Neuropathy or Neuralgia

Overview of Neuropathy

Neuropathy can stem from multiple causes and comprehensive pain management is vital to a patient’s healing process. 

Neuropathy is also often called Peripheral Neuropathy because it involves the peripheral nervous system, which are the nerves located outside the brain and spinal cord (or your central nervous system). The nerves in the peripheral nervous system branch out from the brain and spinal cord into all other parts of the body, your muscles and organs included. The two systems, the peripheral nervous system and central nervous system, work together by the nerves in the central nervous system sending information throughout the body via the nerves of the peripheral system so that these areas can react to stimuli.  

Neuropathy is fairly common, with age being one of the top risk factors. Aside from age, the risk factors for Neuropathy are diabetes, metabolic syndrome (things like high blood pressure and high cholesterol), and continuous heavy alcohol consumption. Those with physically demanding jobs that have them moving around a lot can often suffer from Neuropathy, as well. 

The symptoms that someone with Neuropathy can experience vary depending on which nerves are being affected. There are three types of nerves and they are classified as: 

• Sensory Nerves: The sensory nerves are responsible for reporting information from the 5 senses of the body into the brain. For example, if you touch something scalding hot then the sensory nerves send a message one-way to the brain to indicate such. 
• Motor Nerves: The motor nerves do the opposite of the sensory nerves and send messages from the brain and spinal cord (the central nervous system) into the body, specifically the muscles. These messages tell your muscles how and when to move. For example, when you touch that scalding hot item then your brain will tell that body part to move away immediately so that you do not get burned. 
• Autonomic Nerves: These are the nerves that control involuntary physiological processes, such as breathing, heart rate, digestion, blood pressure, sweating, and sexual arousal. The autonomic nervous system takes in information about the body and the external environment to be able to adjust the processes just listed accordingly. For example, when you are outside in the heat then your body will produce sweat as a means of trying to cool the body down.  

Neuralgia  

There are several types of Neuralgia, with the two most common types being Postherpetic Neuralgia and Trigeminal Neuralgia.  

Postherpetic Neuralgia is a condition that causes pain of the nerves located in the skin. It can occur anywhere on the body and is one of the leading complications of having Shingles. Shingles is a viral infection that is known to cause rashes and blisters and is the result of the varicella-zoster virus, which is the virus that causes Chickenpox. Shingles can manifest anywhere on the body, although it usually appears along one side of the torso, and Neuralgia will often appear where the Shingles outbreak was. The pain from Postherpetic Neuralgia can range from mild to severe and last anywhere from a few months to years. 

Trigeminal Neuralgia is a type of Neuralgia that is related to the trigeminal nerve. This nerve starts in the brain and travels down into the face, where it branches out into different areas, including the nose, mouth, and teeth. Those who have pain from Trigeminal Neuralgia often experience a stabbing or burning sensation or even an electric-shock-like feeling that can be very painful and typically happens on one side of the face. Trigeminal Neuralgia can stem from enlarged blood vessels that press down on the trigeminal nerve to cause irritation or damage. Multiple Sclerosis is also associated with causing Trigeminal Neuralgia.  

Peripheral Neuropathy actually falls under the category of being a type of Neuralgia.

Causes

Neuropathy may be caused by a variety of health conditions or outside factors. The causes are as follows: 

• Diabetes: This is the number one cause of Neuropathy in the United States, with 60%-70% of those diagnosed with Diabetes having Neuropathy, as well. Diabetes can lead to damages of the sensory, motor, and autonomic nerves, which range in level of severity, and leads to the typical symptoms (tingling, burning, and numbness) that are associated with Neuropathy. Foot problems can easily occur in those with Neuropathy caused by Diabetes. 

• Trauma (Physical Injury): Injuries sustained from incidents, such as car accidents, falls, sports injuries, medical procedures, and bone fractures can lead to serious nerve damage. Injuries can also cause nerves to become compressed or stretched, which results in pain. Repetitive motions, where ligaments and tendons swell from stress, are another way that nerves can become compressed, as the spaces where the nerves run become significantly narrower.  

• Autoimmune Diseases: Autoimmune disorders that trigger Neuropathy include Lupus, Guillain-Barre Syndrome, Rheumatoid Arthritis, Sjorgren’s Syndrome, and Chronic Inflammatory Demyelinating Polyneuropathy. Autoimmune diseases are disorders where the immune system (which normally protects against germs, bacteria, and viruses) mistakenly starts to attack the body. These disorders can directly affect the nerves or lead them to be compressed when surrounding tissues are attacked. 

• Infections: Infections (both viral or bacterial) that can cause Neuropathy include Lyme Disease, Human Immunodeficiency Virus (HIV), West Nile Virus, Herpes, Syphilis, Hepatitis B and C, Leprosy, and Diphtheria. Infections have the ability to target nerve tissues and cause Neuropathic symptoms, like sharp pain. HIV, which is the virus that causes Acquired Immunodeficiency Syndrome (AIDS), has the potential to severely damage both the central nervous system and the peripheral nervous system. 

• Medications and Toxic Substances: Chemotherapy drugs, which are used to treat cancer, can damage nerves and cause polyneuropathy in about 30% of people. Radiation also has the ability to damage nerves, which may trigger symptoms as much as months or even years later. Exposure to toxic substances, like lead and mercury, or other chemicals, such as strong household cleaners, in large enough amounts or for long periods of time can impede nerve functioning. 

• Vascular Problems: Neuropathy can occur when blood flow is reduced and oxygen supply to the peripheral nerves is decreased, which can result in nerve tissue damage or even nerve cell death. Vascular problems can be derived from issues such as blood clots, smoking, vasculitis, high blood pressure, and diabetes.  

When the cause of neuropathy is unknown, it is referred to as idiopathic neuropathy.  

Diagnosis of Neuropathy Pain 

Our physicians are board certified, and are dedicated to giving you a comprehensive exam that will aid in diagnosing the cause of your symptoms. Using advanced diagnostic techniques, our doctors will find out the reason for your pain, and then get you on the road to better health right away. Here are a few steps our physicians use when completing their comprehensive exams: 

• We take your complete medical history to identify or rule out possible causes of your pain. 
• We conduct a thorough physical exam 
• We carefully review your symptoms, including how you would describe the pain (burning, achy, dull, etc.) and whether certain positions or activities make the pain feel better or worse 
• We may order diagnostic tests, including x-ray, MRI or CT scan, to help us diagnose your chronic pain 

Once we have an accurate diagnosis, we will work together with you to create a treatment plan that will effectively address your pain.