Neuropathic Pain

Defining Neuropathic Pain

Neuropathic pain, also known as nerve pain, is chronic pain caused by damage or dysfunction of the nervous system, characterised by sensations such as burning, tingling, or shooting pain.

Symptoms of Neuropathic Pain

While your individual experience may vary, nerve pain is characterised by electric shock type or shooting type of pain, burning, icy cold, or itchy sensations, numbness or tingling, or hypersensitivity to touch or temperature.

Neuropathic pain can worsen at night time.

Types of Neuropathic Pain 

Some types of neuropathic pain include:

• Diabetic Neuropathy. Nerve damage caused by diabetes, leading to pain, tingling, or numbness in the extremities.
• Postherpetic Neuralgia. Pain that persists after an episode of shingles (herpes zoster) due to nerve damage from the varicella-zoster virus.
• Trigeminal Neuralgia. Severe facial pain resulting from irritation or damage to the trigeminal nerve, often described as sudden, intense, and sharp.
• Sciatica. Pain that radiates along the sciatic nerve, typically originating from compression or irritation of the nerve roots in the lower back.
• Brachialgia. Pain that is present in the upper limbs due to compression or damage of the nerve roots in the neck.
• Peripheral Neuropathy. Damage to the peripheral nerves, often causing symptoms such as tingling, numbness, or burning sensations in the hands and feet.
• Phantom Limb Pain. Phantom limb pain is pain perceived in a limb that has been amputated or lost, often described as sensations originating from the missing body part.

These are just a few examples of neuropathic pain conditions, and there are many other types that can affect different areas of the body. 

If you think you are suffering from one of the above conditions, reach out to a pain management doctor (you can start with your general practitioner for a referral) and start the evaluation process.

It could be your first step towards relief from neuropathic pain. 

Neuralgia Versus Neuropathy

Neuralgia and neuropathy are both conditions involving nerves, but they have distinct differences.

Neuralgia typically refers to pain along the path of a single nerve, whereas neuropathy involves damage or dysfunction of multiple nerves, leading to a broader range of symptoms.

Neuralgia refers to sharp, stabbing, or shooting pain along the path of a nerve. It is often triggered by irritation or damage to a specific nerve, leading to sudden and intense pain.

Common types of neuralgia include trigeminal neuralgia (affecting the trigeminal nerve in the face) and postherpetic neuralgia (resulting from nerve damage after a shingles outbreak).

It typically affects one specific nerve or nerve branch.

On the other hand, neuropathy involves damage or dysfunction of multiple nerves, often affecting sensation, movement, or organ function.

It can result from various underlying conditions, such as diabetes, infections, autoimmune diseases, or traumatic injuries.

Neuropathy may cause symptoms such as numbness, tingling, burning pain, weakness, or loss of coordination.

It can affect peripheral nerves (peripheral neuropathy), cranial nerves, or nerves in the spinal cord (radiculopathy).

Where Does Neuropathic Pain Occur?

Neuropathic pain can occur in various parts of the body, depending on the underlying cause and the nerves affected. 

Some common areas where neuropathic pain may occur include:

1. Extremities. Neuropathic pain frequently affects the hands and feet, leading to symptoms such as burning, tingling, numbness, or shooting pain.
2. Back and Spine. Conditions like sciatica or nerve compression in the spine can cause neuropathic pain that radiates down the legs or arms.
3. Face. Trigeminal neuralgia is a type of neuropathic pain that affects the trigeminal nerve in the face, resulting in severe, stabbing pain in the jaw, cheek, or forehead.
4. Abdomen. Neuropathic pain in the abdomen can result from conditions like diabetic neuropathy or post-surgical nerve damage.
5. Pelvis. Conditions such as pudendal neuralgia can cause neuropathic pain in the pelvic region, affecting the genitals, perineum, or rectum.
6. Chest. Neuropathic pain may occur in the chest area due to conditions like postherpetic neuralgia following an episode of shingles or nerve damage from thoracic surgeries.
7. Limbs. Neuropathic pain can also affect the arms or legs, either localised or radiating from the spine or nerve roots.

These are just a few examples, and neuropathic pain can occur in any part of the body where there is nerve damage or dysfunction.

