Prevention & Recovery

What is neuropathic pain?

Author: Canadian Living

Prevention & Recovery

What is neuropathic pain?

This story was originally titled "Neuropathic Pain" in the November 2009 issue of Canadian Living magazine. Subscribe to Canadian Living today and never miss an issue!

Neuropathic pain is a complex, chronic pain that comes from an injury or disease that affects the nervous system (nerves, the spinal cord and brain). It's caused by misfiring nerve fibres that cause pain, swelling and aching. Here's what  you need to know.

1. A burning sensation, combined with shooting pain, is the most common way neuropathic pain is described. However, the type of pain experienced can be very different from person to person, says Dr. Cory Toth, an assistant professor of neurosciences at the University of Calgary who specializes in neuropathic pain. Here are some other pain descriptions and symptoms: tingling; numbness; pins and needles; sensitivity to touch or cold; a crushing sensation; deep, aching pain; swelling; temperature changes; skin discoloration; shock-like sensations.

2. With neuropathic pain, the mechanics that normally tell you to jerk your hand away from a hot stove may not work. Why? Nerves normally carry messages from parts of your body to your brain through your spinal cord. Your brain responds by sending a message back down your spinal cord, telling your body how to react. If a nerve fibre is damaged, it may not effectively communicate how something feels throughout your body.

3. There are two main types of neuropathic pain.
Peripheral neuropathic pain is caused by injury or a condition that has damaged the nerve fibres – such as diabetes, shingles, chicken pox, HIV infection or AIDS – or occurs after surgery or amputation. Central neuropathic pain is caused by a wound, injury or disease to the central nervous system, such as stroke, spinal cord injury, multiple sclerosis, or cancer of the brain or spinal cord.


Page 1 of 2 -- On page 2, learn why diagnosing neuropathic pain is often so difficult.


 4. Diagnosing neuropathic pain can sometimes be a tricky task. There is no medical test that detects pain, so a doctor must rely on information from you, and a physical exam. Your doctor will use tests that involve shining a light on your skin and pricking your skin with a pin to see if you have areas of reduced or exaggerated sensation. Your doctor will also test for diabetes by measuring blood sugar levels, since it is a common cause, and ask you questions about how you would describe your pain (when and where it occurs, and if anything triggers it). Your doctor will then determine whether your symptoms fit the specific diagnostic criteria for neuropathic pain.

5. Unfortunately, treatment options often do nothing to reverse the condition, but they may help improve your quality of life. There are a number of medications, from topical ointments that contain hot peppers to help kill off bad nerve fibres, to pills, such as antidepressants or opioids. But Toth says many patients don't respond to treatment. In fact, a 30 per cent reduction in pain is usually considered to be a success. And, in most cases, the pain may even get worse over time. Another option to help manage pain is exercise. Toth says swimming is especially good because being in water reduces pressure on your body. Alternative or complementary medicine such as acupuncture, physical therapy and electrical nerve stimulation may also help manage pain.

Learn how you can sleep away the pain
If you have nerve-related pain, you may be experiencing poor sleep as well as depression.
Sleep problems have been reported by 88 per cent of people with neuropathic pain.
• More than half (55 per cent) of people who have neuropathic pain said they have experienced anxiety or depression.
• The catch is that if you are tired, depressed or anxious, your body is likely to be more sensitive to pain.

What else can you do?
Make sleep and relaxation a priority. Try meditation, relaxation therapy or counselling.
• You can also talk to your doctor about prescription medications to help you sleep better and ease depression and anxiety. That said, exercise has been shown to be effective in lifting depression and improving sleep. 


Page 2 of 2 -- Do you know the causes of neuropathic pain? Find out on page 1.
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