Humans experience two types of pain. Nociceptive pain is the normal response to bodily injury, such as a bruise, sprain or burn. In contrast, neuropathic pain arises when damage occurs to the nerves that transmit pain signals. The sensations associated with neuropathic pain typically include aching, burning, stabbing or an electrical shock feeling. People with neuropathic pain often experience a combination of pain sensations. Many different neurological disorders can give rise to neuropathic pain.
Trigeminal Neuralgia
Trigeminal neuralgia, or tic douloureux, is a chronic neuropathic pain disorder characterized by episodes of sudden, severe facial pain. Pain arises from the trigeminal nerve, which carries sensory messages to and from the face. People with trigeminal neuralgia describe their pain as an excruciating shock-like or burning sensation on one side of the lower face, cheek or jaw or around the eye. A pain attack typically lasts from several seconds to a few minutes, notes the National Institute of Neurological Disorders and Stroke. Trigeminal neuralgia most commonly occurs in people older than age 50, with women disproportionately affected.
Although trigeminal neuralgia is not a life-threatening disorder, the pain attacks can prove disabling. Possible treatment options include antiseizure or antidepressant medication, acupuncture, biofeedback and other complementary therapies. People who experience frequent pain episodes that do not respond to other forms of treatment may opt for surgery to relieve pressure on the affected nerve.
Occipital Neuralgia
Occipital neuralgia is a pain disorder caused by irritation or damage to the occipital nerves. Sporadic shock-like or shooting pains occur in conjunction with continuous burning, aching or throbbing pain that begins at the nape of the neck and radiates upward over the back of the head. Pain may also occur on the side of the head or behind the eye. Certain types of neck movement may provoke pain.
The American Academy of Neurological Surgeons reports that possible causes of irritation or injury to the occipital nerves include trauma to the back of the head, chronic neck muscle tension, arthritis of the spine bones of the neck, degenerative disk disease in the neck, diabetes-related nerve damage and tumors that compress the nerves. Treatment options for occipital neuralgia include physical therapy, anti-inflammatory and antiseizure medications, muscle relaxants, nerve blocks, and surgery.
Multiple Sclerosis
Multiple sclerosis is a chronic neurological condition characterized by inflammation of the nerves of the brain and body. The disease process leads to loss of myelin, a substance that insulates the nerves and aids in the transmission of nerve signals. People with multiple sclerosis may have abnormalities of the pain nerves, which can lead to shock-like, shooting, burning or stabbing sensations. In a 2004 article published in "American Family Physician," Dr. Peter Calabresi notes that Lhermitte's sign---an electrical shock sensation that radiates down the spine with bending the head toward the chest---is a classic symptom of multiple sclerosis. Patients with multiple sclerosis may also experience symptoms of trigeminal neuralgia. Treatment of multiple sclerosis involves symptomatic therapy and medications to slow disease progression.
References
- National Institute of Neurological Disorders and Stroke: Trigeminal Neuralgia
- American Association of Neurological Surgeons: Occipital Neuralgia
- "American Family Physician"; Diagnosis and Management of Multiple Sclerosis; Peter A. Calabresi, M.D.; November 2004
- The Merck Manual for Healthcare Professionals: Pain, Introduction
- American Association of Neurological Surgeons: Trigeminal Neuralgia