The specific location and characteristics of the pain often depend on the underlying condition causing the neuropathy.

What Causes Neuropathic Pain?

Neuropathic pain can be caused by various conditions that result in damage or dysfunction of the nervous system.

Some common causes include:

1. Diabetes. Diabetic neuropathy occurs due to prolonged high blood sugar levels, leading to damage to the nerves, particularly in the legs and feet.
2. Trauma or Injury. Physical trauma, such as accidents or injuries, can damage nerves directly, leading to neuropathic pain.
3. Infections. Certain viral or bacterial infections, such as herpes zoster (shingles), HIV/AIDS can cause neuropathic pain.
4. Autoimmune Diseases. Conditions like multiple sclerosis or Guillain-Barré syndrome involve the immune system attacking the nerves, resulting in neuropathic pain.
5. Neurological Disorders. Disorders affecting the brain or spinal cord, such as stroke, Parkinson’s disease, or spinal cord injury, can cause neuropathic pain.
6. Chronic Compression. Prolonged compression of nerves, as seen in conditions like carpal tunnel syndrome or sciatica, can lead to neuropathic pain.
7. Medications or Toxins. Certain medications, such as chemotherapy drugs or antiretroviral drugs, as well as exposure to toxins, can damage nerves and cause neuropathic pain as a side effect.
8. Nutritional Deficiencies. Deficiencies in certain vitamins or minerals, such as vitamin B12 deficiency, can lead to nerve damage and neuropathic pain.
9. Genetic Factors. In some cases, genetic factors may predispose individuals to develop neuropathic pain conditions.
10. Idiopathic Causes. In some instances, neuropathic pain may occur without a clear underlying cause, known as idiopathic neuropathy.

Overall, neuropathic pain can result from a wide range of conditions affecting the nervous system, and the specific cause often determines the treatment approach and prognosis.

Dr Mittal and her cross-disciplinary team can help evaluate your nerve pain, determine the source, and create a treatment plan customised to your needs.

What is a Nerve Pain or Neuropathic Pain Specialist?

A neuropathic pain specialist is a healthcare professional who specialises in diagnosing and treating nerve-related chronic pain conditions.

Often, like Dr Mittal, neuropathic or nerve pain doctors work with a multidisciplinary team that includes neurologists, physical therapists and rehabilitation specialists, psychologists and mental health professionals, and other healthcare professionals as needed.

How Does a Pain Specialist Treat Neuropathic Pain?

Dr Mittal is a neuropathic pain specialist who employs a multidisciplinary approach to treat neuropathic pain, focusing on alleviating symptoms, improving function, and enhancing overall well-being.

Her treatment plans are designed in collaboration with a team of healthcare professionals and are tailored to your specific needs.

They may include the following components:

• Medications. Pain specialists may prescribe medications to manage neuropathic pain, including antidepressants, anticonvulsants, opioids (only in select cases temporarily), topical analgesics, and nonsteroidal anti-inflammatory drugs (NSAIDs). These medications work by targeting different pathways involved in pain perception and transmission.
• Interventional Procedures. Nerve or neuropathic pain specialists may perform interventional procedures to deliver targeted treatments directly to the affected nerves or tissues. These procedures may include nerve blocks, epidural steroid injections, spinal cord stimulation, radiofrequency ablation, or peripheral nerve stimulation.
• Physical Therapy. Physical therapy can help improve mobility, strength, flexibility, and function in individuals with neuropathic pain. Therapeutic exercises, manual techniques, modalities such as heat or cold therapy, and education on proper body mechanics may be incorporated into the treatment plan.
• Psychological Support. Chronic pain can have a significant psychological impact, leading to symptoms of anxiety, depression, or stress. Pain specialists may collaborate with psychologists or counsellors to provide cognitive-behavioural therapy (CBT), relaxation techniques, stress management strategies, and coping skills training to address the emotional aspects of living with neuropathic pain.
• Lifestyle Modifications. Pain specialists may recommend lifestyle modifications to help manage neuropathic pain, such as maintaining a healthy diet, getting regular exercise, managing body weight, practising good sleep hygiene, quitting smoking, and managing stress levels. These lifestyle changes can complement other treatments and support overall well-being.
• Collaborative Care. Dr Mittal collaborates closely with other healthcare professionals, including general practitioners, neurologists, physiotherapists, psychologists, and pain management teams, to provide comprehensive and coordinated care. This multidisciplinary approach ensures that all aspects of your condition are addressed effectively.

