Nerve Pain: Causes, Symptoms, and Treatment

September 7, 2022

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Neuropathic pain can occur if your nervous system is injured or not functioning properly. Pain can be felt at any nervous system level, including the peripheral nerves, spinal cord, and brain. The central nervous system comprises the spinal cord and the brain. Peripheral nerves run through the rest of your body to organs, arms, legs, fingers, and toes.

Neuropathy is a malfunction or modification in one or more nerves. Diabetes accounts for approximately 30% of all neuropathy cases. It is not always convenient to determine the cause of neuropathic pain. This type of pain is associated with hundreds of diseases.

Types of Nerve pain

Post-herpetic – occurs after shingles (herpes zoster) and affects the same area as the shingles rash.
Trigeminal – pain in the jaw or cheek.
Occipital – causes pain at the base of the skull that can spread to the back of the head.
Pudendal – causing pain between the legs in the ‘saddle area’

Causes of Nerve pain

Difficulties in the central nervous system (brain and spinal cord) or the nerves that run from there to the muscles and organs can cause nerve pain. It is usually the result of a disease or an injury.

Alcoholism.
Diabetes.
HIV infection or AIDS.
Central nervous system disorders like stroke, Parkinson’s disease, multiple sclerosis, etc.)
Complex regional pain syndrome.

Symptoms of Nerve pain

Nerve pain is frequently described as a shooting, stabbing, or burning sensation. It can be as strong and unexpected as an electric shock at times. People who suffer from neuropathic pain are often extremely sensitive to touch or cold. They may encounter discomfort due to stimuli that would not generally be excruciating, such as brushing their skin. Nerve pain frequently interferes with essential aspects of life such as sleep, sex, work, and exercise.

There may be numerous other symptoms when it comes to neuropathic pain, which includes:

Pain without stimulation: Tingling, numbness, or a “pins and needles” sensation; shooting, burning, stabbing, or electric shock-like pain.
Evoked pain: Pain caused by non-painful stimulation such as cold, gentle skin brushing, pressure, etc. This is known as allodynia. Evoked pain can also refer to increased pain caused by generally painful stimuli such as pinpricks and heat.
Sleeping difficulties and emotional issues as a result of sleep disruption and pain.
An unpleasant, unusual sensation that occurs spontaneously or is induced (dysesthesia)
Pain that is reduced as a result of an ordinarily painful stimulus (hypoalgesia)

Other conditions can cause nerve pain.

Sciatica is caused by pressure on the nerves in the lower back, causing pain down the leg. Pins and needles, numbness, or weakness in the leg may accompany the pain.

Fibromyalgia is a chronic pain syndrome characterised by burning or aching pain in various body parts. The cause is unknown, but can be provoked by emotional distress and lack of sleep. There could also be genetic factors.

Peripheral neuropathy is caused by damage to the peripheral nerves that link the brain and spinal cord to the rest of the body. Diabetes, autoimmune diseases, and other conditions are to blame.

Diagnosis & Tests

Your doctor will take your health information and perform a physical exam. If your provider knows or suspects that you have nerve damage, they will recognise typical nerve pain symptoms. Your provider will then attempt to identify the underlying cause of your neuropathy and track down the symptoms.

Treating neuropathic pain

The primary purpose of the treatments are:

Treat the underlying condition
Offer pain relief.
Keep the functionality.
Enhance your quality of life.

To treat neuropathic pain, multimodal therapy (including medications, physical therapy, psychological counselling, and, in some cases, surgery) is usually required.

Medicines that are usually prescribed for neuropathic pain are anti-seizure drugs, namely:

Gabapentin (Neurontin).
Pregabalin (Lyrica).
Topiramate (Topamax).
Carbamazepine (Tegretol).
Lamotrigine (Lamictal).

Doctors also prescribe antidepressants like:

Amitriptyline (Elavil).
Nortriptyline (Pamelor).
Venlafaxine (Effexor).
Duloxetine (Cymbalta).

Getting an anti-seizure or antidepressant-prescribed medication from your pain specialist does not imply you have seizures or are depressed. However, chronic pain can be exacerbated by anxiety or depression.

Topical treatments such as lidocaine or capsaicin—patches, creams, or ointments—can be applied to the painful area. Opioid analgesics are less effective in treating neuropathic pain, and their side effects may preclude long-term use.

Pain specialists can also administer nerve blocks, which include doses of steroids, local anaesthetics, or other medications into the nerves. In addition, spinal cord stimulation, peripheral nerve stimulation, and brain stimulation can be used to treat neuropathic pain that has not responded to the previous therapies.

Non-medicine method

Non-pharmaceutical treatments can help people understand and cope with pain. They are as follows:

Being educated and getting the right guidance
Exercising regularly
Acupuncture
Techniques for relaxation
Psychological treatments that can help you feel more in charge of your pain and less distressed
Transcutaneous Electrical Nerve Stimulation (TENS) to prevent pain sensations from reaching your brain

People suffering from chronic pain may find it beneficial to visit a multidisciplinary pain clinic where health professionals can devise a personalised pain management plan. A doctor’s referral is required to attend a pain clinic. The Pain Australia website has a list of pain services.