On Your Last Nerve With Nerve Pain
Nerve pain, or neuropathic pain, resulting from damage to nerves or nervous system, is no laughing matter. The symptoms, which include numbness, tingling, shooting pain, and constant aches, can be distressing, impacting everyday life. Most cases affect the peripheral nerves because of an underlying condition like diabetes or sciatica. Multiple sclerosis (MS), shingles, human immunodeficiency virus (HIV), or previous injuries are other causes of nerve pain. Not only is the condition painful, but there are significant emotional consequences like depression and anxiety. Treating nerve pain should be a priority to regain health and wellness. Thankfully, pharmaceutical and surgical options can be tailored to meet the needs of patients.
Try these prescriptions
Doctors or pain management specialists can prescribe medication for pain relief. Prescription anticonvulsants and antidepressants are primarily used for nerve pain management. Anticonvulsants are used to treat seizures but can also help with neuropathic pain. The drug modulates the electrical activity of damaged or hypersensitive nerves. Some anticonvulsants go a step further by managing neurotransmitters, the chemical messengers of nerve cells. Lowering neurotransmitter activity can dampen pain. Some antidepressants can double as a treatment for neuropathic pain. Tricyclic antidepressants (TCAs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can manage neurotransmitter activity. These drugs also disrupt pain pathways, which are neural channels between the brain and spine. Antidepressants and anticonvulsants are provided at lower doses than those required to treat depression and seizures, respectively.
What about pain medication?
Over-the-counter (OTC) pain medication can help but is often limited in treating nerve pain. These drugs can help muscles, joints and other forms of inflammation but may not address neuropathic pain. Some OTC topical treatments, like lidocaine patches or capsaicin creams, can bring temporary relief. Doctors, however, can recommend corticosteroid injections in specific situations. Nerve pain from spinal stenosis, herniated discs, or carpal tunnel syndrome comes from nerve compression. The steroid injections can reduce inflammation, providing relief to nearby nerves. Some patients can benefit from stronger prescription opioids. While all drugs provide relief, the potential side effects are concerning and must be managed.
Can surgery save your nerves?
When used correctly, medication is an effective option for nerve pain, but there are cases where these drugs fail to bring relief. Several surgical interventions are available based on the underlying cause of nerve pain. An orthopedic surgeon or other specialist can perform surgeries on the nerve. For instance, a surgeon may need to perform a direct nerve repair, a delicate procedure that reconnects severed nerve endings. Nerve grafting is another procedure that uses a piece of healthy nerve tissue to fill the gap of a damaged or severed nerve. Another useful technique is a nerve transfer, where a healthy but redundant nerve is moved to the area of the damaged nerve to restore function. These procedures are minimally invasive and have favorable success rates but do require recovery time.
Decompressing your nerves
Nerve pain can come from nearby tissue disrupting or compressing the nerves. By removing the irritant, the nerve can regulate, thereby eliminating pain. Carpal tunnel release surgery is a typical example, where parts of the carpal tunnel are cut away to give room for the median nerve. For nerve pain in the arm or elbow, cubital tunnel release surgery performs a similar function. A spinal discectomy removes part or all of a damaged intervertebral disc causing the nerve pain. This procedure is often combined with a spinal fusion, where 2 vertebrae fuse and form a single piece, eliminating the need for the disc. Nerve decompression surgeries can be performed with minimally invasive techniques but can take several weeks or months of recovery to see results.
Managing pain with SCS
Spinal cord stimulation (SCS) requires special mention as the device can be used for nerve pain management but must be surgically installed. The SCS device sends electrical signals using wires called leads to a targeted area. These leads are surgically installed in the lower back using an x-ray procedure called fluoroscopy. The SCS device is placed outside the body first for a trial period. If the patient sees improvements in pain, the doctor can surgically install the device in the lower back. SCS can last for several years. The patient can control the output for more relief as needed. This device is an excellent option for patients who want to avoid more invasive procedures like spinal fusions.
Downcast to hopeful with nerve pain treatment
Nerve pain can cause significant physical and emotional distress. Without medical or surgical intervention, the pain can worsen or lead to more serious health complications. Prescription medication can address or manage many of the mechanisms responsible for nerve pain. Surgery, on the other hand, can repair nerves or address the underlying cause of nerve pain. While effective, these options can take time to work or may require recovery time. Factors like patient health and severity of nerve damage influence results. Take the first brave step to nerve pain relief by speaking with a doctor or specialist for treatment.
