Nerve pain or Neuralgia is pain which follows the path of a specific nerve. In neuralgia burning, numbness, or pain extends along one or more nerves. Neuralgia can affect any nerve.
There are several causes of nerve pain. Causes of nerve pain include
- Chemical irritation
- Chronic renal insufficiency
- Infections, like shingles, syphilis, and Lyme disease
- Compression or pressure on nerves by nearby structures (for instance, tumors, blood vessels)
- Swelling and irritation of the nerve (inflammation)
- Trauma to the nerve (including surgery)
- In most cases the cause is unknown.
Nerve pain is a complex and chronic painful condition, in which the pain can persist long after the original injury has healed. Nerve pain can start within days after an injury, or can instead take months to develop and be diagnosed. The pain can be triggered by even slight damage to nerves or even in previously healed injuries.
Neuralgia can occur at any age but is commoner in elderly people.
Symptoms of neuralgia include
- Burning sensation, numbness, or pain along the nerve.
- Pain along the path of the involved nerve or pain located anywhere frequently on or near the surface of the body. The pain can be sharp, stabbing or burning pain that comes and goes (intermittent) or is constant.
- Touch or pressure may be felt as pain or movement may be painful as well.
Tests and diagnosis
There is no single test which can help to definitely diagnose nerve pain. Hence the initial diagnosis relies mostly on your symptoms and description of the pain along with a physical examination by a doctor.
Your physical exam may show
- Abnormal or altered sensation in the skin
- Loss of deep tendon reflexes or loss of muscle mass
- Lack of sweating in the involved part of the body (sweating is controlled by nerves)
- Tenderness or pain on touch along the nerve
- Trigger points or areas where even a slight touch can trigger pain.
- Dental examination can exclude dental disorders as a cause of facial pain (such as a tooth abscess).
- Symptoms such as redness or swelling in the involved area may help to diagnose conditions such as infections, bone fractures, or rheumatoid arthritis.
There are no specific tests for exact diagnosis of neuralgia, but the following tests may aid to find the cause of the pain:
- Blood tests for blood sugar and kidney function
- Computed tomography (CT) scans or magnetic resonance imaging (MRIs) to rule out any structural damage or compression of nerve
- Nerve conduction study with electromyography to assess how well the nerves are functioning
- Spinal tap (lumbar puncture)
- Nerve biopsies to evaluate for nerve fiber abnormalities.
Nerve pain is usually difficult to treat, and often does not respond to treatment for pain relief. At times the condition may improve on its own or disappear with time. As nerve pain is not easily treated, the main goals of treatment are:
- Reduce the intensity and amount of pain you experience,
- Help you to manage with persistent pain,
- Minimize the impact of pain on your quality of life, and
- Control or treat any underlying causes of your pain (if found and if treatable such as diabetes, tumor).
- Strict control of blood sugar hastens recovery of neuralgia in people with diabetes.