Neuropathic pain is pain from damage or disease of the nervous system.
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In some people, the cause of nerve pain is not known. In others, it may be caused by things like:
- The nerve not getting the nutrients needed to work
- Infection, such as HIV
- The body's immune system attacking the nerves
Health problems that may raise the risk are:
- Poor glucose tolerance
- HIV infection
- Alcohol use disorder
- Lack of vitamins
- Spinal cord problem or injury
- Carpal tunnel syndrome
- Health problems that are present at birth
Other things that may raise the risk are:
- Back surgery
- Being around toxins or metals
- Taking certain medicines
The pain may be all the time or come and go during the day. Some problems may be:
- Electrical shock
- A feeling of pins and needles
You will be asked about your symptoms and health history. The doctor will ask what your pain is like and when it happens. A physical exam will be done. You may be sent to a doctor who treats the nervous system. You may also need to see a doctor who treats pain.
Tests that may be done are:
- Blood tests to look for problems that may be causing the pain, such as a lack of certain vitamins and minerals
- Nerve conduction tests to find out how well nerves are passing electrical signals
- Electromyography (EMG) to measure the electrical activity in the nerves
- A biopsy to look for problems that may be causing pain
Any underlying problems with the need to be treated, such as diabetes.
The goal of treatment is to manage symptoms. Options are:
One or more of these medicines may be given to manage pain:
- Over the counter pain relievers, such as ibuprofen
- Prescription pain relievers
- Antiseizure medicine
- Topical creams put on the skin or patches, such as capsaicin cream
Some states allow residents to use medical marijuana for health problems. It may be helpful for people with neuropathic pain related to HIV.
Nerve decompression surgery may be advised to ease pain. Other procedures that may be done are:
- A nerve block—An anesthetic is injected into the painful site to block pain.
- Pain pump—A pain pump is placed in the body to deliver pain medicine.
- Nerve stimulators—A device is attached to the nerve and delivers electrical signals to control pain.
- Surgery may be done to block the hurt nerves from sending signals.
The risk of neuropathic pain may be lowered by managing other health problems, such as diabetes.
American Chronic Pain Association https://theacpa.org
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov
Canadian Diabetes Association http://www.diabetes.ca
Chronic Pain Association of Canada http://chronicpaincanada.com
Barrell K, Smith AG. Peripheral Neuropathy. Med Clin North Am. 2019 Mar;103(2):383-397.
Causes. The Foundation for Peripheral Neuropathy website. Available at: https://www.foundationforpn.org/what-is-peripheral-neuropathy/causes. Accessed October 2, 2020.
Peripheral neuropathy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/peripheral-neuropathy . Accessed October 2, 2020.
7/20/2015 EBSCO DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/peripheral-neuropathy : Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015;313(24):2456-2473.
- Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
- Review Date: 09/2020
- Update Date: 05/21/2021