The nerves in the body send a variety of signals to the brain. When nerves are damaged, pain signals can be sent to the brain, resulting in neuropathic pain. Neuropathic pain can be very difficult to treat, but there are a variety of options available for pain relief.
Importance of Diagnosis
Diagnosing the cause of neuropathic pain is important for guiding treatment, the Merck Manual explains. There are a number of different ways in which the cause of the nerve damage can be detected. A MRI or CT scan can be done to look for any problems, such as swelling or a tumor, which could be pressing on nerves. Blood tests can be done to check for any systemic diseases, such as diabetes or auto-immune conditions, which are causing nerve damage. Electromyography is a test that can identify which nerves are damaged. Finally, a nerve biopsy can be performed to look at the cells within the nerve to attempt to determine the cause of the pain.
Treatment of Underlying Disorders
One of the first steps in treating neuropathic pain is to attempt to treat the underling disease causing the nerve damage, the National Guideline Clearinghouse explains. Neuropathic pain caused by diabetes can be treated by lowering the patient's blood sugar. Other conditions that can be treated include vitamin deficiencies, alcohol abuse, and exposure to certain toxic chemicals, MedlinePlus notes. Certain infections, such as HIV, leprosy, hepatitis and Lyme disease, can also cause nerve pain. Finally, some cases of neuropathic pain are caused by immunological problems, such as Guillain-Barre syndrome, lupus, sarcoidosis and Sjogren syndrome. Treatments that reduce the inflammation that these diseases cause can also relieve nerve pain.
Medications
There are a number of medications that can be prescribed for patients with neuropathic pain. Anticonvulsants, which are medications that can also be used to treat epilepsy, are often effective at treating neuropathic pain because they can reduce aberrant signaling from the damaged nerves. Antidepressants, such as nortriptyline, citalopram and duloxetine can also be used to treat neuropathic pain. Topical medications, such as lidocaine and capsaicin can be applied if the pain is occurring in nerve fibers near the skin. Finally, opioids can be used to treat some cases of neuropathic pain. These drugs, however, are less effective for treating neuropathic pain and carry with them a high risk of abuse.
Surgery
Surgery can be effective for the treatment of neuropathic pain that is caused by nerve compression, the Merck Manual indicates. Anything that presses on the nerves can cause the nerves to become squeezed or pinched, which often causes pain signals to be generated. Surgery may be needed to remove a tumor that is pressing on a nerve; it can also be performed to create more space for the nerve in order to avoid further compression.
Physical Therapy
Physical therapy is an important part of neuropathic pain relief because patients may avoid using the affected parts of their body. This can lead to the muscles in the affected area atrophying, which causes progressive weakness. Inactivity stemming from neuropathic pain can also cause loss of joint mobility and arthritis. Additionally, physical therapy can give patients techniques that they can use to minimize the pain while completing everyday activities.
