Neuropathy is a nerve condition that often can result in feeling pain, numbness, tingling, swelling, or muscle weakness in different parts of the body. It usually begins in the hands or feet and gets worse over time. About 20 million people in the United States are afflicted with Neuropathy and it affects those of all ages, although older people have a higher risk for developing the condition.
Neuralgia refers to pain along the nerve pathway as a result of damage or irritation to that nerve. This type of pain is typically described as a burning, stabbing, sharp, and/or shocking sensation.
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Everyone at the office is so friendly and helpful.
From Sabrina at the front desk, to Esther, the nurse practitioner who we saw for the appointment, everyone was professional and courteous.
- Maria D.
After transitioning from a pain and spine doctor in Columbia, MD.. The intake staff member at Pain and Spine Specialist made the scheduling a breeze. They were able to get me in within a week.
- Rashawn JJ
I've been going to the office for at least a year now. Never have I had a poor visit. Staff are friendly, caring and compassionate. All the doctors / NP are Amazing. They actually care about each patients health.
- Debbie Lang
This is an office that exceeded my expectations. The doctor was a good listener and I was impressed with understanding of my pain and symptoms. Highly recommend!!! - Pain and Spine Specialists of Mount Airy.
- Jeanne Wagener
This practice- every member - has been exceptional in helping me to manage sever spinal stenosis. Every care provider ( and I’ve seen most over 3 years) listens carefully and works with me to seek the best treatment modalities.
- Eileen M
My medications are on point and my new injections are awesome! I get my 2nd injection on September 2nd and I can't wait! I couldn't ask for a better doctor than my doctor! I'm very happy with my treatment plan.
- Janeen R
All the people at the practice are very helpful and considerate. Dr. Gandhi listens to what you have to say and then makes his decision on how to proceed with care. Not a lot of doctors today do this so it's a welcomed change.
- Ken S.
I didn't feel judged or anything because I was trying to get help for my back pain. I had a very pleasant experience there to my surprise honestly. I would recommend this office to anyone who experiences severe pain.
- Heather D
Dr. Roa is such an amazing doctor! During my first visit he never tried to rush through my appt., he genuinely listened to all my concerns and then took his time to explain to me in detail all his recommendations and how they would help me.
- Nikki Walker
Always friendly, courteous, and efficient service. From the ladies, who work the front desk, to the nurses and the doctors. I've always had a good experience with the Harrisonburg office in Virginia.
- Krystal Shaffer
I have now been with Dr. Rao for 13 years. He is the most caring Doctor I have ever been to! Dr. Rao makes you feel very comfortable at all times. I would not want to go to any other Doctor... I go to the Hagerstown location, everyone is very nice
- Theresa R.
The entire staff from the folks at the front desk to the Nurse, to the Physicians Assistant to the scribe that records the visit for the doctor - (great idea so the Doctor can focus on the patient!!!)
- NVA F.
Insurance companies can make things complicated. Regardless, I have been treated by Dr. Rao for over 7 years. I receive the utmost respect. Office personnel are caring and friendly. This practice is highly respected.
- Heidi B.
Completely the best care you could want the staff is so pleasant and caring and the doctors have true heart for healing, love being a patient here would give 10 stars if I could & absolutely the most caring during my procedure with Dr B
- Cathern C.
I had been feeling ick and had a fever. I switched to a virtual appointment and was approved. It was wonderful getting to chat and talk about my concerns just as if I was there... A seamless and easy way to be seen if Covid is around.
- HeatherAnn L
They scheduled my appointment very quickly so that I can get to help that I needed immediately instead of like most places having to wait two to three weeks to get in I called and was able to be seen the next day
- John H.
Patients Seen Within Two Weeks
Neuropathy and Neuralgia can stem from multiple causes. Comprehensive pain management is vital to a patient’s healing process. At Pain and Spine Specialists, our doctors can thoroughly evaluate your pain symptoms in order to accurately diagnose the cause and provide the best line of care.
Once we have an accurate diagnosis, we will work together with you to create an individual treatment plan that will effectively address your pain.
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.
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.
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.
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At Pain and Spine Specialists, our team of physicians and nurse practitioners are committed to giving you the most effective treatment when treating your pain. We believe that all patients should have access to quality care, and that is why you can find us conveniently located throughout Maryland, Pennsylvania, and Virginia.
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