Neuropathic pain is a pain condition that’s usually chronic. It’s usually caused by chronic, progressive nerve disease, and it can also occur as the result of injury or infection.
If you have chronic neuropathic pain, it can flare up at any time without an obvious pain-inducing event or factor. Acute neuropathic pain, while uncommon, can occur as well.
Typically, non-neuropathic pain (nociceptive pain) is due to an injury or illness. For example, if you drop a heavy book on your foot, your nervous system sends signals of pain immediately after the book hits.
With neuropathic pain, the pain isn’t typically triggered by an event or injury. Instead, the body just sends pain signals to your brain unprompted.
People with this pain condition may experience shooting, burning pain. The pain may be constant, or may occur intermittently. A feeling of numbness or a loss of sensation is common, too.
Neuropathic pain tends to get worse over time.
About 1 in 3 Americans experience chronic pain. Of those, 1 in 5 experience neuropathic pain.
A 2014 study estimated that as many as 10 percent of Americans experience some form of neuropathic pain.
Understanding the possible causes can help you find better treatments and ways to prevent the pain from getting worse over time.
The most common causes for neuropathic pain can be divided into four main categories: disease, injury, infection, and loss of limb.
Neuropathic pain can be a symptom or complication of several diseases and conditions. These include multiple sclerosis, multiple myeloma, and other types of cancer.
Not everyone with these conditions will experience neuropathic pain, but it can be an issue for some.
Diabetes is responsible for 30 percent of neuropathic cases, according to the Cleveland Clinic. Chronic diabetes can impact how your nerves work.
People with diabetes commonly experience loss of feeling and numbness, following by pain, burning, and stinging, in their limbs and digits.
Long-term excessive alcohol intake can cause many complications, including chronic neuropathic pain. Damage to nerves from chronic alcohol use can have long-lasting and painful effects.
Trigeminal neuralgia is a painful condition with severe neuropathic pain of one side of the face. It’s one of the more common types of neuropathic pain and it can occur without a known reason.
Lastly, cancer treatment may cause neuropathic pain. Chemotherapy and radiation can both impact the nervous system and cause unusual pain signals.
Injuries to tissue, muscles, or joints are an uncommon cause of neuropathic pain. Likewise, back, leg, and hip problems or injuries can cause lasting damage to nerves.
While the injury may heal, the damage to the nervous system may not. As a result, you may experience persistent pain for many years after the accident.
Accidents or injuries that affect the spine can cause neuropathic pain, too. Herniated discs and spinal cord compression can damage the nerve fibers around your spine.
Infections rarely cause neuropathic pain.
Shingles, which is caused by reactivation of the chicken pox virus, can trigger several weeks of neuropathic pain along a nerve. Postherpetic neuralgia is a rare complication of shingles, involving persistent neuropathic pain.
A syphilis infection can also lead to the burning, stinging unexplained pain. People with HIV may experience this unexplained pain.
An uncommon form of neuropathic pain called phantom limb syndrome can occur when an arm or leg has been amputated. Despite the loss of that limb, your brain still thinks it’s receiving pain signals from the removed body part.
What’s actually happening, however, is that the nerves near the amputation are misfiring and sending faulty signals to your brain.
In addition to arms or legs, phantom pain may be felt in the fingers, toes, penis, ears, and other body parts.
Other causes of neuropathic pain include:
- vitamin B deficiency
- carpal tunnel syndrome
- thyroid problems
- facial nerve problems
- arthritis in the spine
What are the symptoms?
Each person’s symptoms of neuropathic pain may vary slightly, but these symptoms are common:
- shooting, burning, or stabbing pain
- tingling and numbness, or a “pins and needles” feeling
- spontaneous pain, or pain that occurs without a trigger
- evoked pain, or pain that’s caused by events that are typically not painful — such as rubbing against something, being in cold temperatures, or brushing your hair
- a chronic sensation of feeling unpleasant or abnormal
- difficulty sleeping or resting
- emotional problems as a result of chronic pain, loss of sleep, and difficulty expressing how you’re feeling
How’s it treated?
A goal of neuropathic pain treatment is to identify the underlying disease or condition that’s responsible for the pain, and treat it, if possible.
An important goal is that your doctor will aim to provide pain relief, help you maintain typical capabilities despite the pain, and improve your quality of life.
The most common treatments for neuropathic pain include:
Over-the-counter pain medication
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve and Motrin, are sometimes used to treat neuropathic pain.
However, many people find these medicines aren’t effective for neuropathic pain because they don’t target the source of the pain.
Opioid pain medications don’t usually reduce neuropathic pain as well as they reduce other types of pain. Plus, doctors may hesitate to prescribe them for fear that a person may become dependent.
Topical pain relievers can be used, too. These include lidocaine patches, capsaicin patches, and prescription-strength ointments and creams.
Antidepressant medications have shown great promise in treating symptoms of neuropathic pain.
Two common types of antidepressant drugs are prescribed to people with this condition:
- tricyclic antidepressants
- serotonin-norepinephrine reuptake inhibitors
These may treat both the pain and symptoms of depression or anxiety caused by chronic pain.
Anti-seizure medications and anticonvulsants are often used to treat neuropathic pain. Gabapentinoids are most commonly prescribed for neuropathic pain.
It’s not clear why anti-seizure drugs work for this condition, but researchers believe the medications interfere with pain signals and stop faulty transmissions.
Your doctor may inject steroids, local anesthetics, or other pain medications into the nerves that are thought to be responsible for the wayward pain signals. These blocks are temporary, so they must be repeated in order to keep working.
This invasive procedure requires a surgeon to implant a device in your body. Some devices are used in the brain and some are used in the spine.
Once a device is in place, it can send electrical impulses into the brain, spinal cord, or nerves. The impulses may stop the irregular nerve signals and control symptoms.
These devices are typically used only in individuals who haven’t responded well to other treatment options.
Physical, relaxation, and massage therapies are all used to relieve symptoms of neuropathic pain. These forms of treatment can help ease muscles.
Your healthcare provider can also teach you ways to cope with your pain.
For example, some people with neuropathic pain may experience increased symptoms after sitting for several hours. This might make desk jobs difficult to perform.
A physical therapist or occupational therapist can teach you techniques for sitting, stretching, standing, and moving to prevent pain.
How can this pain be managed?
If your doctor is able to identify an underlying cause for the neuropathic pain, treating it may reduce and even eliminate the pain.
For example, diabetes is a common cause of neuropathic pain. Proper diabetes care — which includes a healthy diet and regular exercise — may eliminate or reduce neuropathic pain.
Taking care of blood sugar levels can also prevent worsening pain and numbness.
A multipronged approach can be an effective way to manage the condition.
A combination of medications, physical therapy, psychological treatment, and even surgery or implants may be used to bring about the best results.
Neuropathic pain can negatively impact your life if you don’t take steps to treat it and prevent worsening symptoms.
Over time, this can lead to serious disability and complications, including depression, problems sleeping, anxiety, and more.
Fortunately, researchers are learning more about why this condition develops and what can be done to effectively treat it. That’s leading to better treatment options.
Finding the correct treatment options for you can take time, but you and your doctor can work together to find relief from the symptoms of this painful condition.