting worse. Gradually, this can lead to serious disability and complications, such as depression, difficulty sleeping and anxiety.
Continued research is helping to discover more treatment options to successfully manage nerve pain. Although it can take time to find the most effective treatment, it is important that you liaise with your healthcare team to find relief from your symptoms.
Need Help?
Nerve pain treatment is available at One Ashford Hospital in Kent with a leading Pain Management Consultant, and we can book you in for a consultation, usually within 48 hours.
One Ashford Hospital is ideally located for patients in Ashford, Maidstone, Dover, Canterbury, Folkestone and all nearby areas. To book an appointment, call the hospital direct on 01233 364 022 or email here.
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