Neuropathic Pain, otherwise known as nerve pain, is pain that arises from damage or dysfunction of nerves. Strictly speaking, it is pain generated by a lesion or disease of the somatosensory nervous system. Nerve fibres may be injured or damaged, and as result send incorrect signals to pain centres. Neuropathic pain can also be accompanied by a tissue injury.

Neuropathic pain is often severe and unrelenting. It does not start or resolve abruptly – rather, it is a persistent condition. It can be classified as central (arising from the brain or spinal cord) or peripheral (arising from nerves located outside the central nervous system).

Other names for neuropathic pain include but are not limited to: Nerve pain, Neuralgia, or Neuropathy.

Common conditions associated with neuropathic pain include but are not limited to: Peripheral neuropathy (PN), Sciatica, Radicular pain, Brachalgia, Trigeminal Neuralgia, Post-Herpetic Neuralgia (PHN), Shingles, Chronic Post-Surgical Pain (CPSP), Complex Regional Pain Syndrome (CRPS), Phantom Limb Pain (PLP), Diabetic Neuropathy (Diabetes), and Failed Back Surgery Syndrome (FBSS).

There are a variety of causes for nerve pain, including disc, back, leg or hip problems, chemotherapy, alcoholism, diabetes, multiple sclerosis, shingles or spine surgery, to name a few.

Signs and Symptoms

Signs and symptoms of nerve pain vary for each patient. However, unlike other persistent pain, nerve pain has few objective signs. There are many descriptors for what neuropathic pain feels like: burning, shooting, electric shocks, cold, tingling, crawling, numb pain, pins-and-needles. Patients experiencing nerve pain are often asked to rate their pain on a scale, in order for specialists to help identify what each patient is feeling.

Commonly neuropathic pain is associated with:

  • Allodynia: pain from a sensation which is not normally painful (eg. a breeze or rubbing of clothing causing pain on the affected area)
  • Hyperalgesia: increased pain from a sensation which is normally only mildly painful (eg. a pin prick)
  • Hypersensitivity: overly sensitive skin or body membranes
  • Referred pain: Pain which appears in a different area to the lesion or disease of the nerve.

Management

Neuropathic pain can often be difficult to treat. However, recent years have seen major advancements, with new technology, new drugs and new ways to administer old drugs. Technologies that have shown impressive response rates include Spinal Cord Stimulation and Dorsal Root Ganglion Stimulation. QPain’s pain specialists are able to use their expertise to administer this new technology.

QPain’s pain specialists work on the cutting edge of these advanced technologies. Specialists can diagnose pain, and create a personalised treatment plan to suit your needs and manage your pain.

Nerve Pain treatment can often involve:

  • Non-procedural treatments:
    • Pharmacotherapy (medications)
    • Antineuropathic medications
      • Anticonvulsants: pregabalin (Lyrica), gabapentin (Neurontin), carbamazepine (Tegretol)
      • Antidepressant medications: amitryptylline (Endep), nortryptylline (Allegron), duloxetine (Cymbalta), venlafaxine (Efexor), desvenlafaxine (Pristiq)
  • Opioids and related drugs: tapentadol (Palexia), oxycodone (Endone, Targin, Oxycontin), buprenorphine (Norspan, Temgesic), fentanyl (Durogesic).
  • Others: botulinum toxin, local anaesthetics (lidocaine), pamidronate, ketamine.

Treatment is often a combination of all options, which can be multimodal or multidisciplinary treatment.

Patients may benefit from a pain management program, which works to improve quality of life and function. If this sounds like something that would be beneficial, contact a QPain specialist, who can arrange a program for you.