Neuropathic pain or nerve pain is a relatively common experience which can cause significant debility. This is a type of pain related to pinched or damaged nerves. This disease can result in an error in the brain’s ability to send signals to a target in your body, preventing that information from reaching the target. Alternatively, something could be wrong along the pathway of signals returning to your brain and the signals coming back from the body to the brain may be misinterpreted. In any case, there is something off about the way signals are being sent or received in your body resulting in the activation of pain receptors and some very intense pain as a result.
What causes nerve pain?
Some diseases that may result in neuropathic pain as a complication include diabetes, cancer, stroke, amputations, and shingles. Locally pinched nerves could also give you neuropathic pain as well. Despite many things being associated with neuropathic pain, most cases are considered idiopathic – meaning we don’t know what is causing this pain.
How to treat nerve pain
Exercise is the best medicine
Treating nerve pain can be difficult because everyone’s body responds to pain and medications differently. Often times, the best treatment is not necessarily medication but working with a good physical therapist that tailors a program to your specific issues. Research has shown that even regular exercise can help with nerve pain (and really, any kind of pain). There are many theories as to why this is the case, but likely involves exercise desensitizing pain and stretch receptors in your body over time.
Aside from exercise and therapy, there are many topical and oral medications that your doctor may recommend you to try.
Topical medicine or anything you put on your skin includes nearly a whole aisle in the drug store devoted to pain creams and patches. These medicines typically work by sending signals to local pain receptors where the medication is applied that may calm them down, or result in non-painful sensations interpreted by your brain. For example, a lot of creams include lidocaine that tends to give people a cooling sensation where it is applied. Sometimes a doctor may prescribe you a compounded cream – a cream put together by pharmacists with custom ingredients. These can work slightly better than traditional creams for certain people. Sometimes these creams include capsaicin, the main ingredient responsible for the “hotness” in peppers. This may unfortunately create an intense burning sensation in some individuals. But, capsaicin can have excellent effects in people that tolerate it so many creams still include it.
When the pain you experience is in a larger area or topical medicines are not enough, sometimes it is necessary to try oral medications. Most of these medications work by slowing down nerve transmissions in your body. This results in an unintended side effect in some people of making them slow or tired. Some medications your doctor may prescribe include gabapentin, pregabalin (Lyrica), duloxetine (Cymbalta), and amitriptyline. When these medications do not work, you may also be prescribed medications more typical for treating depression or anxiety, or medications for seizures. Since medications to treat these conditions also change the way nerves communicate in your body, sometimes they are helpful for treating nerve pain.
There are also other, equally effective options for treating nerve pain. These include the use of tools such as a TENS unit. TENS, or Transcutaneous Electrical Nerve Stimulation. These devices can be bought without a prescription and require the use of pads that are stuck to the site of pain. The device sends small repetitive shocks to the area where the pads are attached. These shocks result in signals being sent to your brain, that may help desensitize or change the way the brain is interpreting the signals in general.
Besides therapy, creams, pills, and medical devices, there are many other treatment options. These include surgically implanted devices such as a spinal cord stimulator, and use of intravenous medications such as ketamine or lidocaine. Sometimes it is worth seeking out alternative treatments such as accupuncture or osteopathic manipulation. Though many options exist for treating nerve pain, no one treatment works well for most people. With the help of an experienced physician and therapist, treating this difficult problem can be successful.