Clearing's Chronic Pain Blog
The Complete Guide to Nerve Pain: Causes, Treatments & Prevention
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Nerves have a complicated job — they serve as a switchboard for the body, relaying all kinds of sensations and signals, including both pleasurable and painful ones. Messages about pain help the body react and protect itself, so they’re very important. What happens though, when nerves themselves get injured?
It’s difficult to predict exactly how nerve damage will feel or to know what exactly causes it. Nerves are so closely involved with the rest of the body, there are hundreds of conditions that can affect the way they function and perhaps even more specific sensations they can transmit.
What is nerve pain?
Nerves thread the body to carry electrical impulses that are coded as chemicals. Neurotransmitters help translate and transmit these chemical and electrical signals. Usually when the nerves relay information about pain, they’re reporting injuries or damage happening elsewhere in the body, which is called nociceptive pain. This kind of pain often has a sense of sharpness and urgency or may feel dull and throbbing, depending on what kind of damage happened.
Specialists classify nerve pain by which nerves are most greatly affected:
Autonomic nerves that help control “non-voluntary” bodily functions like your heartbeat and digestion. Damage to these nerves results in trouble regulating body temperature and sometimes in swallowing.
The nerves involved with voluntary motion are called motor nerves. When these nerves are damaged, it often shows up as cramps or spasms, twitching and muscular weakness. Damaged motor nerves may also cause pain.
The sensory nerves report and transmit sensations (heat or cold, roughness or smoothness, etc.) If small sensory fibers are damaged, they may not report pain sensations normally, so sensations may feel unpredictable, intense and often very unpleasant. Large sensory fibers report data about vibrations and touch.
What does nerve pain feel like?
Tingling, buzzy sensations that may feel like being burned, stabbed or electrified may be neuropathic pain, which is pain originating from the nerves themselves. Damaged nerves are in an odd position, so to speak — they have to signal that they’ve been hurt, even though their functionality is compromised.
Nerve pain may feel as though it is:
Coming out of the blue or even not there at all
Sometimes nerves hurt for mysterious reasons, and the causes may seem inexplicable. Phantom limb pain is an example of feeling pain from an area of the body that is no longer physically present.
Sometimes nerves are so damaged or impaired, they cannot transmit properly, and so the body reports only numbness, which can be confusing.
Amplified or muffled
Damaged nerves can emit a kind of pain that feels far past “normal” pain levels. A sheet draped across a foot, for example, may feel nearly unbearable, due to how sensitive the nerves have become. This is called allodynia.
Damaged nerves may transmit a “muffled” kind of pain that doesn’t convey the true level of hurt. That’s why you should consult a doctor right away if you burn or cut yourself, for example, and barely feel anything.
Difficult to describe
The nerves are complicated and capable of transmitting many different sensations. When nerves are damaged, some people describe the resulting sensations as being like “pins and needles,” prickly, burning or very sharp and strong.
What causes nerve pain?
Neuropathic pain doesn’t always show up where you might expect. A tingling sensation in the lower calf might actually be from a nerve compressed much higher up in the spine, for example. Many diseases and conditions are also linked to nerve pain, so it can occasionally be difficult to pinpoint the cause of neuropathic pain.
Common causes of nerve pain include:
- Diabetes: Diabetes accounts for about 30 percent of reported neuropathy cases. Nerve pain related to diabetes (diabetic neuropathy) often shows up in the lower legs and feet.
- Compression or inflammation: Sciatica, herniated discs, pinched nerves and other anatomical conditions that put pressure on nerves or irritate them can trigger nerve pain.
- Repetitive motions or injuries: Doing the same motions the same way over and over or experiencing an accidental injury can damage nerves.
- Certain diseases: Liver disease, multiple kinds of cancers and other diseases impact nerves. Sometimes the medications or radiation used to treat cancer can lead to neuropathies as well.
- Central nervous system disorders: Disorders such as Parkinson’s disease or multiple sclerosis affect nerves.
- Autoimmune diseases: Rheumatoid arthritis, Sjogren’s syndrome, Guillain-Barre syndrome and other diseases that cause the body to attack its own tissues can damage nerves as well.
