The invisible pain of neuralgia
Neuralgia is sharp, and often severe, pain that runs along the path of a nerve. The basic cause of neuralgia pain is damage or irritation of a nerve. This damage or irritation can be caused by several different conditions, from disease to trauma.
To understand the cause of neuralgia, it’s first necessary to understand how nerves work.
The nervous system is responsible for carrying information back and forth from the brain to the rest of the body. Nerves are the long bundles of fibers that connect sensitive nerve endings to the rest of the nervous system.
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Nerves are protected by a layer of protein and fatty substances called the myelin sheath. If the myelin, or the nerve that’s insulated by it, is damaged, the impulses sent along the nerve can be slowed or interrupted. This can lead to problems like neuralgia or neuropathy.
Both neuralgia and neuropathy are nerve-related and caused by damage to the nerves. However, by breaking down the origins of each word, it’s possible to see how the two conditions are different. Neuro- (or neura-) means nerve. –algia means pain, while –pathy means disease. Therefore, while neuropathy can be accompanied by pain, it’s also characterized by tingling, numbness, weakness, or other symptoms. Neuralgia, however, refers only to nerve pain.
Neuralgia pain is usually a side effect or symptom of something else.
According to the Better Health Channel:
“Generally, neuralgia isn’t an illness in its own right, but a symptom of injury or a particular disorder. In many cases, the cause of the pain is not known. Older people are most susceptible, but people of any age can be affected.”
Sometimes simple old age can be blamed for neuralgia. Other times, a disease might cause damage to the nerves, as in diabetes or multiple sclerosis. Infections like HIV, Lyme disease, or syphilis can also sometimes cause nerve damage. Even a bacterial infection, such as an abscessed tooth, can irritate nearby nerves and cause neuralgia. Pressure on a nerve might cause neuralgia pain, too; bone, tissue, or tumors that press on a nerve can cause painful irritation.
Unfortunately, some medications—including the medications used to treat cancerous tumors—might also lead to neuralgia. Sometimes even trauma, whether from an injury or from a surgical procedure, can cause neuralgia pain. Essentially, anything that can damage the myelin sheath can potentially cause neuralgia.
The different types of neuralgia are generally characterized by the cause or the location of the pain.
For example, the two most common types of neuralgia are post herpetic neuralgia and trigeminal neuralgia. Post herpetic neuralgia is characterized by its cause. It is the result of nerve damage from the herpes zoster virus, commonly called shingles.
Trigeminal neuralgia is diagnosed according to which nerve is affected and where the pain is felt. In this type of neuralgia, the trigeminal nerve is damaged or has painful pressure exerted on it. Trigeminal neuralgia pain affects the face. In addition to pain, there might also be such intense hypersensitivity that even brushing the teeth or feeling a breeze on the cheek can cause severe pain. The pain may begin in just one area or on one side of the face, but it can spread as the condition worsens.
Another type of nerve pain is glossopharyngeal neuralgia, which is somewhat uncommon. This occurs when the glossopharyngeal nerve is irritated or damaged, which produces pain in the neck and throat. Sometimes the pain can also extend to the tongue, back of the throat, tonsils, or ears.
Occipital neuralgia occurs when the occipital nerves, or the nerves that run from the top of the spinal cord up to the scalp, are injured or inflamed. This often causes pain that starts at the back of the head and radiates forward, but it can also cause pain on one or both sides of the head or behind the eye. Sensitivity to light or a tender scalp may also occur. This condition can sometimes go undiagnosed because its symptoms are easy to mistake for headaches or migraines.
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Conditions related to neuralgia
There is a host of conditions that can cause or be accompanied by neuralgia pain.
Multiple sclerosis is well-known as a nerve-related disease, and it can indeed cause neuralgia pain. In fact, nerve pain is one of the best-known symptoms of multiple sclerosis. However, it’s not the only disease that can cause neuralgia pain.
Other conditions that might be accompanied by neuralgia include:
- Diabetes
- Porphyria
- Chronic kidney disease (also called chronic renal disease or insufficiency)
- Lupus
- Hypothyroidism
- Complex regional pain syndrome
- Stroke
- Spinal stenosis
- Fibromyalgia
- Sciatica
People with neuralgia pain have a lot of treatment options.
Each individual’s treatment for neuralgia pain might be different, depending on what caused the pain. For example, since the high blood sugar levels associated with diabetes are responsible for damaging nerves, someone with diabetes-related neuralgia pain might benefit from stricter control of diet (and possibly diabetes medications) to keep blood sugar levels at heathier levels. Treating the underlying condition causing the neuralgia is often a good way to treat the pain.
If treating the condition doesn’t relieve neuralgia pain—or if the cause of the pain can’t be identified—there are many other non-surgical treatment options. In some cases, over-the-counter pain medications may be sufficient. Heat therapy, massage, or rest might also do the trick. If not, a physician might be able to prescribe stronger medications, such as antidepressants, antiseizure drugs, or narcotics. Skin patches or creams that contain pain-relieving medications might also help. Physical therapy can sometimes be indicated, as well.
If the pain still persists, the physician may suggest injections of pain medications, such as an occipital nerve block injection for occipital neuralgia. He or she might also suggest radiofrequency ablation, which is focused heat that damages a painful nerve in order to cut off pain signals before they’re sent to the brain.
If non-surgical methods have failed to alleviate neuralgia pain, there are surgical ways that can treat it. The most common surgical procedures to correct neuralgia attempt to relieve the pressure on a painful nerve, perhaps by moving the blood vessel that’s pressing on the nerve. Other surgical procedures have a similar goal as radiofrequency ablation: the interruption of the nerve to stop pain signal transmission.
Unfortunately, some people are unable to find relief from neuralgia pain despite attempting all available treatments. However, most neuralgia pain is relatively minor and responds well to treatment.
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