Neuralgia (ICD code: M79.2), as nerve pain is also known, is characterized by sudden, severe pain that affects the area supplied by the affected nerve. Neuralgia can occur when the nerves are damaged or irritated. It is also possible that the nerve pain occurs as a result of another underlying disease.
Neuralgiform pain typically feels pulling, stabbing or tearing . The nerve pain occurs unexpectedly and usually only lasts a few seconds. However, it is also possible for a single pain attack to last several minutes. Continuous pain without interruptions is rarer.
The symptoms follow a stimulus that would not normally cause pain - for example a light touch, a draught or a movement. Each nerve only supplies certain areas of the body and receives stimuli from there. For this reason, nerve pain always occurs in the same area. If the stimulus does not touch the pain receptors but acts at a different point along the nerve pathway, this is neuropathic pain.
Finely branched: peripheral nervous system. © arsdigital / Fotolia
The trigeminal nerve (trigeminal nerve) 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
The trigeminal nerve (trigeminal nerve) is damaged in trigeminal neuralgia . In this case, the nerve pain occurs on one side of the face.
Another form of nerve pain in the head area is triggered by the glossopharyngeal nerve (glossopharyngeus). The pain caused by glossopharyngeal neuralgia can be felt in the face. The nerve pain occurs in the following areas:
- root of the tongue
- palate
- pharynx
- tonsils
The pain can also radiate to the ear.
Post-zoster neuralgia is also known as post-herpetic neuralgia, as it is caused by an infection with herpes zoster. This is a virus that is responsible for shingles. The herpes virus originates from a previous chickenpox infection. The viruses, varicella zoster, remain permanently in the ganglia of the nerve tracts after the acute chickenpox. There they are inactive until the virus infection flares up again with the typical blisters. The zoster viruses are reactivated by a weakened immune system, pronounced stress, during accompanying illnesses or in old age. The nerve pain occurs in the area where the herpes or shingles appears.
Morton neuralgia causes discomfort in the
foot . Accordingly, the pain manifests itself when walking and is mainly felt in the midfoot. It is triggered by thickening of a nerve section in the foot.
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 with concomitant diseases of the chest(thorax), spine, ribs or shingles.
The various forms of nerve pain can essentially be traced back to a common cause, namely damage to a peripheral nerve. A common cause of such a lesion is severe pressure exerted on the nerve. The pressure can occur when the surrounding tissue swells considerably. It is also conceivable that the nerve is crushed or pinched. This is possible after a herniated disc, for example.
Another cause of nerve pain is inflammation. They can also damage the affected nerve or lead to temporary functional problems. Post-zoster neuralgia is caused by this mechanism.
If the cause of the nerve pain cannot be determined, doctors refer to it as idiopathic neuralgia.
Neuralgiform pain attacks are triggered by many different stimuli that do not in themselves pose a threat. Doctors refer to these stimuli as triggers. In contrast to the causes, the triggers are not responsible for the development of the clinical picture, but they do trigger the acute pain attack. If you suffer from neuralgia, caution is advised with such stimuli.
Common triggers include:
- overexertion (for morton neuralgia: prolonged walking, for glossopharyngeal neuralgia: eating, yawning, talking)
- low temperatures
- strong sunlight
- draughts
- incorrect sitting posture
- psychological stress
- Pressure on the affected nerve
- mere touch
- awkward movements
© vectorfusionart / Fotolia
To find out what is causing the pain, a doctor will carry out various examinations. They often start by checking the reflexes and carrying out other external tests. The doctor strokes the skin with a pen-like instrument to find out whether the perception of stimuli is functioning or overreacting.
The anamnesis, the precise recording of the patient's medical history, also plays an important role. The attending physician often uses imaging procedures such as X-rays, CT or MRI to check for other possible causes of the symptoms.
If the neuralgia is due to another underlying disease that can be treated, the focus is on treating this disease. Often, however, no clear cause is known, so treatment focuses on alleviating the symptoms. The doctor will also address any accompanying illnesses such as depression.
If treatment with various medications and physiotherapy does not bring any progress, surgery is an option for some patients. If possible, the surgeon only cuts the part of the nerve that falsely triggers a pain signal.
Painkillers are often used in neuralgia therapy. The German Pain Society (DGSS) aims to reduce pain by a third to a half. This already significantly improves the quality of life. The duration of the illness varies greatly. Of the people diagnosed with trigeminal neuralgia by a doctor, around two thirds suffer further attacks of pain.
Don't despair, take action yourself
For some people, nerve pain is very stressful. Don't let the pain wear you down, but stay on the ball and provide distractions and positive activities. Sufficient rest and relaxation also soothe irritated nerves. Before everything becomes too much for you, think about psychotherapy. Therapists not only deal with mental illnesses, but also with the mental consequences of physical illnesses.
An effective self-help measure is to avoid triggers as much as possible. On cold days, make sure you dress warmly. A hot water bottle, a cherry stone cushion or warm compresses at home provide relief if cold is a trigger for your neuralgiform pain. Other patients help themselves with cooling if the nerve pain of acute herpes accompanies the inflammatory symptoms that are perceived as hot.
Contact our neuralgia specialists to find the most suitable form of treatment.
