A Guide To Neuropathic Pain

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This guide was part of a campaign we led called Mystery Pain in 2009. It was an information booklet produced to help people who suffer from pain. It explains the different types of pain, describes the symptoms and suggests possible treatment options.

When pain hits a nerve – understand how you are feeling

A simple guide to pain and its treatment
Pain is a widespread complaint and one of the most common reasons for seeking medical help. Pain is one of our body’s natural reactions that informs us about dysfunctions in our body or about damaging external factors. The sensation of pain occurs when pain receptors on the ends of sensory nerves are stimulated to transmit signals via the spinal cord to the brain.
. . .
Classification of pain by time

Acute pain (also described as short-term pain) is generally a warning signal and vital to life, protecting for example against burns, and signalling wounds and infections.

Another type of pain is chronic pain, which differs from acute pain in that it lasts for long periods of time and, if not treated, can seriously affect people’s quality of life and general well-being. It is pain that lasts beyond the expected period of healing and usually has no protective function.

. . .
Mechanisms of pain

Pain may be classified by:

    • duration (acute or chronic pain)
    • cause (e.g. arthritis) or
    • location (e.g. headache, back pain)

It can also be classified by the underlying mechanism; two types are typically distinguished:

Nociceptive pain

Nociceptive pain is caused by damage to tissue (e.g. bones and muscles). Substances released at the site of the injury stimulate pain nerves and transmit this information to the brain which recognises it as pain. In this instance, pain serves as a warning signal and a protection mechanism function, and it usually disappears when the initial damage has healed.

Neuropathic pain

Neuropathic pain results from direct damage to any part of the nervous system (peripheral nerves, the spinal cord or the brain). The damage causes nerves to transmit signals abnormally to the brain where they are recognised as pain. The pain is often very intense, and may occur spontaneously. The pain may persist after the original damage has been repaired, and in this situation it has no protective function.
. . .
What are the symptoms of neuropathic pain?

Neuropathic pain can be a chronic pain and it can be triggered by things that are not usually painful, such as something touching the skin or a slight change in the ambient temperature or sometimes even without any stimulus.

People often describe neuropathic pain as:

    • Burning, shooting or stabbing
    • An electric shock
    • Itching, oversensitivity or numbness
    • Tingling (like the feeling of insects crawling over the skin)

The pain can happen at any time and can sometimes have a severe impact on a person’s ability to do simple things like getting dressed, walking, or even lying in bed.

Chronic back pain can often have a neuropathic component.

. . .
What can cause neuropathic pain?

A number of conditions can directly damage nerves and lead to neuropathic pain, such as:

    • Multiple sclerosis 
    • Amputation of a limb (phantom pain) 
    • An accident (i.e. deep tissue wound, broken bones)

Neuropathic pain can also be a relatively common complication of other conditions which affect the nerves such as:

    • Diabetes 
    • Shingles 
    • Back problems

This explains why neuropathic pain is a more common cause of chronic pain than many people realise. Fortunately, neuropathic pain can be treated.

. . .

How is pain treated?

Pain diagnosis and treatment should always be carried out by a doctor. There are a number of effective treatments for pain, and different types of pain need different kinds of treatments. Therefore it is important to be diagnosed by your doctor so you can be treated as soon as possible.
. . .

How is neuropathic pain treated?

Conventional painkillers (analgesics) often don’t work well in treating neuropathic pain. This has led to the development of specific medications.

There are a number of different neuropathic pain treatments available, including medicines that act to reduce the excessive pain signals.

Although medications may not completely relieve the symptoms of neuropathic pain, they can help improve associated problems such as disrupted sleep.

Different treatments are suitable for different people, and your doctor will choose what is best for you.

Other treatment options are: 

    • Physical therapies (e.g. using heat therapy) 
    • Physiotherapy (e.g. stretching or strengthening exercises) 
    • TENS (transcutaneous electrical nerve stimulation) treatment 
    • Acupuncture 
    • Psychological methods of treatment (e.g. coming to terms with pain, relaxation techniques, psychotherapeutic methods)
. . .
Helpful tips
    • You are not alone – in Europe nearly 1 in 5 (19%) of people suffer from chronic pain. In Ireland, 1 in 3 people have chronic pain
    • Don’t wait too long before seeking professional help – visit a doctor as soon as possible 
    • Be honest with your doctor and provide details of your pain and, if necessary, the effect it has on your life (e.g. ability to work, lack of interest, social withdrawal, etc.) 
    • Ask your doctor questions and become properly informed 
    • Consider that your pain could be ‘neuropathic pain’ 
    • It could be useful to involve specialists (e.g. neurologists, pain specialists) 
    • Pain must be treated early and consistently 
    • Always take your medicines regularly – only change the dose after discussion with your doctor 
    • Remain physically active – inactivity causes the muscles to become weak and tight, which could increase the problems caused by pain 
    • Do not become withdrawn. Do not isolate yourself from friends and acquaintances 
    • Good pain therapy should help you to take an active part in everyday life 
    • With effective pain therapy you, not your pain, will decide how to live each day
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