When Lightning Keeps Striking: Nerve Pain.

What is Nerve Pain? (Neuralgia)

A shock, an itch, the prick of a pin, the stab of a needle, an intense burning; these are a few words that more than 40 million people in the United States may use to describe their experiences with nerve pain. Also known as peripheral neuropathy or neuralgia, it is a condition in which the peripheral nerves are damaged or irritated, causing sharp and intense pain.

The peripheral nerves are the body’s link that sends sensory information from the brain and spinal cord to the rest of the body. Sensory information mobilizes our body, allows us to sense temperature, and is responsible for functions such as blood pressure, digestion, heart rate, and bladder function. Damage to the peripheral nerves can be very critical. Depending on the severity, it could lead to paralysis of body functions, and eventually, the central nervous system. 

Symptoms of Nerve Pain (Neuralgia)

Individuals with nerve pain may experience extreme sensitivity to touch, pins, and needles in their hands and feet, numbness, muscle weakness, sharp pain, or burning pain. Those with nerve pain may also suffer intense pain from activities that would usually not cause pain or had not caused pain before the condition. Frustratingly, someone cannot predict nerve pain, and symptoms often are very prevalent at night time. 

Nerve pain often causes a significant impact on exercise, sleep, and work and carries a financial burden ($4 billion annually in the United States) of medical treatment for the condition. Sleep disturbance is widely reported in individuals with nerve pain. In one study, researchers found that the prevalence of sleep disturbances in individuals with nerve pain ranged from 50 to 80 percent. Unfortunately, low sleep quality may worsen the nerve pain in the individual. Studies have shown that the negative impact on the quality of life may be very severe. In one study, 72 percent of patients with nerve pain were at risk of developing depression. 

What are the causes of Nerve Pain?

Surprisingly, there are over 100 types of nerve pain that vary in symptoms and prognosis. However, the significant causes of nerve pain are diabetes and injury to the brain and spinal cord. 

Diabetes

Diabetic neuropathy is caused by long term, high levels of blood sugar. They are mostly affecting the nerves in the legs and feet, causing pain, numbness, tingling, and weakness. It may also affect the digestive system, urinary tract, blood vessels, and heart. Diabetic neuropathy pain may range from mild to severe and occurs in up to 70 percent of patients with diabetes. Depending on the type of diabetic neuropathy (peripheral, autonomic, proximal, and mononeuropathy), one has symptoms ranging from tingling sensation, numbness, sharp pains, foot ulcer, bowel dysfunction, amongst others, can occur.

Injury to the brain or spinal cord

There are roughly 2.6 million people who suffer from brain trauma annually and 249,000 to 363,000 people currently living with a Spinal Cord Injury in the United States.

When there is an injury to the brain or spinal cord, it can affect nerves and impulses. The body may no longer be able to perform some functions that may have come easily before. 

Individuals with a spinal cord injury may experience sensation loss: the inability to feel hot or cold, pressure, pain, and may not regulate body temperature. They may also experience the loss of movement or muscle control and the loss of bowel and/or bladder control. 

Brain injury, or traumatic brain injury, is typically caused by accident or injury. Symptoms range from mild to severe. A review of multiple studies found that 26 to 96 percent of individuals with Brain Injury or Spinal Cord Injury experienced chronic pain. After a year of treatment, 59 percent of individuals still experienced nerve pain. Researchers found that nerve pain was the “most debilitating” and “difficult to treat” pain condition.

Other causes of neuralgia

some medications: cancer medications, blood pressure medication, etc.

heavy alcohol use

vitamin B12 or vitamin B1 deficiency

phantom pain after an amputation 

• deficient blood supply to the nerves

multiple sclerosis

HIV/AIDS

• cancer chemotherapy treatment 

Sciatica, Radiating Nerve Pain

Another form of nerve pain is Sciatica, most prevalent in those with low back pain, where pressure on the nerves of the low back (sciatic nerve) causes intense radiating leg pain that may extend to the toes. It has been estimated that 40 percent of people will likely experience Sciatica at some point in their life. Pain caused by Sciatica could lead to an antalgic gait or even immobility, resulting in the lower extremities’ muscles’ atrophy.

