Neuropathic pain (nerve pain) is long-term pain caused by nerve damage. It can occur for many reasons, affects people with a wide range of conditions and although it mainly affects people over the age of 50, can occur at almost any age. The pain can arise in a variety of conditions including:
• diabetes
• cancer
• shingles
• trigeminal neuralgia
• surgical scarring (following an operation)
• back problems (sciatica, collapsed disc etc)
This is just a short list, there are many more potential causes. Your doctor would be able to give a definitive opinion on your individual case. What is clear that neuropathic pain can be felt anywhere in the body and is associated with several other symptoms, including:
• tiredness, loss of energy
• sleeplessness, insomnia
• problems in concentrating
• sensitivity to cold, heat or touch on the skin
Again, these are just a few of the possible associated symptoms in addition to the pain.
The pain itself can be described as:
• burning
• sharp
• shooting
• stabbing
• like an 'electric shock'
• numbness of the affected area
• an itchiness
• like 'creepy crawlies' over your skin
In every case the combination of symptoms, frequency, triggers and its effects on daily living are probably unique for every individual. Diagnosis can be difficult in the early stages as the pain develops over a period of time usually and symptoms change.
Questions your doctor will ask to help with a diagnosis include:
• When did it start and how long have you experienced the pain?
• What is the frequency (how often do you get it)?
• What brings it on (triggers such as cold, stress, cleaning your teeth etc)?
• Location of pain in your body?
• What kind of pain do you have (shooting, stabbing, burning etc)?
• Do you have different types of pain (does it vary)?
You may be asked to keep a pain diary. Be sure to record not only the symptoms but also any triggers you identify, the type of pain and how long it lasts.
The doctor may refer you for specialist investigations including X-rays, CAT scans, MRI or nerve tests. Treatment varies depending on the actual diagnosis and it may take time to find the treatment that works for you. With intractable pain surgery may be an option but this is always a last resort. New drugs and surgical options are coming forward all the time but some of the long-established drugs still prove useful in the majority of cases so you should be able to find an effective treatment in most cases.
Whatever the cause of your nerve pain and the treatment you receive, neuropathic pain is a serious condition and will have an impact on your life, possibly a dramatic one. However, there are numerous support and self-help groups and you should seek these out. It always help to know that you are not alone with your pain.
My personal experience meant that I had to have major neurosurgery to implant a nerve stimulator into my trigeminal nerve root. This came after years of increasing drug dosages with the resulting side-effects. I was off work for almost three years and it was only with the implant that my pain came under control. Most people, fortunately, don't suffer such severe pain.
Finally:
• Neuropathic pain affects almost 10% of the population at some time
• Around 50% of sufferers are aged over 50
• It affects about 1 in 3 cancer sufferers and half of people suffering a spinal cord injury
• Around a quarter of people with diabetes will experience nerve pain, mainly in hands and feet.
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Contributor's Note
I was a nurse for over 15 years, working in mental health, general medicine, surgery, cardiology and intensive care. I was diagnosed with trigeminal neuralgia in 2000 and had surgery in 2003 to implant a cranial nerve stimulator.
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