Neuropathic Pain: Causes, Symptoms, Treatment, Management, and Overview

It is a chronic pain condition. It is usually the result of, or is accompanied by, injury, illness, or infection.

However, neuropathic pain is not the direct result of any factor.

Typically, the pain is due to injury or illness. For example, if you drop a heavy book on your foot, your nervous system sends pain signals immediately after the book arrives.

With neuropathic pain, no event or injury causes the pain. Instead, the body simply sends pain signals to your brain spontaneously.

People with this type of pain may experience burning pain. The pain can be constant or it can happen randomly. A feeling of numbness or loss of sensation is also common. Neuropathic pain may get worse over time or it may get better.

About 1 in 3 Americans experience chronic pain. Of these, 1 in 5 experiences neuropathic pain. One study estimates that up to 10 percent of Americans experience some form of neuropathic pain.

Understanding the possible causes can help you find better treatments and ways to prevent pain from getting worse over time.

What Causes Neuropathic Pain?

The most common causes of neuropathic pain can be divided into four main categories:

Accidents

Injury to tissue, muscles, or joints can cause neuropathic pain. Similarly, back, leg, and hip problems or injuries can cause lasting nerve damage. While the injury may heal, the damage to the nervous system may not.

As a result, you may experience persistent pain for many years after the accident.

Accidents or injuries that affect the spine can also cause neuropathic pain. Herniated discs and spinal cord compression can damage the nerve fibers around the spine.

Infection

Infections are a common cause of neuropathic pain. People with HIV or AIDS can experience this unexplained pain. A syphilis infection can also cause burning, stabbing, and unexplained pain. Shingles, which is caused by the chickenpox virus, can trigger long-lasting neuropathic pain.

Surgery (amputation)

A rare form of neuropathic pain is called phantom limb syndrome, and this syndrome can occur when a limb of the body (an arm or a leg) has been amputated. Despite the loss of that limb, your brain still believes that it is receiving pain signals from the removed body part.

What is happening, however, is that the nerves near the amputation are failing and sending faulty signals to your brain. In addition to the arms or legs, phantom pain may be felt in the fingers, toes, ears, and other parts of the body.

Disease

Neuropathic pain can be a symptom or a complication of various diseases and conditions. These include multiple sclerosis, multiple myeloma, and cancer. Not all people with these conditions will experience neuropathic pain, but it can be a problem for some.

Diabetes is responsible for 30 percent of neuropathic cases, according to the Cleveland Clinic. Chronic diabetes can affect how your nerves work. People with diabetes commonly experience loss of sensation and numbness, followed by pain, burning, and stinging in the limbs and fingers.

Long-term binge drinking can cause many complications, including chronic pain. Nerve damage from chronic alcohol use can have long-lasting and painful effects.

Lastly, cancer treatment can cause neuropathic pain. Chemotherapy and radiation can affect the nervous system and cause unusual pain signals.

Other causes

Other causes of neuropathic pain include:

  • Vitamin B deficiency.
  • Carpal tunnel syndrome.
  • Thyroid problems
  • Facial nerve problems.
  • Arthritis in the spine.

What are the symptoms?

Each person’s symptoms of neuropathic pain may be different, but the following symptoms are the most common:

  • Stabbing or burning pain
  • Tingling and numbness, or a ‘tingling’ sensation.
  • Spontaneous pain, or pain that occurs without something to cause it.
  • Evoked pain, or pain caused by events that are generally not painful, such as rubbing against something, being in cold temperatures, or brushing your hair.
  • A chronic feeling of feeling abnormal or unpleasant.
  • Difficulty sleeping or resting.
  • Emotional problems as a result of chronic pain, loss of sleep, and difficulty expressing how you feel.

How is it treated?

The first goal of treating neuropathic pain is to identify the underlying disease or condition that is responsible for the pain, and to treat it, if possible. Your doctor will then try to relieve pain, help you maintain typical abilities despite pain, and improve your quality of life.

The most common treatments for neuropathic pain include:

Over-the-counter pain medicine

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve and Motrin, are sometimes used to treat neuropathic pain. However, many people find that these medications are not effective for neuropathic pain.

Unlike pain caused by an injury or headache, neuropathic pain has no “target” for these medications.

Medical prescription

Opioid pain relievers can help some people, but they may not reduce neuropathic pain and may reduce other types of pain. Also, doctors may hesitate to prescribe them for fear that a person will become dependent.

Topical pain relievers can also be used. These include lidocaine patches, capsaicin patches, and strong prescription creams and ointments.

Antidepressant drugs

Antidepressant medications have shown great promise in treating the symptoms of neuropathic pain. Two common types of antidepressant medications are prescribed for people with this condition. They are tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitors.

These can treat both pain and symptoms of depression or anxiety caused by chronic pain.

Anticonvulsants

Sometimes anticonvulsant and anticonvulsant medications are used to treat neuropathic pain. Gabapentinoids are most often prescribed for neuropathic pain.

It’s not clear why anti-seizure drugs work for this condition, but researchers believe the drugs interfere with pain signals and stop faulty transmissions.

Nerve blocks

Your doctor may inject steroids, local anesthetics, or other pain relievers into the nerves that are believed to be responsible for the stubborn pain signals. These blocks are temporary, so they must be repeated to continue working.

Dispositivo implantable

This invasive procedure requires a surgeon to implant a device in your body. Some devices are used in the brain and others are used in the spine.

Once the device is in place, it can send electrical impulses to the brain, spinal cord, or nerves. The impulses can stop irregular nerve signals and control symptoms.

These devices are generally used only in individuals who have not responded well to other treatment options.

Other treatments

Massage, relaxation, and physical therapies are used to relieve symptoms of neuropathic pain. These forms of treatment can help relieve muscles, which can reduce nerve problems.

Your healthcare provider can also teach you ways to cope with your pain. For example, some people with neuropathic pain may experience increased symptoms after sitting for several hours. This could make desk jobs difficult to do.

A physical or occupational therapist can teach you techniques for sitting, stretching, standing, and moving that can prevent pain.

How can this type of pain be managed?

If your doctor can identify an underlying cause of neuropathic pain, treatment can reduce or even eliminate the pain. For example, diabetes is a common cause of neuropathic pain.

Proper diabetes care, including a healthy diet and regular exercise, can eliminate or reduce neuropathic pain. Taking care of the symptoms of diabetes can also prevent worsening pain and numbness.

Multimodal therapy

Neuropathic pain is not one-size-fits-all, and a multi-pronged approach can be an effective way to manage the condition. A combination of medications, physical therapy, psychological treatment, and even surgery or implants can be used for the best results.

Panorama

Neuropathic pain can negatively affect your life if you don’t take steps to treat it and prevent symptoms from getting worse. While the pain condition may improve on its own, it can also get worse.

Over time, this can lead to serious disabilities and complications, including depression, trouble sleeping, anxiety, and more.

Fortunately, researchers are learning more about why this condition develops and what can be done to treat it effectively. That is leading to better treatment options.

Finding the right arrangement of treatment options for you may take time, but you and your doctor will work together to find relief from the symptoms of this painful condition.