Doctor's Notes on Neuropathic Pain
Neuropathy is a nerve dysfunction that can lead to loss of sensation and in some patients, pain. Neuropathic pain is a chronic pain condition that results from nerve dysfunction. There are numerous conditions that can cause neuropathic pain, such as diabetes, HIV, kidney failure, injury to a peripheral nerve, disc herniation, alcoholism, tobacco use, some prescription drugs, vitamin deficiency (vitamin E, B1, B6, B12, niacin), repetitive stress injury (such as carpal tunnel syndrome), cancer, genetic causes, and shingles.
Neuropathic pain symptoms are chronic, and pain is often felt in the feet, though legs and upper extremities may also be involved. The quality of pain may be unique for every person and may be described as burning, stabbing, prickling, tingling, or aching. Because the entire hands and feet are commonly affected, the symptoms are often described as being in a "stocking-glove distribution."
(Nerve Pain) Symptoms
Chronic pain is the most common complaint of patients with neuropathic pain. Although many people experience pain in their feet, legs and upper extremities can also be involved. There is no obvious cause for the pain and often the pain has been present for many weeks to months before patients will seek evaluation. The quality of pain may be unique for every person; burning, stabbing, prickling, or tingling are words commonly used to describe the symptoms that people are experiencing. Because the entire hands and feet are commonly affected, the symptoms are often described as being in a "stocking-glove distribution."
(Nerve Pain) Causes
There are multiple causes of neuropathy, ranging from diabetes mellitus (the most common cause of neuropathy in the U.S.) to exposure to toxins. Many illnesses -- not just diabetes -- may be associated with development of neuropathy, including HIV and kidney failure. Injury to a peripheral nerve can lead to neuropathy. Alcohol and tobacco can lead to neuropathy and some prescription drugs have been shown to cause neuropathy. Shingles (herpes zoster) can lead to pain in the nerve fibers which were affected by the rash. Once neuropathy has developed, pain may begin at any point. At this time, doctors aren't able to predict who will develop neuropathic pain. In fact, many people are unaware of the presence of neuropathy until pain begins.
A partial list of factors which can cause peripheral neuropathy:
- Diabetes mellitus
- Disc herniation/spinal stenosis
- Kidney disease
- Thyroid hormone abnormality
- Excess growth hormone
- Vitamin deficiency (vitamin E, B1, B6, B12, niacin)
- Vasculitis/blood vessel disease
- Tumor formation/cancer
- Repetitive stress injury (such as carpal tunnel syndrome)
- Toxin exposure (arsenic, lead, mercury, thallium, others)
- Prescription medications (chemotherapeutic agents, antiseizure medications, antibiotics, others)
- Infections (shingles, HIV, Lyme disease, diphtheria, leprosy)
- Inherited (genetic) causes
- Small fiber neuropathy
People can decrease their risk of developing neuropathy by limiting their exposure to alcohol, tobacco, and environmental toxins, as well as maintaining good general health.
The perception of pain varies with each individual; terms such as stabbing, prickling, burning, tingling, and other descriptions have been used. Nerve pain is difficult to live with but in most individuals, it can be reduced. Nerve pain is also called neuropathic pain.
Pain : Test Your IQ of Pain QuizQuestion
Medically speaking, the term "myalgia" refers to what type of pain?See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.