Neuralgia: Everything You Need to Know About Nerve Pain

Pain from nerve damage is different than other types of pain

Medically reviewed by Michael Menna, DOMedically reviewed by Michael Menna, DO

Neuralgia, sometimes called nerve pain, is a term for pain caused by nerve disease or damage. It can be caused by nerve irritation, inflammation, trauma, degeneration, or damage. There are several types, and they can affect many different areas of the body.

The effects of neuralgia can range from mild to severe. The pain can interfere with your ability to concentrate or take care of your everyday needs.

This article describes neuralgia, its causes, outlook, and medications, procedures, and surgical interventions that can effectively treat symptoms of neuralgia.

Types of Neuralgia

Some types of neuralgia are defined by their location in the body, and others are defined by the cause of nerve damage. Each type of neuralgia has a specific pattern of symptoms, which may involve characteristic timing, duration, and severity.

Trigeminal Neuralgia

Trigeminal neuralgia causes severe facial pain, typically affecting only one side of the face. You could develop trigeminal neuralgia due to trigeminal nerve damage from dental problems, surgery, or without any known trigger. The trigeminal nerve transmits sensations from the face and controls the chewing muscles.

Postherpetic Neuralgia

Postherpetic neuralgia is a painful condition that can develop after an episode of shingles. Shingles is a painful rash caused by reactivation of the herpes virus that causes chickenpox. Most people who develop shingles will not experience postherpetic neuralgia.

If you have postherpetic neuralgia, you should know that it can often be treated with medication or a nerve block injection.

Occipital Neuralgia

Occipital neuralgia is a rare disorder that causes headaches due to irritation of the occipital nerve, which perceives sensation in the scalp. Many causes of occipital nerve irritation exist, including a pinched nerve.

Peripheral Neuralgia

Usually part of peripheral neuropathy, peripheral neuralgia is a condition that causes pain in one or more extremities. It can affect the hands, feet, arms, or legs. The pain can feel burning, sharp electric shock sensations, pins and needles, tingling, cold, or hypersensitivity to touch.

Intercostal Neuralgia

Intercostal neuralgia causes pain under the ribs and can be caused by trauma, surgical nerve damage, shingles, infection, or a tumor around the nerves that control sensation to this region of the body. A similar condition, pudendal neuropathy, causes pain in the groin area.

Glossopharyngeal Neuralgia

Glossopharyngeal neuralgia is a rare condition that causes pain of the throat, tongue, and mouth due to irritation of the glossopharyngeal nerve. This nerve detects and relays sensation from the mouth and throat.

Symptoms of Neuralgia

The symptoms of neuralgia can vary, usually depending on cause and type. Often, symptoms can change over time. In general, nerve pain is described as neuropathic pain, which differs from pain caused by situations, such as a broken bone, a wound, or a stomachache.

Common symptoms and effects of neuralgia include:

• Pain, even without a trigger

• Hypersensitivity to touch, pain, or temperature

• Numbness, tingling, or electric shock sensations

• Weakness or diminished coordination

You can have trouble sleeping due to the pain or discomfort of neuralgia. It’s common to have challenges as you try to cope, which can lead to anxiety, depression, or lack of motivation. Some people may have difficulty carrying out daily living or self-care tasks and may have trouble with work duties.

The challenges of living with neuralgia can sometimes cause a person to avoid others or avoid activities that used to be enjoyable. If you are having any symptoms of neuralgia or emotional challenges associated with the symptoms of neuralgia, it’s important to discuss your situation with a healthcare provider so that you can get the help you need.

Learn More: What Does Nerve Pain Feel Like?

Potential Causes and Risk Factors of Neuralgia

Any medical condition or trauma that temporarily or permanently harms the nerves can lead to neuralgia. Shingles are the most common cause of neuralgia, but there are many other underlying conditions or factors that can cause it.

Infection

Although infections do not commonly cause neuralgia directly, some may induce an immune reaction that causes nerve inflammation and pain. Additionally, post-infectious conditions, such as shingles or postherpetic neuralgia, can cause severe and persistent pain.

Pressure on Nerves

Pressure on a nerve can cause nerve pain. Nerves can be compressed by a tumor, degenerative spine disease, abnormal blood vessels, abscess (a pocket of infection), and more.

Multiple Sclerosis (MS)

Multiple sclerosis (MS) is an inflammatory neurological disease that causes damage to the myelin coating that promotes nerve function in the brain and spinal cord. Nerve pain is a common symptom of MS. One of the common effects is the "MS hug", which feels like squeezing pressure around the trunk.

Diabetes

One of the most common causes of peripheral neuropathy is diabetes. When diabetes is not adequately treated, it can lead to metabolic changes that cause nerve damage. Neuralgia is a common part of diabetic neuropathy. Other symptoms include diminished sensation and weakness.

Less Common Causes

Traumatic nerve injuries, alcohol toxicity, kidney disease, liver disease, and nutritional deficiencies can cause nerve impairment that may lead to neuropathy and neuralgia.

How Is Neuralgia Diagnosed?

Neuralgia is diagnosed based on a medical history, physical examination, and diagnostic tests. The diagnostic process involves identifying the type and cause of neuralgia, as well as which areas of the body are involved.

Your healthcare provider will use a medical history and physical examination to identify your risk factors and determine whether you have impaired sensation or hypersensitivity, as well as changes in your strength, reflexes, coordination, and walking ability.

