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Neuropathic Pain and Neuropathy Treatment

Neuropathy is a disease that damages the nerves and causes them to function abnormally. The pain caused by the damage, dysfunction and/or injury of the nerve tissue is called neuropathic pain. Because nerve fibers exist throughout the body in complex networks, finding the source of the neuropathic pain and getting the proper treatment can de difficult.

Neuropathic pain can be the result of any of the following types of neuropathy:

autonomic neuropathy, which affects the nerves of the body that function automatically without a patient's control (i.e., nerves in the bladder, digestive tract, etc.)
mononeuritis multiplex,which affects many individual, unconnected nerves at the same time
mononeuropathy, which affectsnerves in or connected to the brain and/or spinal cord
polyneuropathy, which affectsmany connected nerves throughout the body.

The most common type of neuropathy is peripheral polyneuropathy that typically affects the limbs. For example, phantom limb pain is a form of peripheral polyneuropathy in which a patient still feels pain in a limb that has been removed from the body.

Although researchers continue investigating why phantom limb pain exists, many believe that crossed nerve networks send erroneous messages to the brain that pain is occurring in a limb that is no longer there.

Risk Factors for Neuropathic Pain

About 1.5 percent of Americans and 7.7 percent of Europeans are believed to be affected by neuropathic pain. However, these estimates are likely on the low side, given that many cases of neuropathic pain go undiagnosed due to the elusive nature of this condition.

Some of the factors that put people at risk of developing neuropathic pain include:

age (People over the age of 40 are more likely to suffer from this condition.)
chemical imbalances
diabetes
ethnicity (Europeans are far more likely to suffer from this condition than those of over ethnicities.) poor circulation
smoking or chewing tobacco
suffering or recovering from a serious physical trauma (such as an amputation or a major surgery).

Causes of Neuropathic Pain

Neuropathic pain can be caused by a variety of factors, including:

alcoholism
amputation
chemotherapy
diabetes
facial nerve problems
HIV or AIDS
malnutrition
multiple sclerosis
shingles
some types of tumors and cancer.

Keep in mind that there are far more causes of neuropathic pain, some of which still haven't been identified by researchers. With so many possible causes, diagnosing this condition can be especially tricky.

Symptoms of Neuropathy

Neuropathy is marked by any combination of the following symptoms:

allodynias (translated to mean "other pain"), an extreme pain in the response to a non-harmful stimulus
burning sensations
dysesthesias, a hallucination of the sensory organs in which the patient feels an odd sensation without the trigger of any stimulus
numbness
pain that continues after the cause of the pain has been removed
sharp, stinging pain (Many patients describe this pain as feeling like pins and needles.)
tingling sensations
warm sensations in the affected area.

If you start experiencing any of these symptoms, consult your doctor immediately for a proper diagnosis. Early diagnosis is essential to making treatments as effective as possible.

Diagnosing Neuropathy

Because neuropathies are complex, elusive conditions, they are hard to diagnose. Doctors start the diagnosis process by asking the patient about his and his family's medical history. The doctor will then ask the patient specific questions about his symptoms (i.e., about the type and intensity of the pain, the duration of the symptoms, etc.).

Next, the doctor will perform a thorough physical examination on the patient to rule out any other conditions that may be causing the patient to suffer from symptoms similar to those of neuropathy.

In addition, doctors will also likely perform a series of tests, including MRIs and CT scans, to complete the physical examination. After performing the exam and analyzing the test results, the doctor will be able to determine whether or not a patient suffers from neuropathy.

Neuropathy Treatment

While no cure for neuropathy exists, patients do have some treatment options that revolve around minimizing and managing the symptoms. The type of neuropathy treatment that will work best for an individual patient will vary widely depending on the cause of the pain and whether or not the patient suffers from other conditions.

In most cases, doctors prescribe one (or a combination) of the following medications:

anticonvulsants
antidepressant drugs (specifically tri-cyclic antidepressants)
morphine
non-steroidal anti-inflammatory drugs (NSAIDs)
Vicodin®.

Doctors may also suggest that the patient undergo transcutaneous electrical nerve stimulation (TENS), a treatment in which electrical waves are fed into the body's pressure points (much in the same way acupuncture uses needles).

If diabetes or another underlying condition has caused the neuropathy, talk to your doctor about ways to treat or manage the underlying condition, as it may alleviate the neuropathic pain.

However, in some cases, patients do not respond well to any therapies. In these rare instances, the neuropathy tends to worsen over time, eventually leading to serious disability.

When nothing else works, doctors may attempt more invasive therapies such as implanting a pain management device to help manage the pain.

Resources

Grayson, Charlotte E., MD (June 2004). Pain Management: Neuropathic Pain. Retrieved August 28, 2007 from the Medicine Net Web site: http://www.medicinenet.com/neuropathic_pain/article.htm.

Cleveland Clinic (2007). Neuropathic Pain. Retrieved August 28, 2007 from the Cleveland Clinic Web site: http://www.clevelandclinic.org/health/health-info/docs/3600/3687.asp?index=12094.

Neuropathic Pain Network (2004). How Common is Neuropathic Pain? Retrieved August 28, 2007 from the Neuropathic Pain Network Web site: http://www.neuropathicpainnetwork.org/english/index.asp.

Richeimer, Steven, MD (2000). Understanding Nociceptive & Neuropathic Pain. Retrieved August 28, 2007 from the Richeimer Institute Web site: http://www.helpforpain.com/arch2000dec.htm.

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