What is it?
Nerve Pain (Neuralgia, Neuropathy, Neuritis) is a type of pain originating from the peripheral and/or central nervous system. Neuropathy means nerve disease or damage. It is usually a sharp pain that follows the path of a nerve. The source of the pain is commonly due to the nerve being trapped, damaged, compressed, or pinched. It can also be due to disease affecting the nerve.
Trigeminal neuralgia is the most common form of neuralgia. A related but uncommon neuralgia affects the glossopharyngeal nerve, which provides feeling to the throat. Neuralgia is most common in elderly people, but it may occur at any age.
Sciatica is one of the most common forms of nerve pain. Sciatica is pain in the lower extremity resulting from irritation of the sciatic nerve.The pain of sciatica is typically felt from the lower back to behind the thigh and radiating down below the knee. The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the lower back and extends through the buttock area to send nerve endings down the lower limb. The pain of sciatica is sometimes referred to as sciatic nerve pain.
Shingles is another common form of nerve pain. Shingles is a skin rash caused by the same virus that causes chicken pox (Varicella zoster virus) from the herpes family of viruses. Most neuralgias are not life-threatening and are not signs of other life-threatening disorders. However, pain can be severe.
For severe pain, it is advisable to see a pain specialist to explore all treatment options.
What causes it?
Causes of neuralgia include:
- Certain drugs
- Chemical irritation
- Chronic renal insufficiency
- Infections (eg shingles, syphilis and Lyme disease)
- Pressure on nerves by nearby structures (eg tumors)
- Swelling and irritation (inflammation)
- Trauma (including surgery)
But in many cases, the cause is unknown.
Diabetic neuropathy is nerve damage caused by diabetes. Diabetics (people with diabetes) often have high blood sugar levels. Over time, high bloodsugar levels can damage nerves throughout your body. The older you get, and the longer you have diabetes, the more likely you are to have nerve damage. People with diabetes who drink too much alcohol are also more likely to have nerve damage. About half of all people with diabetes will develop diabetic neuropathy.
Sciatica is usually the result of a lumbar disc herniation directly pressing on the nerve. However, any cause of irritation or inflammation of the sciatic nerve can reproduce the symptoms of sciatica. Apart from a pinched nerve from a disc, other causes of sciatica include irritation of the nerve from adjacent bone, tumors, muscle, internal bleeding, infections, injury, and other causes. Sometimes sciatica can occur because of irritation of the sciatic nerve during pregnancy.
Most neuralgias will respond to treatment. Attacks of pain usually come and go. However, attacks may become more frequent in some patients as they get older. The goal of treatment is to reverse or control the cause of the nerve problem (if found) and provide pain relief.Treatment varies depending on the cause, location, and severity of the pain, and other factors. Even if the cause of the neuralgia is never identified, the condition may improve on its own or disappear with time. The cause (if known) should be treated. This may include surgery to remove tumors or separate the nerve from blood vessels or other structures that press on it. Physical therapy may be helpful for some types of neuralgia. Strict control of blood sugar may speed recovery in people with diabetes who develop neuralgia. Treating shingles with antiviral medication may help to ease the pain of the rash and to reduce the length of the attack. Cool wet compresses can help with the itch to prevent scratching and therefore scarring.
Medications to control nerve pain may include:
- Anti-depressant medications
- Anti-seizure medications (for trigeminal neuralgia pain)
- Mild over-the-counter analgesics
- Narcotic analgesics (codeine) for short-term relief of severe pain
- Topical creams containing capsaicin
Other treatments may include:
- Local injections of pain-relieving (anesthetic) drugs
- Nerve blocks
- Surgical procedures (such as ablation using radiofrequency, heat, balloon compression, or injection of chemicals) to reduce feeling in the nerve. Unfortunately, these procedures do not guarantee improvement and can cause loss of feeling or abnormal sensations. Your doctor is the best person to recommend appropriate treatment.