Your physical exam can Identify patterns characteristic of certain types of neuralgia. For example, peripheral neuropathy causes symptoms in the distal extremities (toes and fingers). Trigeminal neuralgia affects one side of the face.

Diagnostic testing used in the evaluation of neuralgia include:

• Complete blood count (CBC): A blood test can identify signs of inflammation or infection, which can help guide the diagnosis of neuralgia in some situations.

• Electrolyte lab tests: Significant abnormalities in mineral levels can indicate disorders that could cause neuralgia, like kidney disease or infections that may require treatment.

• Urinalysis: This simple and noninvasive test may detect certain changes in the urine, such as high glucose (a sign of diabetes) or protein, which could be a sign of kidney disease.

• Liver function tests: Alcohol toxicity can lead to peripheral neuropathy, as well as liver damage. Additionally, other types of liver disease may also be associated with neuropathy.

• Kidney function tests: Severe kidney disease can lead to a buildup of toxins in the body that could cause neuropathy.

• Nerve conduction studies (NCV) and electromyography (EMG): These noninvasive tests measure nerve function and can identify different types of nerve damage.

• Brain imaging studies: Some neurological disorders cause brain structure changes that can be detected with brain imaging tests.

• Lumbar puncture: This test is invasive, so it is not commonly used in the diagnosis of neuralgia. A lumbar puncture involves taking a sample of the fluid that surrounds the brain and spinal cord through a needle placed in the lower part of the back. This test can help identify abnormal proteins in the spinal fluid, which could indicate certain neurological or infectious diseases.

• Genetic testing: Specialized blood tests can identify genetic or hereditary diseases that may cause nerve damage.

Neuralgia Triggers

Neuralgia symptoms can fluctuate. Getting enough rest, managing stress, staying hydrated, and maintaining physical comfort can help avoid triggers that worsen neuralgia pain.

Treatment Options for Neuralgia

Various treatments may be used to control neuralgia and treat the underlying cause. Treatments for neuralgia pain can include medications or procedures to help alleviate the pain.

Medications for Pain Management

Medications used for neuralgia pain can include standard pain treatments, but neuropathic pain is usually treated with different medications that aren’t typically used for other types of pain.

Standard pain treatments may include over-the-counter medications such as Tylenol (acetaminophen), Advil/Motrin (ibuprofen), and topical lidocaine creams or sprays. The pain-relieving effects of these treatments usually last 5 to 12 hours.

Related: Topical Creams for Neuropathy

Prescription medications that are used for treating neuropathic pain can be more effective for treating neuralgia, and usually include antidepressants such as amitriptyline or anti-epilepsy medications such as Neurontin (gabapentin). These therapies need to be taken every day to prevent neuropathic pain because they do not work on an as-needed basis.

Nerve Blocks and Injections

Injected anesthetic (medications that numb pain) medications can help relieve neuralgia pain for weeks, months, or longer.

Nerve blocks are injections that prevent a nerve from functioning and can help relieve pain for months. With a nerve block, the nerve is unable to perceive sensation. Sometimes, repeated injections are needed when the nerve block therapy wears off.

Surgical Interventions and Nerve Stimulation

Surgical interventions for neuropathic pain may include removing a structure that is compressing the nerve, such as a tumor. In some situations, surgical intervention for neuralgia pain may involve transection (cutting through) of a sensory nerve to permanently prevent it from functioning.

Nerve stimulation is sometimes used as an option for neuralgia treatment. Different methods of nerve stimulation exist. It may include applying superficial electrical signals to a region of the body that is associated with nerve pain to diminish the pain signals from the nerve.

Substantial progress has been made in using nerve stimulation to treat neuralgia pain, and research regarding its effectiveness and optimal approach is ongoing.

Learn More: What Is Occipital Nerve Stimulation?

What’s the Outlook for Someone With Neuralgia?

The outlook can vary for different types of neuralgia. Some conditions may resolve completely with treatment, and some may progress, even with treatment. For example, with trigeminal neuralgia, it can be challenging to achieve pain control, even with treatment.

Generally, when neuralgia is diagnosed early, treatment more effectively reduces symptoms and prevents progression.

When to Contact a Healthcare Provider

If you develop any symptoms of neuralgia or neuropathy, see a healthcare provider for a diagnosis and a treatment plan. Some types of neuropathies can progress very quickly, causing distressing symptoms and even permanent nerve damage within just a few days. Most neuropathic disorders, such as peripheral neuropathy, will develop over months or longer.

The sooner you get medical attention, the sooner you will get a diagnosis and be able to begin a treatment plan. If you have a primary care provider, you can call the office and make an appointment to be seen and evaluated. You might need to have a referral to a specialist who could begin treatment or who may order further specialized diagnostic tests to identify the cause of your pain.

Summary

Neuralgia involves painful symptoms that occur because of nerve damage or disease. There are many different types and causes of neuralgia, including nerve trauma, diabetes, nutritional deficiencies, alcohol, toxicity, and others. If you develop any of the symptoms of neuralgia, including episodes of pain, tingling, numbness, or shock-like sensations, you can receive relief and therapy to help prevent the progression of your condition.

When you make an appointment to see a healthcare provider, they will discuss your medical history and health risks and use your physical examination and diagnostic tests to identify the type and cause of your nerve disease.

Treatment can include therapies that help relieve pain or discomfort and manage the underlying cause. Living with neuralgia can bring many challenges, but appropriate diagnosis and treatment can help alleviate many of your symptoms and many of the effects of neuralgia.

Read the original article on Verywell Health.