Neuropathic pain is a chronic pain condition caused by damage to the nerves, spinal cord, or brain. It often develops after an injury, a stroke, or as a result of diabetic neuropathy. In some cases, there is no clear trigger. The pain can also continue even after the original stimulus is gone.
In addition to pain, you may also feel other sensations in the affected area, such as burning, an electric shock–like feeling, or a “pins and needles” sensation.
If neuropathic pain is suspected, it is important to see a neurologist. Once the diagnosis is confirmed, treatment may include medications (such as pain relievers or anticonvulsants) and, in some cases, surgery.
Common symptoms
The main symptoms of neuropathic pain are:
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Pain in parts of the body without a specific cause;
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Increased or decreased sensitivity in the affected area;
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Burning, tingling, stabbing, or electric shock-like sensations on the skin;
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Tingling or numbness in parts of the body.
Neuropathic pain often starts with stimuli that usually do not cause pain, such as clothing brushing against the skin, a light touch, or walking on soft surfaces. According to the International Association for the Study of Pain (IASP), this type of “pain due to a stimulus that does not normally provoke pain” is called allodynia. Sometimes, the pain may continue even after the stimulus is removed.
Neuropathic pain can make it difficult for a person to manage daily activities and may also lead to other problems, including anxiety, depression, and trouble sleeping.
Possible causes
Neuropathic pain occurs when the part of the nervous system responsible for sensation does not function properly. It can develop after damage to the nerves, spinal cord, or specific regions of the brain.
According to the CDC, high blood sugar can cause nerve damage known as diabetic neuropathy, a common source of neuropathic pain. This condition is also more likely to occur in people with alcohol use disorder or vitamin deficiencies, and it can develop after accidents or surgeries that result in nerve injury in the affected area.
Neuropathic pain can also develop with conditions such as untreated HIV, multiple sclerosis, and certain tumors. It may also occur after chemotherapy treatment or following a stroke.
Is neuropathic pain fibromyalgia?
Neuropathic pain is not fibromyalgia. Even though they can sometimes feel similar, neuropathic pain may be linked to other causes, such as alcohol use disorder, vitamin deficiencies, and accidents.
Confirming a diagnosis
Neuropathic pain is usually diagnosed by a neurologist based on symptoms, health history, and a physical exam.
Additional tests may also be recommended to confirm the diagnosis and help identify the cause, such as electromyography, nerve conduction studies, MRI, or a skin biopsy.
Treatment options
The main treatment options for neuropathic pain are:
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Antidepressants, such as amitriptyline and duloxetine;
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Anticonvulsants, such as carbamazepine, gabapentin, and pregabalin;
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Strong pain relievers, such as tramadol;
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Pain patches with lidocaine or capsaicin, for example;
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Rehabilitative therapies, such as physical therapy, occupational therapy, and talk therapy;
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Botulinum toxin (Botox) injections to block nerve signaling in specific nerves;
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Surgery, when the pain is caused by nerve compression, for example.
To treat neuropathic pain, it is also important to treat underlying conditions such as HIV and diabetes.
Is neuropathic pain curable?
Depending on the cause, neuropathic pain may not be curable. Still, symptoms can be relieved and the condition’s progression can be managed with the treatment recommended by a healthcare provider.
In some cases, neuropathic pain may become chronic pain.