Nerve-related pain is also called neuropathic pain. According to the International Association for the Study of Pain (IASP), neuropathic pain is defined as a direct consequence of a disease or lesion that affects the somatosensory system. According to studies, neuropathic pain affects around 7% of the general population. The treatment of neuropathic pain centers around the underlying cause. When curing the pain is not possible, the main role of pain management is to control the symptoms.
The symptoms of neuropathic pain can be debilitating and chronic. Symptoms include burning, tingling, numbness, and changes in sensation. Many patients describe the pain as “pins and needles.” Common causes of neuropathic pain include post-herpetic neuralgia, trigeminal neuralgia, peripheral neuropathy, carpal tunnel syndrome, spinal stenosis, and disc herniation.
- Anticonvulsants – Epilepsy medications (anticonvulsants) are used to stabilize irritable nerve membranes to reduce pain. Side effects include drowsiness, dizziness, headaches, and confusion. Phenytoin, Neurontin, and valproate all were found effective for various types of nerve-related pain in clinical studies.
- Tricyclic antidepressants – Amitriptyline, clomipramine, and dothiepin are examples of tricyclic antidepressants. These drugs inhibit nerve pain. Common side effects include dry mouth, sedation, and constipation. In controlled trials, these medications were effective for post-stroke pain, polyneuropathy, post-herpetic neuralgia, and post-mastectomy pain.
- Capsaicin cream – Derived from chili peppers, capsaicin cream is absorbed through the skin. It works by reducing levels of substance P, which is a neurotransmitter associated with pain and inflammation. This drug works best when applied 3-4 times each day. Side effects include redness of the skin and localized heat.
- Muscle relaxants – Also called antispasmodics, examples include Baclofen and Flexiril. These drugs relieve pain by decreasing impulses of the nerve and muscle tissue.
- Opioids – These medications work on the level of the central nervous system, offering pain relief by interfering with pain signal transmission. Examples include tramadol, morphine, oxycodone, and fentanyl. Studies support the use of opioids for neuropathic pain, with intravenous administration working well for peripheral nerve pain, and morphine showing effectiveness for phantom limb pain, post-herpetic neuralgia, and peripheral neuropathy.
- Topical lidocaine – Also called Lidoderm, the lidocaine patch is quite effective for pain relief, and they should be applied once every 24 hours. Topical lidocaine gel is also quite effective. This medication was shown to work well in patients with post-herpetic neuralgia and allodynia.
- Intradermal botulinum toxin (Botox) – This neurotoxin has been proven effective for nerve pain. This muscle-paralyzing agent is thought to stop pain signal transmission.
- NMDA antagonist – When given as an intravenous infusion, NMDA antagonists have been shown to relieve neuropathic pain. In addition, high-dose dextromethorphan had been shown to work well for painful diabetic neuropathy.
Trans-Electrical Nerve Stimulation (TENS)
This machine produces mild electrical impulses via wires that run from the unit and attach to electrodes placed on the body. TENS works through selective stimulation of nerve fibers that block pain signals.
To reduce pain for several weeks or months, the Colorado pain specialist may perform a nerve block. This involves injecting an anesthetic and/or neurolytic agent around the affected nerve to stop transmission of pain signals to the brain.
Acupuncture involves insertion of tiny needles into certain body points (called acu-points), which are considered to be energy channels. This stimulates the body’s natural healing response and restores energy flow and balance. The insertion of the fine needles creates a tingling sensation.
Biofeedback and Relaxation
Biofeedback and relaxation are techniques used to control and influence body functions. Many patients are able to relax tense muscles and decrease pain using this mechanism.
Spinal Cord Stimulator
As a last resort option, a spinal cord stimulator implant can help those with neuropathy relieve pain. In addition, the implant can also help restore lost sensation, which has been an amazing result!
For the top neuropathy treatment in Northern Colorado, the Board Certified providers at Colorado Clinic offer comprehensive therapy options. Most insurance is accepted at the 5 locations, including Boulder, Loveland, Greeley, Buena Vista and Fort Morgan. Call us today!