Neuropathic pain is a type of pain that results from an injury to the nervous system, which can be caused by infections, such as herpes or diseases such as diabetes, for example, or result from a dysfunction of the nervous system. In addition, pain may be accompanied by edema and sweating, changes in local blood flow or changes in tissues, such as atrophy or osteoporosis.
This specific type of pain is caused when a "short circuit" changes the nerve signals that are then abnormally interpreted in the brain, which can cause a burning sensation and other extremely painful sensations, with neuropathic pain being classified as one of the main types of chronic pain.. Find out what is a chronic pain and main types.
This disease does not respond very well to the usual treatments for pain, and it is necessary to resort to centrally acting analgesics, anticonvulsants or antidepressants.
What symptoms
Neuropathic pain is an intense pain in the nerves of the body that can be accompanied by burning, needles, shocks and hypersensitivity to touch, and may be accompanied by tingling or numbness in the region of the body whose nervous path is compromised. However, more than one nerve may be involved, leading to widespread pain, which can affect the trunk, legs and arms.
Pain can also be accompanied by an exaggerated sensitivity to stimuli that usually do not cause pain, such as contact with clothing or other objects, and may persist even after removing the painful stimulus.
The pain can be intermittent or continuous and its intensity can be mild to very intense, depending on the cause and the nerves that are involved.
Causes of neuropathic pain
Neuropathic pain can be caused by several factors such as:
- Alcoholism or nutritional deficiency, which significantly affect nerve function; Diabetes mellitus, which mainly affects the limbs, causing peripheral diabetic neuropathy; Facial nerve problems; Thyroid problems; Infections by bacteria or viruses, such as syphilis, herpes or AIDS by example, which can affect the nerves by releasing toxins; Trauma to the spinal cord, caused by accidents, fractures or surgery; Amputation of a limb, in which pain referred to the missing limb appears, known as phantom limb pain.
In addition, chemotherapy and diseases such as multiple myeloma and multiple sclerosis can also cause neuropathic pain. Learn more about multiple sclerosis.
How the diagnosis is made
The symptoms help to distinguish neuropathic pain from other types of pain, but they are not enough to confirm the diagnosis. So, it is very important to talk to the doctor, who will be able to ask some questions in order to know how the pain is, when it occurs and with what intensity, and perform a physical evaluation or neuromuscular exams, in order to determine which neurological regions are affected.
What is the treatment
Neuropathic pain is usually curable, but if it is not possible, there are treatments that can help alleviate the suffering caused by the disease. Treatment depends on the disease that causes neuropathic pain, and consists of treating that disease or the nerve, and relieving the pain.
For this, anticonvulsant medications, such as Carbamazepine, Gabapentin or Pregabalin, for example, can be used, which work by decreasing the electrical activity of nerves or inhibiting the passage of pain through certain nerve pathways, centrally acting analgesics such as Tramadol and Tapentadol, which they calm the pain and decrease the electrical activity of the nerves, or even antidepressants such as Amitriptyline and Nortriptyline, which besides relieving the pain, also act in depression, very frequent in people with pain in the chronic phase.
Physiotherapy, occupational therapy and the use of electrical and thermal stimuli can also improve physical function and help a person gain functionality. In more severe cases of neuropathic pain, it may be necessary to resort to surgery.