Fibromyalgia and Nerve Pain

Widespread pain, pressure sensitivity, sleep disturbances, and overwhelming fatigue are symptoms of the debilitating condition, Fibromyalgia. More prevalent in females, Fibromyalgia is estimated to affect up to 4 percent of the United States population and 8 percent of the global population. Ninety percent of those with the condition are female. 

Also associated with Fibromyalgia is nerve pain. In one study, half of the group individuals had been found to have nerve damage and evidence of Small-Fiber Polyneuropathy, SFPN. It was found that most individuals with the condition report numbness, burning and tingling, and up to 70 percent report frequent migraine headaches. Throbbing, aching, shooting and burning have all been used to describe the type of pain. 

Nerve Pain Treatments

When treating nerve pain, it is essential to identify and diagnose what is causing the patient’s pain. The diagnosis and cause of nerve pain will determine the course of treatment for the patient. However, suppose the physician is unable to identify the cause of the pain. In that case, the physician may recommend general therapies such as administering pain relievers, relaxation and exercise medicines and administering essential vitamins.

Vitamin B12 and Nerve Pain

Fish, clams, beef liver, and eggs are a few natural sources of Vitamin B12. A nutrient that helps create DNA produces red blood cells and prevents anemia, Vitamin B12 is vital to our health and has been studied since 1948 when it was first isolated in a lab. However, it has been estimated that up to 15 percent of people are deficient in this essential vitamin. As critical it is to our health, Vitamin B12 has been researched as an effective treatment for nerve pain. Vitamin B12 alleviates pain by increasing nerve regeneration, reducing nerve firing, and promoting the myelin sheath. Researchers studying the activated form of Vitamin B12, Methylcobalamin, found it has an analgesic effect for individuals with low back pain, neck pain, diabetic neuropathic pain, and other neuralgia conditions and best works when in combination with other pain medications.

Capsaicin and Nerve Pain

Capsaicin, the ingredient that gives peppers the heat and kicks, may be useful in providing topical relief for those with nerve pain. Capsaicin works topically by stimulating fibers that encourage the brain to release sensory neurotransmitters that mediate pain—working by reducing substance P, responsible for painful impulses. Although it may cause discomfort upon first application, with frequent use, It has been found to desensitize nerve endings when applied topically and now is often used as an analgesic.

Research has shown that capsaicin is more effective when used as an additional treatment to medical therapies. In the European Journal of Pain, medical researchers found that Qutenza, a drug with an 8 percent component of capsaicin, can relieve significant pain to a very minimal level. In research published in the Isfahan University Medical Journal, a 12-week test was carried out on diabetic peripheral neuropathy patients using clonidine gel and capsaicin cream. Researchers found that both remedies are effectively relieving neuropathy from diabetes and other types of related pain.

Also, in the Evidence for the efficacy of alternative medicines in osteoarthritis treatment review journal, they found that capsaicin is very useful for arthritis and pain conditions involving the wrists, knee, and other joints.

Nerve Block Injection

When suffering from nerve pain, the idea of injection might be highly unappealing,

However, nerve block injections are frequently used to prevent or control pain temporarily. The main types of nerve blocks are spinal, non-spinal, peripheral, and sympathetic. Each responsible for treating pain in different areas of the body. Nerve blocks treat acute pain, arthritis, neuralgias, phantom limb pain, and migraines. 

In addition to treating pain, nerve block injections may be used as a diagnostic tool to discover the source of pain and also as a preemptive measure to reduce pain from specific procedures. 

During the injection, the physician will use imaging guidance, fluoroscopy to help guide the needle to the desired location. When the needle is in the proper place, the anesthetic medication is injected. The effects may be felt within 15 minutes to 45 minutes of the injection and typically last anywhere from days to months.

Disclaimer: The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek your physician’s advice or other qualified health providers with any questions regarding a medical condition.

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