- Pain Management: Neuropathic Pain Center
- Surprising Reasons You're in Pain Slideshow
- Take the Pain Quiz
- Chronic Pain Slideshow
- Find a local Doctor in your town
Neuropathic pain is a complex, chronic pain state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional or injured. These damaged nerve fibers send incorrect signals to other pain centers. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.
One example of neuropathic pain is called phantom limb syndrome. This occurs when an arm or a leg has been removed because of illness or injury, but the brain still gets pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.
What causes neuropathic pain?
Neuropathic pain often seems to have no obvious cause; but, some common causes of neuropathic pain include:
What are the symptoms of neuropathic pain?
Symptoms may include:
- Shooting and burning pain
- Tingling and numbness
How is neuropathic pain diagnosed?
A doctor will conduct an interview and physical exam. He or she may ask questions about how you would describe your pain, when the pain occurs, or whether anything specific triggers the pain.
How is neuropathic pain treated?
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.
In cases that are difficult to treat, a pain specialist may use invasive or implantable device therapies to effectively manage the pain. Electrical stimulation of the nerves involved in neuropathic pain generation may significantly control the pain symptoms.
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.
Health Solutions From Our Sponsors
Reviewed by Ephraim K Brenman, DO on January 28, 2008
Top Pain Management: Neuropathic Pain Related Articles
Alcohol Abuse and AlcoholismAlcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It can cause myriad health problems, including cirrhosis of the liver, birth defects, heart disease, stroke, psychological problems, and dementia. Counseling and a few medications can be effective for alcoholism treatment.
Causes of Body AchesBody aches are a symptom of the flu, arthritis, autoimmune disease, infections like Lyme disease, and other conditions. Body pain and muscle aches may accompany fever, headache, and other symptoms. Body aches are a general symptom of many potential underlying conditions. Only a doctor can diagnose and treat the cause.
CancerCancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
ChemotherapyChemotherapy is the treatment of cancer with drugs that can destroy cancer cells. These drugs often are called "anticancer" drugs. Chemotherapy is often used with other treatments. Coping with side effects (fatigue, nausea, vomiting, pain, hair loss, infection, diarrhea, constipation, fluid retention, mouth and throat problems) are important to understand when undergoing chemotherapy treatment. It is important to eat well during chemotherapy, and get the support you need both during and after treatment.
Chronic PainChronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Diabetes MellitusDiabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Cymbalta (duloxetine) is in the drug class SSRI. Cymbalta is prescribed for the treatment of:
- generalized anxiety disorder,
- and neuropathic pain associated with diabetic peripheral neuropathy.
The most common side effects of Cymbalta are:
- dry mouth,
- and dizziness.
Facial Nerve ProblemsBell's palsy is one type of facial nerve paralysis. The 7th cranial nerve controls the muscles of the face, and although scientists do not know the exact cause of Bell's palsy, they think it may be due to nerve damage from an infection, for example, the flu, common cold viruses, and more serious infections like meningitis. The symptoms of Bell's palsy vary from person to person, but can include mild weakness to total paralysis, dry eye, dry mouth, eyelid drooping, drooling, mouth drooping, dry mouth, changes in taste, and excessive tearing in one eye.
People with Bell's palsy usually don't need medical treatment, however, drugs like steroids, for example, prednisone seem to be effective in reducing swelling and inflammation are used when medical is necessary. Most people with Bell's palsy begin to recover within two weeks after the initial onset of symptoms. Full recovery may take three to six months.
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce mild to moderate pain, inflammation, and fever. Ibuprofen works by blocking an enzyme that makes prostaglandin (a hormone-like substance that participates in a variety of body functions), which results in lower levels of prostaglandins in the body. Lower levels of prostaglandins reduce pain, inflammation, and fever.
Ibuprofen is prescribed to treat diseases and conditions that cause mild to moderate pain, fever, and inflammation. For example, Pain from strains and sprains; pain from cuts, scrapes, and puncture wounds; muscle aches and pains; tooth pain; common cold; mild headache; some arthritis conditions; joint pain; and to reduce fever.
Common side effects of ibuprofen include, diarrhea, constipation, nausea, heartburn, belly pain, drowsiness, headaches, tinnitus (ringing in the ears), and mild rash.
More serious side effects and adverse effects include, increased bleeding after injury, stomach ulcers, impaired kidney function, severe allergic reaction (anaphylaxis), blood clots, heart attack, heart failure, and high blood pressure.
The maximum dose prescribed under a doctor's care is 3.2 g daily. Otherwise, the over-the-counter (OTC) maximum daily dose is 1.2 g daily. Dosage depends upon the age, weight, and any current medical conditions of the patient. Several drugs interact with ibuprofen so check with your doctor, pharmacist, or other health care professional with questions in regard to this drug. Doctors don't know if it is safe to take ibuprofen if your are pregnant, therefore it is not recommended if you are pregnant. According to the American Academy of Pediatrics, ibuprofen is safe to take while breastfeeding.