- Inherited conditions: Some neuropathies can be inherited, as with Charcot-Marie-Tooth disease.
- Infections or disorders: Lyme disease, shingles, HIV, Epstein-Barr virus, Hepatitis C, diphtheria and other infections can cause nerve pain.
- Toxin exposures and deficiencies: Certain medications, exposures to lead, arsenic or mercury or drinking too much alcohol may contribute to nerve pain. So can problems like vitamin B12 deficiency.
Nerves are so integral, they can be damaged in a wide variety of ways, which can complicate the process of getting an accurate diagnosis. Ways of treating and preventing nerve pain exist, however, and many neuropathies are eventually managed successfully.
What treatments work for nerve pain?
A pain specialist is a good place to start, as different types of pain require careful diagnostic work to determine what’s going on. The right diagnosis is very important to establish, as the treatments appropriate for other kinds of pain won’t always work for nerve pain management.
The process of diagnosing and treating neuropathies can follow several different stages:
Your doctor will likely take a medical history: You might fill out an intake form to describe your nerve pain. Your doctor may also want to know about risk factors or complications that may affect your diagnosis.
After that, your doctor may conduct certain tests and exams: To determine what might be going on, your doctor may request both physical and neurological tests. They may also request a genetic test if an inherited condition is implicated. And they may do other evaluations like blood tests to see if there is any evidence of disorders or deficiencies.
Several kinds of tests can indicate how your nerves are functioning. These can include:
- Physiological tests that help determine how well nerves are conducting electrical impulses and whether or not tissues perform as expected (sweating capacity, for example)
- Skin or nerve biopsies that remove small amounts of tissue for analysis
- Imaging studies like CT and MRI scans help show if nerve compression or other trauma is occuring
Address any underlying causes
Since other conditions can influence the nerves, your doctor may focus on controlling contributing diseases or disorders as much as possible. This could include trying to shrink tumors that are pressing on nerves, for instance. If any anatomical elements are making nerve pain worse, surgery may be recommended.
Relieve the pain
Nerve pain can be tricky to address, but many approaches to decreasing nerve pain exist. Painkilling patches and creams are topical solutions that may help, particularly if the pain is localized to a comparatively small area. Lidocaine and capsaicin can help curb pain in the nerve endings.
Stimulating nerves with electricity (like transcutaneous electrical nerve stimulation, or TENS) may also help, and is sometimes recommended for diabetes-related neuropathies. Some classes of drugs that were originally developed to treat depression can help modulate pain signals in nerves, since pain and mood interpretation often uses the same pathways in the brain. Drugs that regulate nerve signaling or reduce inflammation may also help.
Nerve pain management techniques may also include mental components, such as meditation or cognitive behavioral therapy. Finally, physical therapy or acupuncture may also provide at least a measure of pain relief.
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What prevents nerve pain?
The behaviors that help prevent nerve pain are the same behaviors that help keep you healthy in general. They include:
Mixing up your movements
This includes avoiding too much repetition (so, being careful if you play baseball, golf or other sports with repetitive movements, and trying to remember to use different set-ups for typing or working with machinery.) Mixing up your movements means exercising regularly as well, for about 30 minutes at least three times a week if possible. If that’s not possible, try five minutes or a few stretches.
Building a good nutrition foundation
Arm yourself with fruits, veggies, and whole grains, which give your body the nutrients and many of the vitamins it needs to support your nerves. Steer clear of too many toxins and limiting alcohol and smoking.
Clearing can help with nerve pain
Clearing combines cutting-edge science with a personalized approach to chronic pain management. If you’re interested in pain relief, you may want to try Clearing. Your program will be tailored to your needs. Program components can include tailored exercise programs, compounded topical creams that aren’t available elsewhere, nutraceuticals, CBD cream and interactive access to pain specialists.
This article is for informational purposes only and does not constitute professional medical advice. Always seek the advice of your healthcare professional with any questions or concerns you may have regarding your individual needs and medical conditions.