Almost 50 million Americans experience chronic or severe pain, according to the National Institutes of Health’s (NIH) National Center for Complementary and Integrative Health. The report, published by the American Pain Society, estimated that 25 million suffered daily chronic pain while over 23 million felt severe pain every day. NIH also states that experiencing pain regularly can have a negative impact on sleep, cardiovascular health, brain function, sexual function and general quality of life.
What is neuropathic pain?
Pain is a warning signal sent to the brain that indicates something in the body isn’t right. Nociceptorsare the nerve pain receptors that set off these signals when provoked by trauma, burns, inflammation, or infection. Acute pain can be caused by such actions as a hammer hitting a thumb. After the initial cause of pain ceases, the pain itself usually diminishes. Chronic pain lasts much longer. Pain signals continue to be generated and sent toward the brain at a more powerful level, even after the original source of the pain has long healed. Pain gets worse. Thus, the most common cause of chronic pain is inadequately treated acute pain. It can also be caused by factors including injury or illness, such as a back sprain, arthritis or disease like cancer.
When the nociceptors that send pain signals to the brain activate themselves, the result is neuropathic pain. Sensations of itching, tingling, stabbing, aching, or devastating pain may result, not from a particular cause but from unprovoked activity by the nociceptors. This has a definite psychological impact and may result in depression and other unpleasant conditions.
Diagnosing neuropathic pain
Several methods can be used to diagnose neuropathic pain. Physicians should be told the frequency and severity of the pain, where it emanates and if it radiates to other areas of the body. The type of pain, such as burning, shooting, tingling or crushing is taken into consideration, as well as anything the patient does that seems to improve it. Medical conditions, including previous strokes, shingles and diabetes are also considered.
A physical exam incorporating neurological tests, an evaluation of muscles spasms and blood tests are also used to diagnose neuropathic pain. Imaging methods, such as X-rays, ultrasound, CT, and MRI are used to focus on a limb with chronic neuropathic pain, but are also used to identify any structural conditions (nerve compression) or masses (benign and malignant tumors) that may be causing chronic pain.
Additionally nerve conduction studies can determine if pain signals are being sent to the brain properly. Electromyography is another technique that tracks electrical activity of muscle fibers. This may determine whether the pain is related to nerves or muscles.
Neuropathic pain can be managed and treated several different ways. Behavioral and physical therapy programs may be prescribed, as well as medication. Neuromodulation is another option. With this method, transcutaneous electrical nerve stimulators (TENS units) can send impulses to the spine to block the painful impulses. Spinal neuro-stimulation using implantable electrodes can do the same but target the painful area more specifically.
Preventing neuropathic pain can begin by immediately and aggressively treating acute pain after it occurs. That prevents acute pain from becoming chronic. Further, relieving acute nerve compression or inflammation can help in warding off chronic and neuropathic pain.
Treating emotional and psychological conditions, such as hopelessness and depression, also can prevent neuropathic pain. Chronic pain syndrome can have a negative impact on marriage and relationships, employment and financial stability. There is a vicious cycle of pain and depression and then more pain, so improving these issues can also prevent neuropathic pain.
To learn more about neuropathic pain, log on to vascularhealthclinics.org and visit Neuropathy Pain Institute under the Institutes and Divisions tab.