A patient’s guide to neuropathic pain

Neuropathic pain is a complex and often misunderstood type of pain that originates from damage or dysfunction in the nervous system. Unlike pain caused by an injury, such as a cut or a broken bone, neuropathic pain arises when nerves themselves are injured, irritated, or not functioning correctly. This can lead to unusual and often debilitating sensations, making it challenging to manage in day-to-day life.

We speak to an experienced consultant in pain management who explains the causes and diagnosis of neuropathic pain.

What does neuropathic pain feel like?

Neuropathic pain can vary widely between individuals. Some people describe it as a burning, shooting, or stabbing sensation, while others report tingling, numbness, or an "electric shock" feeling. These symptoms might be constant, or they could come and go unpredictably. Additionally, certain areas of your skin may become overly sensitive to touch, even to things that wouldn’t typically cause discomfort, such as wearing clothing or a light breeze.

What causes neuropathic pain?

There are several potential causes of neuropathic pain. Conditions such as diabetes, which can damage nerves over time, are common culprits. This type of nerve damage is referred to as diabetic neuropathy. Other causes include shingles, which may lead to postherpetic neuralgia, and injuries to the spinal cord or nerves themselves. In some cases, neuropathic pain develops after surgery or as a side effect of certain medications. Sometimes, no clear cause can be identified, which can make diagnosis and treatment more challenging.

How is neuropathic pain diagnosed?

Diagnosing neuropathic pain involves a thorough evaluation by a doctor. They will typically ask you about your symptoms, medical history, and any underlying conditions that could be contributing. Physical and neurological exams are often performed to check how your nerves are functioning. In some cases, tests like blood work, imaging scans, or nerve conduction studies might be used to gather more information.

What treatments are available?

Treating neuropathic pain often requires a tailored approach, as what works for one person might not work for another. Medications such as antidepressants and anti-epileptic drugs are commonly prescribed, as they can help to calm overactive nerves. Topical treatments, like creams or patches containing anaesthetic or capsaicin, may also provide relief.

For some people, physical therapy or counselling can be beneficial, especially if the pain is affecting mobility or emotional well-being. In cases where these options are not sufficient, advanced treatments such as nerve blocks or spinal cord stimulation might be considered.

How can lifestyle changes help?

Although neuropathic pain is a medical condition, certain lifestyle adjustments can support overall management. Maintaining good blood sugar control, if you have diabetes, is vital. Regular physical activity, under the guidance of a professional, can help improve nerve function and reduce pain. Stress management techniques, such as mindfulness or yoga, may also lessen the intensity of symptoms.