Nerve pain

Neuropathic pain: When "nerves hurt"

Neuropathic, or nerve, pain is a specific type of chronic pain that arises not from irritation of pain receptors in tissues (as with a cut or burn), but as a result of direct damage or disease of the nervous system itself—peripheral nerves, spinal cord, or brain. This is a "misplaced" pain that occurs without actual damage in the part of the body where it is felt. The brain receives false pain signals from damaged nerves.

How does neuropathic pain feel?

The characteristics of this pain differ radically from ordinary (nociceptive) pain. Patients often describe it with unusual words:

• Burning, hot, "as if scalded with boiling water".
• Shooting, "like an electric shock".
• Stabbing, "thousands of needles".
• Accompanied by other sensations: numbness, tingling ("crawling ants"), heightened sensitivity to touch (allodynia), where even a light touch of clothing causes pain.

Causes of nerve damage

Many conditions can lead to the development of neuropathic pain.

• Mechanical nerve compression:
  • Radiculopathy ("root syndrome"): Compression of a nerve root by a herniated intervertebral disc. A classic example is sciatica.
  • Tunnel syndromes: Compression of a nerve in narrow anatomical channels, for example, carpal tunnel syndrome.
• Metabolic and infectious lesions:
  • Diabetic polyneuropathy: Nerve damage due to high blood sugar levels.
  • Postherpetic neuralgia: Pain that persists after an episode of shingles.
• Toxic lesions: Consequences of chemotherapy or alcohol abuse.

Treatment of neuropathic pain is complex, as ordinary analgesics (NSAIDs) are largely ineffective. Specialized medications—anticonvulsants and antidepressants—are used, which affect the transmission of pain signals in the brain.