brain, spinal cord, and nerve disorders
Neuropathic Pain
Treatment of Neuropathic Pain
Drugs (such as pain relievers, antidepressants, and antiseizure drugs) Physical and/or occupational therapy Surgery if needed Stimulation of the spinal cord or nerves A nerve block Understanding what the nature of neuropathic pain is and what to expect often helps people feel more in control and better able to manage their pain. Treatment of neuropathic pain can vary depending on the specific disorder causing it. For example, if the cause is diabetes, better control of blood sugar levels may help slow the progression of the nerve damage that causes pain. Often, treatment of neuropathic pain begins with drugs. Drugs can help reduce the pain, making it less debilitating and disruptive, but it is often difficult to completely relieve the pain with drugs. Other treatments include physical therapy, electrical stimulation of nerves or the spinal cord, Nerve block , and sometimes surgery. Psychologic factors that may contribute to the pain, such as Treatment and Pain relievers(analgesics) may be given to reduce neuropathic pain. Pain relievers used to treat neuropathic pain include the following: Adjuvant Analgesics are drugs that change the way nerves process pain. These drugs can reduce pain intensity. Many adjuvant analgesics are usually used to treat other problems (such as seizures or depression), but they were found to sometimes relieve pain, including neuropathic pain. These drugs include Anesthetics (topical drugs), such as a Opioid Pain Relievers partially relieve neuropathic pain in some people, but the risk of side effects is usually higher than that with adjuvant analgesics. However, drugs often provide only partial relief and typically only in fewer than half of people with neuropathic pain. Physical Therapy (PT) and Continue to move the painful part and thus prevent muscles from wasting away Increase or maintain the joint’s range of motion Function better Decrease sensitivity of the affected area to pain Surgerymay be needed if the pain results from an injury that puts pressure on a nerve. Electrical stimulation None Peripheral nerve stimulationinvolves placing thin wires under the skin to stimulate an individual peripheral nerve. (Peripheral nerves are those outside the brain and spinal cord.) The wires are attached to a small device (stimulator) placed on the skin's surface. This treatment is particularly effective for neuropathic pain, and it targets the painful area better than TENS. Placing the wires under the skin is a minimally invasive outpatient procedure because it requires making small cuts into the skin. may be used to relieve neuropathic pain in people with nerve damage after back surgery or with Complex Regional Pain Syndrome . This treatment involves implanting a spinal cord stimulator under the skin, usually in a buttock or abdomen. Like a heart pacemaker, this device generates electrical impulses. Small wires (leads) from the device are placed in the space around the spinal cord (epidural space). These leads transmit impulses to the spinal cord. The impulses change the way pain signals are sent to the brain and thus change how unpleasant symptoms are perceived. Nerve blocksare used to disrupt a nerve pathway that transmits or enhances pain signals. Nerve blocks may be used in people with severe, persistent pain when drugs cannot relieve the pain. Various techniques may be used: Injecting the area around the nerves with a local anesthetic to prevent the nerves from sending pain signals (doctors commonly use ultrasonography to help them locate the nerves to be treated) Injecting the area around collections of nerve cells called ganglia to help regulate the transmission of pain signals Injecting a caustic substance (such asphenol) into a nerve to destroy it Freezing a nerve (cryotherapy) Burning a nerve with a radiofrequency probe 