Neuropathic pain - Find specialists for nerve pain

Neuropathic pain (nerve pain) is a type of chronic pain. In contrast to other types of pain, neuropathic pain is caused by direct damage to sensorimotor nerve structures and is difficult to treat.

Further information on neuropathic pain can be found below.

Causes of nerve pain

Neuropathic pain is caused by nerve damage to the peripheral or central nerve structures. There are many possible causes. Common causes are damage to the nerves due to injuries (operations or herniated discs) and infections caused by shingles (post-herpes zoster neuralgia - i.e. after herpes zoster and trigeminal neuralgia). However, poorly controlled diabetes, chemotherapy or multiple sclerosis and a stroke can also result in neuropathic pain.

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What are the characteristic symptoms of nerve pain?

Neuropathic pain is typically associated with a disorder of skin sensitivity. This means that patients suffering from nerve pain react to external stimuli such as heat, cold and pressure with hypersensitivity or reduced sensitivity of the affected areas of skin, such as numbness when touched. This is accompanied by burning pain and sudden attacks of pain of high intensity.

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How is nerve pain diagnosed?

In addition to talking to the doctor (anamnesis) about the patient's medical history and the occurrence and nature of the pain, skin sensitivity is tested during the neurological examination . Nerve damage can be determined using diagnostic procedures such as measuring nerve conduction velocity. Imaging procedures such as computed tomography (CT) or magnetic resonanceimaging (MRI) are also frequently used to visualize nerve damage.

How is neuropathic pain treated?

The treatment of neuropathic pain is usually lengthy and difficult. Absolute freedom from pain is rarely achieved. The pain specialist should set realistic treatment goals with the patient from the outset. These are defined by the German Pain Society (DGS) as follows:

• Reduction of pain by > 30-50%
• Improvement in sleep quality
• Improvement in quality of life
• Maintaining social activities and relationships
• Maintaining the ability to work

Drug-based pain therapy is at the heart of pain therapy for neuropathic pain. In order to find the right medication, the doctor and patient need to patiently try out the optimal combination of medication. Neuropathic pain is different for every patient, so there is no one-size-fits-all treatment.

Alternative methods to reduce pain such as nerve blocks, infiltrations, electrical nerve stimulation, physical measures, occupational therapy and psychotherapy can also be used. The video shows one therapy option:

Counteracting pain memory: preventing the chronification of nerve pain

Modern pain research assumes that any acute pain can become chronic. This is why adequate pain therapy should start as early as possible and be as intensive as necessary. Slogans of perseverance are of no use to pain patients and put them under additional pressure. The fear of taking medication unnecessarily should also be taken away from the patient. Pain chronification can only be prevented if pain therapy is started at an early stage.

Sources:

http://www.neuro.med.tu-muenchen.de/dfns/patienten/Def_NeP.html

http://www.schmerzliga.de/nervenschmerzen.html

http://www.aerzteblatt.de/archiv/64643/Diagnostik-und-Therapie-neuropathischer-Schmerzen

http://www.dgss.org/patienteninformationen/schmerzerkrankungen/nervenschmerz/