Nerve pain explained
Nerve pain is a specific type of pain that doesn’t normally respond to traditional painkillers. If you’re experiencing chronic nerve pain, you’re not alone – it’s thought to affect around seven out of 100 people in the UK. Read on to find out more about nerve pain, and how it can be treated and managed.
What is nerve pain?
To understand nerve pain, you have to first understand what the nerves are and what they do in the body. Nerves are bundles of fibres that connect the nervous system with different areas of the body, sending impulses to and from the central nervous system i.e. the brain and spinal cord.
There are different types of nerves around the body. Sensory nerves receive and send sensory information about things you’ve felt, smelt, tasted and heard, which means they’re important for detecting things like pain and temperature. Motor nerves tell your muscles to move. Autonomic nerves control automatic processes in the body like breathing or digesting food.
When the nerves are healthy, they receive and send “information” about what’s happening in the body correctly. For example, if there is damage to the body, e.g. from a cut or a burn, our sensory nerves will detect this and send pain messages to the brain – in other words, we will feel pain. However, this is not considered as “nerve pain”.
Nerve pain, or neuropathic pain, occurs when there is a problem with the nerves themselves. This means that the normal process of detecting and sending messages about pain, as well as other types of sensation, is disrupted. As a result, you might feel pain even when there’s been no new injury to the body.
Symptoms of nerve pain
Neuropathic pain has quite distinctive symptoms, and it feels different from other types of pain. If you have nerve pain you might experience burning, stabbing or shooting pains, or a feeling like an electric shock. You might also experience tingling, and pins and needles, or weakness in the affected area.
Peripheral neuropathy (nerve damage)
Nerve pain is particularly associated with peripheral neuropathy and is often caused by diabetes. This is a condition that affects the peripheral nervous system (i.e. the network of nerves outside of the brain and spinal cord) and specifically effecting the extremities, for example the hands, feet and arms.
Symptoms of peripheral neuropathy
The symptoms of peripheral neuropathy vary depending on which nerves are affected.
Sensory neuropathy can cause:
- Pins and needles
- Numbness, especially in the feet
- Reduced ability to feel pain or temperature changes
- Burning or sharp pains, usually in the feet
- Pain from a light touch to the skin/body part
- Loss of balance and difficult coordinating hands and feet
Motor neuropathy can cause:
- Twitching of the muscles
- Muscle cramps
- Muscle weakness or paralysis
- Thinning of the muscles
- Difficulty lifting your toes
Autonomic neuropathy can cause:
- Nausea and bloating
- Low blood pressure
- Rapid heartbeat
- Excessive sweating or not sweating enough
- Erectile dysfunction
- Problems emptying your bladder
What causes nerve pain?
There are lots of things that can cause nerve pain, including:
- Conditions such as trigeminal neuralgia – sudden severe pain in the face
- Multiple sclerosis – a condition affecting the brain and spinal cord
- Amputation of a limb, leading to phantom limb pain
Diabetes is also a common cause of nerve pain, and particularly peripheral neuropathy (i.e. nerve pain, tingling and weakness in the feet and hands). This is because high levels of sugar in the blood can damage the blood vessels that supply your nerves.
Other conditions that can cause peripheral neuropathy include:
- Vitamin deficiencies e.g. low vitamin B12
- Physical damage to the nerves, such as an injury
- Underactive thyroid
- Infections like Lyme disease
- Liver disease or kidney disease
- Rheumatoid arthritis
There are also certain types of medication and medical treatment that can cause peripheral neuropathy, including certain types of chemotherapy.
Diagnosing nerve pain
If you think you’re experiencing nerve pain, you should visit your GP for advice. It’s important to get a diagnosis from a doctor so you can begin addressing the problem with the correct treatments and lifestyle changes.
What is the best medication for nerve pain?
One of the problems with nerve pain is that it doesn’t respond well to standard, over-the-counter painkillers like paracetamol or ibuprofen. Instead, the main treatment which is recommended for neuropathic pain are antidepressants, as these work by interfering with nerve signals. The standard type prescribed is a tricyclic antidepressant, but others such as duloxetine can be used.
Other treatment options are:
- Anti-epileptic medicines like gabapentin and pregabalin
- Painkillers like codeine and tramadol
- Capsaicin cream
Treatment for peripheral neuropathy
For peripheral neuropathy, the first step may be addressing the underlying condition causing the symptoms. As an example, diabetics may require lifestyle changes like quitting smoking, cutting back on alcohol, and exercising. Or if you are vitamin b12 deficient, this can be treated with tablets of vitamin b12 injections. Medication like steroids or immunosuppressants may be prescribed to address certain led common types of peripheral neuropathy.
To relieve the pain itself, you might be prescribed one of the treatments listed above, such as antidepressants or capsaicin cream.
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