By: Dr. Rami Rustum – Sept. 2016
Neuropathy is the term used to describe a problem with the nerves, usually the peripheral nerves as opposed to the central nervous system (the brain and spinal cord).
When the sensory system is impacted by injury or disease, the nerves within that system cannot work to transmit sensation to the brain. This often leads to a sense of numbness, or lack of sensation. However, in some cases when this system is injured, individuals experience pain in the affected region. Neuropathic pain does not start abruptly or resolve quickly; it is a chronic condition which leads to persistent pain symptoms. For many patients, the intensity of their symptoms can wax and wane throughout the day.
Causes of Neuropathic Pain:
Neuropathic pain often seems to have no obvious cause; but, some common causes of neuropathic pain include:
* Back, leg, and hip problems
* Facial nerve problems
* HIV infection or AIDS
* Multiple sclerosis
* Spine surgery
* Circulation (Vascular) Problem as a result of smoking or insufficient blood supply
Symptoms of Neuropathic Pain:
Neuropathic pain symptoms may include:
* Shooting and burning pain
* Tingling, pins and needles or numbness
In advanced cases, the patient may complain of skin color changes, skin temperature change or hair distribution change over the limb or affected area.
More, accidental touching of non- painful items or objects may result in aggravated symptoms.
Diagnosing Neuropathic Pain:
Diagnosing neuropathic pain starts by detailed interview and physical exam by neurologist or pain physician. He or she may ask questions about how you would describe your pain, when the pain occurs, or whether anything specific triggers the pain. The doctor may also request both blood, nerve tests and sometimes MRI studies to rule out other possible reasons for the neuropathy.
Neuropathic Pain Treatment:
Some neuropathic pain studies suggest the use of non-steroidal anti-inflammatory drugs, such as Aleve or Motrin, may ease pain. Some people may require a stronger painkiller, such as those containing morphine. Anticonvulsant and antidepressant drugs seem to work in some cases.
If another condition, such as diabetes, is involved, better management of that disorder may alleviate the pain. Effective management of the condition can also help prevent further nerve damage.
In cases that are difficult to treat, a pain specialist may use an invasive or implantable device to effectively manage the pain. Electrical stimulation of the nerves involved in neuropathic pain may significantly control the pain symptoms and has proven to be very effective long term treatment.
Other kinds of treatments can also help with neuropathic pain. Some of these include:
* Physical therapy
* Working with a counselor
* Relaxation therapy
* Massage therapy
Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability. A multidisciplinary approach that combines therapies, however, can be a very effective way to provide relief from neuropathic pain.
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