REFERENCE: FDA Prescribing Information.
Lyrica vs Gabapentin
Lyrica (pregablin) and gabapentin (Neurotin) are drugs used to prevent seizures and to treat nerve pain associated with various conditions, for example, shingles. Lyrica and gabapentin are chemically related, but researchers do not know exactly how they work. Gabapentin also has several off-label uses to treat other conditions that cause pain, and substance abuse withdrawal.
Both pain medications also treat fibromyalgia. Off-label uses (non-FDA approved) for gabapentin are hot flashes, hiccups, restless leg syndrome (RLS), hyperhidrosis (excessive sweating), headaches, and diabetic neuropathy. Lyrica also treats pain associated with spinal cord injuries.
Lyrica and gabapentin both cause similar side effects, for example, tremors, blurred or double vision, memory or concentration problems, dizziness, and drowsiness.
Side effects of Lyrica that are different from gabapentin include constipation, weight gain, dry mouth, constipation, breast enlargement, and edema (swelling). Side effects unique to gabapentin include viral infections, fever, speech problems, unusual eye movements, and jerky movements.
The generic name for Lyrica is pregabalin. Gabapentin is available in the US under the brand names Neurontin, Gralise, Horizant, Fanatrex, and FusePag.
Medical Marijuana (Medical Cannabis)
Medical marijuana (medical cannabis) is a medicine that is plant based. There are two species of medical marijuana; 1) Cannabis sativa, and 2) Cannabis indica. Medical marijuana is used to treat pain, nausea, anxiety, MS, insomnia, seizures, and muscle spasms. Medical cannabis is legal in a variety of states in the US. A card or licence is required to purchase medical marijuana in states where it is legal; however, medical cannabis is against Federal law. Medical marijuana comes in a variety of products, for example, gummy bears and other candy, muffins, cookies, drinks, salves, ointments, creams, oils, and wax.
Multiple Sclerosis (MS)Multiple sclerosis or MS is an autoimmune disorder in which brain and spinal cord nerve cells become demyelinated. This damage results in symptoms that may include numbness, weakness, vertigo, paralysis, and involuntary muscle contractions. Different forms of MS can follow variable courses from relatively benign to life-threatening. MS is treated with disease-modifying therapies. Some MS symptoms can be treated with medications.
Occipital NeuralgiaOccipital neuralgia is a type of headache that involves inflammation or irritation of occipital nerves. Signs and symptoms include a stabbing and throbbing head pain, and an aching pain in the upper back of the head and neck.
Potential causes include infection, irritation, or trauma of the occipital nerves. This type of headache is diagnosed by physical examination findings and imaging tests. Treatment involves a multidisciplinary approach that includes massage, rest, physical therapy, heat, muscle relaxants, and anti-inflammatory drugs. Invasive procedures and even surgery may be considered if first-line treatments fail to bring relief from the chronic pain of this type of headache.
Oxycodone vs Tramadol for Pain
Oxycodone and tramadol are prescription medications used to manage acute and chronic moderate to severe pain. Oxycodone is an opiate (narcotic) derived drug whereas tramadol is a man-made synthetic drug. Tramadol is not a narcotic, and it is not a nonsteroidal anti-inflammatory drug (NSAIDs). Some of the side effects of oxycodone and tramadol are the same, for example:
- Dry mouth
Serious side effects for oxycodone and tramadol differ. Oxycodone and tramadol are habit forming drugs and patients may become addicted. Withdrawal symptoms include:
Drug interactions, dosing, and pregnancy and breastfeeding safety information differs for these drugs and should be reviewed prior to administration.
Peripheral NeuropathyPeripheral neuropathy is a problem with the functioning of the nerves outside of the spinal cord. Symptoms may include numbness, weakness, burning pain (especially at night), and loss of reflexes. Possible causes may include carpel tunnel syndrome, shingles, vitamin or nutritional deficiencies, and illnesses like diabetes, syphilis, AIDS, and kidney failure. Peripheral neuropathy is diagnosed with exams and tests. Treatment for the condition depends on the cause. Usually, the prognosis for peripheral neuropathy is good if the cause can be successfully treated or prevented.
15 Ways to Reduce PainChronic pain can be a symptom of many conditions, including arthritis, headaches, and others. Comprehensive pain management therapy may include physical therapy, lifestyle strategies such as exercise, diet changes, meditation, journaling, medications, and avoiding alcohol and tobacco use. Make helpful changes to manage your chronic condition.
Shingles (Herpes Zoster)Shingles, or herpes zoster, is a painful rash caused by the varicella zoster virus. Other shingles symptoms include headache, fever, nausea, and body aches. Treatment focuses on pain management and shortening the duration of the illness with antiviral medications.