Nerve Pain (Neuralgia) - Information and Specialists

Neuralgia (ICD code: M79.2), as nerve pain is also known, is characterized by sudden, severe pain in the area innervated by the affected nerve. Neuralgia can develop when nerves are damaged or irritated. It is also possible that the nerve pain is a result of another underlying condition.

Neuralgic pain typically feels like a pulling, stabbing, or tearing sensation. The pain occurs unexpectedly and usually lasts only a few seconds. However, it is also possible for a single pain attack to last several minutes. Continuous pain without breaks is less common.

The symptoms follow a stimulus that would not normally cause pain—for example, a light touch, a draft, or a movement. Each nerve supplies only specific areas of the body and receives stimuli from those areas. For this reason, nerve pain repeatedly occurs in the same area. If the stimulus does not touch the pain receptors but acts on another part of the nerve pathway, the pain is classified as neuropathic pain.

Finely branched: the peripheral nervous system. © arsdigital / Fotolia

The trigeminal nerve (Nervus trigeminus) runs through the face and branches out from the temple into three pathways: to the eye, along the upper jaw to the nose and lips, and along the lower jaw to the chin.

© Henrie / Fotolia

In trigeminal neuralgia, the trigeminal nerve (Nervus trigeminus) is damaged. In this case, the nerve pain occurs on one side of the face.

Another form of nerve pain in the head region is triggered by the glossopharyngeal nerve. The pain caused by glossopharyngeal neuralgia is felt in the face. The nerve pain occurs in the following areas:

• base of the tongue
• Palate
• Throat
• Tonsils

The pain can also radiate to the ear.

Post-herpetic neuralgia is also known as postherpetic neuralgia, as it results from an infection with the herpes zoster virus. This is the virus responsible for shingles. The herpes virus originates from a previous chickenpox infection. The Varicella zoster virus remains dormant in the nerve ganglia after the acute chickenpox infection. There, it remains inactive until the viral infection flares up again, causing the characteristic blisters. The zoster viruses are reactivated by a weakened immune system, severe stress, during concomitant illnesses, or with advancing age. The nerve pain occurs in the area where the herpes or shingles appears.

In contrast, intercostal neuralgia affects the nerve that supplies the muscles between the ribs. The pain wraps around the body like a belt and occurs in conjunction with conditions affecting the chest (thorax), spine, or ribs, or with shingles.

The various forms of nerve pain essentially stem from a common cause: damage to a peripheral nerve. A common cause of such damage is intense pressure exerted on the nerve. This pressure can result from severe swelling of the surrounding tissue. It is also possible that the nerve is compressed or pinched. This can occur, for example, following a herniated disc.

Inflammation is another cause of nerve pain. It can also damage the affected nerve or lead to temporary functional problems. Post-herpetic neuralgia is caused by this mechanism.

If the cause of the nerve pain cannot be determined, doctors refer to it as idiopathic neuralgia.

Neuralgic pain attacks are triggered by many different stimuli that do not in themselves pose a threat. Medical professionals refer to these stimuli as triggers. Unlike the underlying causes, triggers are not responsible for the development of the condition, but they do provoke the acute pain attack. If you suffer from neuralgia, caution is advised when encountering such stimuli.

Common triggers include:

• Overexertion (in trigeminal neuralgia: prolonged walking; in glossopharyngeal neuralgia: eating, yawning, speaking)
• low temperatures
• strong sunlight
• Drafts
• poor posture
• psychological stress
• Pressure on the affected nerve
• mere touch
• Unfavorable movements

© vectorfusionart / Fotolia

To determine the cause of the pain, a doctor performs various examinations. Often, the doctor begins by checking reflexes and conducting other physical tests. During this process, the doctor runs a pen-like instrument over the skin to determine whether the sensation of touch is functioning normally or is overreacting.

The medical history—a detailed review of the patient’s past medical history—also plays an important role. The treating doctor often uses imaging techniques such as X-rays, CT scans, or MRIs to rule out other possible causes of the symptoms.

If the neuralgia is caused by another underlying condition that is treatable, the primary focus is on treating that condition. Often, however, no clear cause is known, so treatment focuses on alleviating the symptoms. The doctor also addresses any comorbid conditions, such as depression.

If treatment with various medications and physical therapy does not yield improvement, surgery may be considered for some patients. During the procedure, the surgeon cuts only the part of the nerve that is mistakenly triggering a pain signal, if possible.

Pain relievers are frequently used in the treatment of neuralgia. The German Pain Society (DGSS) aims to reduce pain by one-third to one-half. This alone significantly improves quality of life. The duration of the condition varies widely. Of the people diagnosed with trigeminal neuralgia by a doctor, about two-thirds experience further pain attacks.

Don’t despair—take action yourself

For some people, nerve pain is an enormous burden. Don’t let the pain wear you down; instead, stay on top of things and find distractions and positive activities. Getting enough rest and relaxation also helps soothe the irritated nerve. Before it all becomes too much, consider psychotherapy. Therapists don’t just deal with mental health conditions—they also address the psychological effects of physical illnesses.

An effective self-help strategy is to avoid triggers as much as possible. On cold days, be sure to dress warmly. A hot water bottle, a cherry pit pillow, or warm compresses can provide relief at home if the cold triggers your neuralgia-like pain. Other patients find relief through cooling when nerve pain associated with an acute herpes outbreak accompanies inflammatory symptoms that feel hot.

Contact our neuralgia specialists to find the appropriate form of treatment.