Neuropathic Pain Management

Neuropathic pain is often described as a shooting or burning pain. It can go away on its own but is often chronic. Sometimes it is unrelenting and severe, and sometimes it comes and goes. It often is the result of nerve damage or a malfunctioning nervous system. The impact of nerve damage is a change in nerve function both at the site of the injury and areas around it.

One example of neuropathic pain is called phantom limb syndrome. This rare condition 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.

Causes of Neuropathic Pain

Neuropathic pain often seems to have no obvious cause. But some common causes of neuropathic pain include:

• Alcoholism
• Amputation
• Chemotherapy
• Diabetes
• Facial nerve problems
• HIV infection or AIDS
• Multiple myeloma
• Multiple sclerosis
• Nerve or spinal cord compression from herniated discs or from arthritis in the spine
• Shingles
• Spine surgery
• Syphilis
• Thyroid problems

Diagnosing Neuropathic Pain

To diagnose neuropathic pain, a doctor will conduct an interview and physical exam. They may ask questions about how you would describe your pain, when the pain occurs, or whether anything specific triggers the pain. The doctor will also ask about your risk factors for neuropathic pain and may also request both blood and nerve tests.

Neuropathic Pain Treatment

Anticonvulsant and antidepressant drugs are often the first line of treatment. Some neuropathic pain studies suggest the use of non-steroidal anti-inflammatory drugs (NSAIDs), such as Aleve or Motrin, may ease pain. Some people may require a stronger painkiller. Be sure to discuss the pros and cons of the medicine you take with your doctor.

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.

Other kinds of treatments can also help with neuropathic pain. Some of these include:

• Physical therapy
• Working with a counselor
• Relaxation therapy
• Massage therapy
• Acupuncture

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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