What Is Nerve Pain?

Neuropathic pain, or nerve pain, happens when the central nervous system malfunctions or is damaged. Nerve pain varies in degrees of intensity and is usually experienced as a sharp, burning, electric, tingling, or pins and needles sensation. Nerve pain can be intermittent or chronic, and the pain can range from mildly irritating to debilitating.

Nerve pain is controlled by your nervous system, which consists of your brain and your spinal cord. Peripheral nerves run through your body’s extremities and nerve pain can be experienced in the arms, hands, fingers, legs, feet, or toes. When nerve pain is experienced in the body’s extremities it is referred to as peripheral neuropathy.

When damaged nerve fibers send incorrect pain signals to different areas of the body, it causes neuropathic pain (nerve pain). Neuropathy is a disturbance of function in one or several nerves. About 30% of nerve pain is related to diabetes. Other conditions that may contribute to nerve pain are HIV/AIDS, shingles, and alcohol use disorder.

Signs and Symptoms

Nerve pain can be experienced in different ways and in varying degrees of intensity. Nerve pain can be chronic or intermittent and can range from mildly irritating to debilitating.

Symptoms may include:

• Spontaneous pain. Pain that happens for no reason and may be experienced as burning, stabbing, electric shock-like, tingling, numbness, or pins and needles sensations.
• Allodynia. Extreme sensitivity to touch from things that do not normally cause pain (touching something cold, pressure against your skin, light brushing against your skin).
• Hyperalgesia. A hypersensitivity or extreme pain to normally painful stimuli (heat or pinpricks hurt more than they should).
• Hypoalgesia. This occurs when a normally painful stimuli elicits a reduced pain response, or no pain is experienced.
• Dysesthesia. Unexpected sensations that feel weird, unpleasant, or painful.
• Insomnia. Difficulty sleeping.

Causes

There are several causes for nerve pain. Causes tend to be related to various diseases, injury, infection, nerve damage, and certain medications.

Specifically, causes include:

• Diabetes
• HIV/AIDS
• Shingles
• Alcohol use disorder
• Facial nerve conditions
• Central nervous system (CNS) disorders (Parkinson’s disease, multiple sclerosis, stroke)
• Complex regional pain syndrome
• Chemotherapy drugs
• Radiation therapy
• Phantom limb pain from an amputation
• Spinal inflammation or nerve compression
• Injury or trauma
• Surgery that results in nerve damage
• Tumors that press on the nerve
• Vitamin B deficiency
• Thyroid problems

Diagnosis

Diagnosing nerve pain requires a physical examination and thorough medical history. If diagnosis cannot be determined based on the exam, medical history, and symptoms, your doctor may order blood work or imaging tests for further assessment. Specific imaging tests include an electromyography (EMG), or magnetic resonance imaging (MRI).

Treatment

Treatment will be determined based on the underlying cause of the nerve pain. There are several different types of treatment for nerve pain. Common treatments include:

• Medications. Medications for nerve pain include over-the-counter medications to help reduce inflammation (NSAID’s such as Ibuprofen, Advil, or Aleve, prescription pain medication (opioids and topical pain relievers), antidepressants (tricyclic and SSRI’s), or anticonvulsants (anti-seizure medication)
• Nerve blocks. This includes your doctor injecting a steroid, pain medicine, or local anesthetic into the affected area. Nerve blocks only provide temporary relief and often must be repeated to keep being effective.
• Implantable devices. This treatment is typically not recommended unless other treatment options have proven ineffective. It includes a procedure to implant a device in the brain or spine. The device then sends electrical impulses between the brain and spinal cord to stop irregular nerve signals and reduce nerve pain symptoms.
• Treating underlying disease. Nerve pain may get better once underlying causes, such as diabetes or tumors pressing against the nerves are treated.
• Surgery. In some cases, surgery may be recommended to reduce nerve pain. A surgeon can repair or remove the damaged nerve(s) to help eliminate or reduce nerve pain.
• Lifestyle treatments. Physical therapy, occupational therapy, massage therapy, stress-reduction, or mental health counseling may all be recommended as treatment for dealing with nerve pain. Your doctor will also discuss lifestyle changes you can make in your day to day to reduce symptoms of nerve pain.

Management and Prevention

Nerve pain cannot always be prevented, but there are ways to reduce the risk of developing nerve pain. There are also effective ways to manage your pain.

Preventative measures include:

• Stop smoking
• Limit your alcohol intake
• Eat a healthy and balanced diet with vegetables, fruit, and lean protein
• Regular exercise
• Treat any underlying disease, such as diabetes (keeping blood sugar at a healthy level and taking extra care of your feet)

Once the underlying cause of your nerve pain is determined, your doctor can help you put together a pain management plan. This plan may consist of many of the above listed measures, as well as physical therapy, occupational therapy, massage therapy, medication management, and mental health counseling.

Lifestyle Modifications for Underlying Conditions

It is important to treat the underlying causes of your nerve pain, as this will help to eliminate or reduce symptoms of nerve pain. Your doctor will help you create a personalized plan, taking into consideration the underlying cause and any lifestyle modifications that can be implemented into your day to day. This may focus on diet and exercise, making sure you are not sitting for too long, and incorporating stretching into your day.

Strategies to Reduce the Risk of Nerve Damage

The most important thing you can do to reduce your risk of nerve pain is to consult with your doctor if you start to notice nerve pain symptoms. Additionally, it is important to follow through on any of the recommended lifestyle modifications and pain management strategies for your nerve pain.

Coping Strategies for Chronic Pain

Chronic pain can impact your quality of life. It is important to consult with your doctor and put together a plan that implements safe and healthy lifestyle modifications, pain management strategies, as well as focusing on your mental health. Chronic pain often leads to symptoms of anxiety and depression, so it is typically recommended to consult with a mental health professional, who can work with you to develop specific coping strategies.

Learn More about Nerve Pain

Untreated nerve pain can significantly impact your quality of life, which is why it is so important to consult with your healthcare provider if you are noticing any symptoms of nerve pain. The sooner you address the nerve pain and develop a pain management plan, the sooner you will begin to regain your quality of life.