Treatment for nerve pain depends on what is causing the pain, so before you can be treated, your doctor has to try to identify the source of the pain. The options include medication, physical therapy, and nerve blocks.
People often describe neuropathic pain as burning, stabbing, electric-like, pins and needles, or shooting. The pain may travel the same path as a specific nerve or it could be rather vague. The pain may come and go with “a mind of its own” or be constant.
Neuropathic pain is produced by damage to or dysfunction of the nerves. It can be caused by:
- Physical injuries that pinch, stretch, or cut nerves.
- Diseases such as diabetes, multiple sclerosis, and shingles.
- Chemicals including cancer therapies (chemotherapy) or excessive use of alcohol.
- A nervous system problem without an obvious cause.
Diagnosing neuropathic pain
Pain from nerves can be thought of as a “short circuit” in our electrical system. Unfortunately, it's not always easy to pinpoint the short circuit. A nerve's path starts at the very tips of the nerve fibers, which then form into specific nerves that go through areas where nerves bundle together.
These nerves then enter the spinal column and go up to the brain through the spinal cord. The brain interprets the final signal.
The diagnosis of neuropathic pain can be difficult because there are limits to what tests, such as X-rays, CT scans, and magnetic resonance imaging (MRI), can reveal about the nerves.
Because of the complexity of the nervous system, even an EMG (electromyography), a test that specifically looks for nerve problems, has its limits in confirming the source of pain.
If there is something pushing on a nerve, treatment will often focus on relieving the pressure, irritation, or inflammation through medication or physical therapy. A common example of this type of pain is a herniated disc in the back that pinches or irritates a spinal nerve, producing pain down a leg.
Nerve blocks (injections of numbing medicine and/or steroid around nerves) are often used to help figure out where the “short circuit” is and try to reset more normal signals. These treatments are given by physician pain specialists.
Medications that are used specifically for nerve pain may also be prescribed, especially if the pain is likely related to a chronic condition.
Although these medication are not narcotics, they can still have side effects that may limit how much can be used. Individual responses will vary and several may be tried before finding the one that helps.
Madhavi Monteforte, M.D., is a pain management specialist and anesthesiologist with Anesthesia Associates of Lancaster. She is the medical director of the Lancaster General Pain Management Center. She earned her medical degree at Temple University School of Medicine and completed her residency at the Hospital of the University of Pennsylvania, where she also completed a fellowship in pain management. She has expertise in the use of various injection treatments for alleviating pain.