A Guide To Neuropathic Pain

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.

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 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.

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.

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)

• • 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