Neuropathic pain

An Overview

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. Neuropathic pain can happen if your nervous system is damaged or not working correctly. You can feel pain from any of the various levels of the nervous system the peripheral nerves, the spinal cord and the brain. Together, the spinal cord and the brain are known as the central nervous system. Peripheral nerves are the ones that are spread throughout the rest of your body to places likes organs, arms, legs, fingers and toes.

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. Peripheral nerves are the ones that are spread throughout the rest of your body to places likes organs, arms, legs, fingers and toes.
Damaged nerve fibers send the wrong signals to pain centers. Nerve function may change at the site of the nerve damage, as well as areas in the central nervous system (central sensitization).
Neuropathy is a disturbance of function or a change in one or several nerves.Diabetes is responsible for about 30% of neuropathy cases.

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. The most common causes for neuropathic pain can be divided into four main categories: disease, injury, infection, and loss of limb.

Causes of Nueropathy pain

Injuries

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.

Infection

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.

Disease

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.
Neuropathic pain can be caused by diseases, including:
• Alcoholism.
• Diabetes.
• Facial nerve problems.
• HIV infection or AIDS.
• Central nervous system disorders (stroke, Parkinson’s disease, multiple sclerosis, etc.)
• Complex regional pain syndrome.
• Shingles. (Pain that continues after your bout with shingles ends is called postherpetic neuralgia.)
• Inherited disorders. Disorders such as Charcot-Marie-Tooth disease are hereditary types of neuropathy.
• Tumors. Growths, cancerous (malignant) and noncancerous (benign), can develop on the nerves or press on nerves. Also, polyneuropathy can arise as a result of some cancers related to the body’s immune response. These are a form of a degenerative disorder called paraneoplastic syndrome.
• Bone marrow disorders. These include an abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (myeloma), lymphoma and the rare disease amyloidosis.
• Other diseases. These include kidney disease, liver disease, connective tissue disorders and an underactive thyroid (hypothyroidism).

Symptoms for Nueropatic pain

• Spontaneous pain (pain that comes without stimulation): Shooting, burning, stabbing, or electric shock-like pain; tingling, numbness, or a “pins and needles” feeling
• Evoked pain: Pain brought on by normally non-painful stimuli such as cold, gentle brushing against the skin, pressure, etc. This is called allodynia. Evoked pain also may mean the increase of pain by normally painful stimuli such as pinpricks and heat. This type of pain is called hyperalgesia.
• Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms
• Sharp, jabbing, throbbing or burning pain
• Extreme sensitivity to touch
• Pain during activities that shouldn’t cause pain, such as pain in your feet when putting weight on them or when they’re under a blanket
• Lack of coordination and falling
• Muscle weakness
• Feeling as if you’re wearing gloves or socks when you’re not
• Paralysis if motor nerves are affected
• An unpleasant, abnormal sensation whether spontaneous or evoked (dysesthesia).
• Trouble sleeping, and emotional problems due to disturbed sleep and pain.
• Pain that may be lessened in response to a normally painful stimulus (hypoalgesia).

Prevention

• Eat a diet rich in fruits, vegetables, whole grains and lean protein to keep nerves healthy. Protect against vitamin B-12 deficiency by eating meats, fish, eggs, low-fat dairy foods and fortified cereals. If you’re vegetarian or vegan, fortified cereals are a good source of vitamin B-12, but talk to your doctor about B-12 supplements.
• Exercise regularly. With your doctor’s OK, try to get at least 30 minutes to one hour of exercise at least three times a week.
• Avoid factors that may cause nerve damage, including repetitive motions, cramped positions that put pressure on nerves, exposure to toxic chemicals, smoking and overindulging in alcohol.

Diagnosis

Your healthcare provider will take a medical history and do a physical exam. If your provider knows or suspects you have nerve injury, they will recognize typical neuropathic pain symptoms. Your provider will then try to find the underlying cause of the neuropathy and trace the symptoms.

People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. In many cases, symptoms improve, especially if caused by a treatable condition. Medications can reduce the pain of peripheral neuropathy

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