By combining various treatment modalities and focusing on personalised care, Dr Mittal seeks to optimise your pain relief, increase functional outcomes, and enhance every day life for individuals living with neuropathic pain. 

Regular monitoring and adjustments to the treatment plan may be made based on your response and evolving needs over time.

Neuropathic Pain Challenges

Living with neuropathic pain presents many challenges that have an overall negative effect on your life. These include but are certainly not limited to:

• Persistent Discomfort. Neuropathic pain often manifests as persistent discomfort, which can be difficult to alleviate with traditional pain management methods. The constant sensation of pain can be exhausting and overwhelming.
• Limited Mobility. Neuropathic pain may cause numbness, tingling, or weakness in affected areas, leading to limited mobility and difficulty performing everyday tasks such as walking, standing, or even holding objects.
• Sleep Disturbances. Chronic pain can disrupt sleep patterns, making it challenging to fall asleep or stay asleep throughout the night. Poor sleep quality can exacerbate pain sensitivity and contribute to feelings of fatigue and irritability during the day.
• Emotional Impact. Living with chronic pain can take a toll on one’s emotional well-being, leading to feelings of frustration, anxiety, depression, or anger. Coping with the physical and emotional aspects of neuropathic pain can be emotionally draining and may require additional support.
• Social Isolation. Individuals with neuropathic pain may find it challenging to participate in social activities or maintain relationships due to limitations in mobility, energy levels, or the need to manage their pain symptoms. This can lead to feelings of isolation and loneliness.
• Financial Burden. The cost of medical treatments, medications, and therapies for neuropathic pain management can be substantial, particularly if insurance coverage is limited or if treatments require ongoing maintenance.
• Impact on Work and Productivity. Neuropathic pain can interfere with one’s ability to work or perform job-related tasks effectively. Absenteeism, decreased productivity, and difficulty concentrating may arise, potentially impacting one’s career and financial stability.
• Challenges in Finding Effective Treatment. Neuropathic pain can be complex and challenging to treat, often requiring a combination of medications, therapies, and lifestyle modifications. Finding the right treatment approach that provides meaningful relief without significant side effects can be a lengthy and frustrating process. 

Overall, living with neuropathic pain requires individuals to navigate various challenges while seeking effective management strategies to improve their quality of life.

However, finding a pain specialist near you who can help you manage your nerve pain is the starting point to overcoming these challenges.

How Do I Find a Neuropathic Pain Specialist Near Me?

Finding a neuropathic pain specialist near you can be a challenge, but a solution might be closer than you think, especially if you are in the Melbourne area and Dr Mittal’s Persistent Pain Solutions clinic is accessible. 

Your general practitioner may also be able to refer you to a neuropathic pain specialist.

Your friends, family, and even support groups for individuals dealing with chronic pain may also be able to help find a pain management doctor who treats nerve pain patients. 

Online directories, hospitals, or clinics for related issues may also be able to refer you to a pain management centre that can provide the expertise and support that you need to effectively manage your neuropathic pain.

Persistent Pain Solutions in Melbourne 

At Persistent Pain Solutions clinic, Dr Meena Mittal and her collaborative dedicated team extend a heartfelt commitment to every patient who walks through their doors.

They recognise the profound impact chronic pain can have, not just physically but emotionally too, on individuals and their families. That’s why their approach is rooted in empathy, understanding, and unwavering support.

From the moment you enter the clinic, you’ll experience a warm and inviting atmosphere where your concerns are not just acknowledged, but truly valued.

Dr Mittal takes the time to listen intently, thoroughly evaluate your condition, and craft personalised treatment plans that cater to your unique needs.

Compassion is a key aspect of healing.

With Dr Mittal’s support, you’ll begin to achieve some relief from your neuropathic pain. You’ll be able to reclaim your daily life and enhance your overall well-being.

Your comfort and progress are our top priorities, and we’re here to guide you every step of the way.