Neuropathic pain is a chronic condition that arises out of wrong signals sent by damaged or malfunctioning nerves. While diabetes is the most common cause for this condition, there are over a hundred different ailments or causes that trigger neuropathic pain. Accordingly, there are various types of neuropathic pain with unique causes and symptoms. In this article, we will explore the same, along with treatment options.
The nervous system in human beings can be broadly divided into – the Central Nervous System (CNS) which consists of the brain and spinal cord, and the Peripheral Nervous System (PNS). The PNS consists of nerves that are distributed throughout the body, such as in the arms, legs, hands, feet and various internal organs. Pain is a natural response of the nervous system to disease or injury, in a specific part of the body. Bone(s), muscle(s) or other tissue(s) in that area may be damaged. Pain signals are sent back and forth between the concerned area and the brain. It is a signal to the human concerned, to take remedial action. This is how the normal pain mechanism works, where nerves are healthy and working as expected.
However, when there is damage to nerves, in one or more parts of the body, due to physical injury, or some bio-chemical changes happening in the body (due to various reasons), they start malfunctioning. They send pain signals even there is no need to. This results in pain, which is called Neuropathic pain. This pain can be mild to severe and is generally chronic. That is, the condition lasts for long durations of time, or is even permanent. In the latter case, treatment options aim at reducing or managing pain better, instead of eliminating it altogether. Incidentally, Neuropathic pain can affect nerves in both CNS and PNS.
Damage to a single nerve is called mono-neuropathy. Mono-neuropathy in multiple places in the body is called multiple mono-neuropathy. And damage to many nerves is called polyneuropathy. There are multiple types of neuropathic pain and newer ones may emerge with time, thanks to lifestyle changes. Here, we will only cover the most common ones.
Like any other tissue in the body, nerves too require their supply of oxygenated blood. Diabetes is a condition marked by high blood-sugar levels in the body. The excess sugar causes damage to blood vessels. This results in reduced supply of oxygen and nutrients to nerves, causing impaired functioning of the nerves, and in turn – neuropathic pain.
As the name implies, this type of pain affects nerves in the PNS, such as those in arms, hands, legs and feet.
As the names implies, here the damage is to a single nerve located in the head, arms, legs or torso. This can cause double-vision, pain and sudden weakness in different parts of the body including the front of the thigh. Bell’s palsy is one such type of focal neuropathy, and is marked by sudden weakness or paralysis in one side of the face.
As the name implies, this affects the Autonomous Nervous System that controls or regulate the functioning of internal organs of various body-systems (circulatory/digestive/respiratory/excretory). Depending on which body-system is affected, this condition shows different symptoms.
A rare type of neuropathy. Here, nerves in the hip, thigh or buttock in one side of the body are affected. The condition can cause severe pain, muscle loss, weight loss and difficulty in movement.
Nearly 80% of people with a missing limb (whether entire or part of the limb is missing) experience this condition. The nerves near the amputated end may be damaged due to amputation. They malfunction and send pain signals to the brain and spinal cord. The pain is frequent in the 6 months following surgery and reduces over the years.
As the name implies, there is damage to a single nerve caused by compression injuries, or even a blood-vessel disease. The narrowed blood-vessels results in reduced blood-flow to the nerves causing this condition. The nerves passing over a joint may get compressed due to injury or a particular movement that is repeated (due to occupation, or wrong habits of movement). The best example of this is Carpal tunnel syndrome, where the median nerve gets compressed at the wrist. This is marked by numbness, swelling and tingling sensation in the fingers while using the hands or sleeping.
Here, nerves in one or both sides of the chest, or abdominal wall, are affected. It is common in people with type-2 diabetes. However, it is not serious and the patient recovers with time.
An incident of stroke or Multiple Sclerosis or a surgery in the face can compress or damage the trigeminal nerve in the head. Symptoms include intense pain in the face which makes even everyday activities such like washing the face and brushing the teeth painful.
Implantable device: Using an invasive surgery, a device is implanted in the brain. This sends out electrical signals to the concerned nerve and helps correct the wrong signals.
Transcutaneous Electrical Nerve Stimulation (TENS): Here, an electrode is stuck on the skin above the affected nerves. Then the TENS machine sends out small electrical signals through the electrode. This stimulates the concerned nerves and blocks out wrong signals. This helps relax the muscles and ease the pain.
Percutaneous Electrical Nerve Stimulation (PENS): Similar to TENS. But here, the electrode is put under the skin using a needle.
Alternative therapies: such as acupuncture, massage therapy, relaxation therapy and physiotherapy.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801
NOTE: Take medications only when prescribed by your doctors, self-medication must be avoided under any circumstances.
Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals
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