Neuropathic pain is referred to a chronic, complex state of pain which is usually comes with tissue injury. In this pain, the nerve fibers may be injured, dysfunctional, or damaged. These damaged or injured nerve fibers send wrong signals to the pain centres. The effect of this injury of the nerve fibers also changes the nerve function in the areas near the injury as well as at the site of the damage.
The Phantom limb syndrome is an example of neuropathic pain. It is a rare condition which occurs when a leg or an arm is amputated due to injury or illness, but the pain signals are still sent to the brain by the nerves which carried impulses originally from the part that’s missing. These nerves cause pain by misfiring and sending wrong pain messages even though the part has been removed long back.
There seems to be no obvious cause for neuropathic pain, yet some of the common causes that have been found are:
- Amputation of limbs due to injury or illness
- Drinking too much alcohol daily or extreme addictive alcoholism
- Hip, leg, and back problems
- Chronic diabetes
- Problems in the facial nerve
- Suffering from AIDS or HIV infection
- Multiple sclerosis
- Spine Surgery
- Chronic liver disease
- Some inflammatory conditions
- Folate or B12 vitamin deficiencies
- Hereditary diseases
Symptoms of Neuropathy:
Different cases of neuropathy may be different in nature and the symptoms vary according to the type of neuropathy.
Sensory Neuropathy –
- Hypersensitivity and pins and needles.
- Numbness and tingling.
- Not being able to detect changes in cold and heat.
- Bot being able to feel pain.
- Increased pain.
- Stabbing, burning, lancing, shooting pains.
- Leg and foot ulcers, and infections and gangrene.
- Nail, hair, or skin changes.
Motor Neuropathy –
- Muscle wasting
- Cramps and twitching in muscles
- Muscle paralysis
- Weakness of muscles, which result in difficulty and unsteadiness while doing small movements like buttoning the shirt.
Autonomic Neuropathy –
- Racing heart
- Not being able to tolerate heat
- Reduction in sweating
- Fainting in dizziness caused by sudden blood pressure change
- Diarrhoea, constipation, or bloating
- Erectile dysfunction (impotence)
- Not being able to control the bladder, leading to the retention of urine or incontinence.
How to Diagnose Neuropathy:
In order to diagnose neuropathy, the doctor will perform a physical exam and an interview. She or he may ask the patients some questions like how the patient would describe his/her pain, when does the pain occur, which body part experiences the pain, etc. The patient may also need to go through nerve and blood tests if the doctor requires so.
- A few studies show that using anti-inflammatory non-steroidal drugs like Motrin or Aleve may help in easing the pain. Some patients may need a stronger painkiller like the ones that contain morphine. Antidepressant and anticonvulsant drugs also work in some cases.
- In case the patient has another condition like diabetes, then managing that disorder in a better way may reduce the neuropathic pain. Proper management of that condition can prevent any further nerve or fiber damage.
- Difficult cases may need a pain specialist to use an implantable or invasive device in the body to manage the pain effectively. Using electricity to simulate the affected nerves may control the symptoms of pain significantly.
Some other types of treatments that can be used to treat neuropathy are:
- Sorting out psychological aspects with a counsellor
- Physical therapy
- Massage therapy
- Relaxation therapy
It has been noted that neuropathic pain does not respond well in some cases to standard treatments and may get worse occasionally instead of getting better. It may lead to serious disability in some patients.