Center for Pain Management

Neuropathic pain

Would you describe your pain as burning, or shooting? Is you pain associated with numbness or pins and needles? Does you pain radiate or shoot into your arms or legs?

Neuropathic pain is associated with injury to or irritation of a nerve. This can result from direct pressure to a nerve as when disc material or a bone spur in the spine presses on a nerve or when a nerve is entrapped in scar tissue following surgery. Inflammation in the area of a nerve can also chemically irritate a nerve causing neuropathic pain. Some conditions such as diabetes and some medications including chemotherapy agents can cause pathological changes in nerve tissue resulting in neuropathic pain.

Neuropathic pain is often described as burning, electric, shooting, or stabbing. Because neuropathic pain can be felt along the distribution of the involved nerve, it can be felt a distance from the actual site of the damage. For example if disc material is pressing on a nerve root leaving the spine in your low back the pain is often felt in the leg. This is sometimes referred to as sciatica. Neuropathic pain often causes hyperalgesia which is increased sensitivity to painful stimuli and allodynia which is pain resulting from stimuli that is not typically painful such as light touch or pressure. This type of pain can also be associated with other symptoms of nerve damage including numbness, and paresthesia (pins and needles.)

Examples of neuropathic pain include radiculopathy, sciatica, peripheral neuropathy, post herpetic neuralgia, and complex regional pain syndrome (RSD).

Causes of neuropathic pain in the low back include disc problems, spinal stenosis, arachnoiditis, and scar tissue following surgery. Other causes of neuropathic pain throughout the body include diabetes, nerve injury due to trauma, chemotherapy, nerve entrapment syndromes, and viral infections.

Assessment of neuropathic pain can include physician examination, MRI or CT scan to look for sources of mechanical nerve compression or tumor, and EMG studies to evaluate nerve tissue function. If an abnormality is observed on MRI or CAT scan, a diagnostic injection can be used to determine if the abnormality is in fact the pain generator.

Neuropathic pain does not always respond to opioid medications. The treatment of this type of pain often requires a combination of medications often including medications used to treat both seizures and neuropathic pain. Nerve blocks, spinal cord stimulation, and physical therapy for desensitization can also provide relief.