Neuropathic Pain

Home , Neuralgia, Neuropathic pain, Peripheral neuropathy

Kaiser Permanente Health Matters Neuropathic Pain

Postherpetic neuralgia The most common type of peripheral Postherpetic neuralgia is a painful neuropathy affects people with diabetes. condition that can follow the virus This specific condition is referred to as known as shingles. Shingles is a painful diabetic neuropathy. This can occur skin rash and is caused by the same virus when a person has high blood sugar that causes chicken pox. Shingles usually levels for many years. When uncontrolled develops on the side of the chest and blood sugar levels stay high for a long back, but can also occur on the forehead, time, damage can occur to the insulation abdomen, arms, and legs. Postherpetic around the nerves (the myelin sheath). neuralgia develops if the pain from This damage can happen with Type 1 or shingles lasts for more than three months Type 2 diabetes, and it can occur at any after the rash heals. It may occur at any age. However, taller people tend to have age, but is especially common for people more diabetic neuropathy than shorter who: people. High blood sugar levels tend to europathic pain refers to pain that • are 50 and over damage the longer nerves in taller people. Nstems from an injury to a single • have other nerve conditions Other factors that contribute to diabetic nerve or to several nerves in the body. • have immune systems weakened by neuropathy include: You actually might feel the pain in one HIV or other diseases • high blood sugar levels for many years or more parts of the body. Neuropathic • had a more severe shingles rash • alcohol overuse pain can occur at any age, but affects If you’ve had shingles—and if you’ve • smoking older people more frequently than experienced a pain that persisted for at • high blood pressure younger people. Damage to the nerves least three months after the rash from the • high blood cholesterol can change a person’s sense of touch and shingles healed—you may also have These behaviors and conditions can also can limit arm and leg movement. developed postherpetic neuralgia. The cause you to lose feeling in your feet, and Although there are several distinct types pain, itching, and tenderness will most of neuropathic pain, the three most likely be within several inches of the area common are: of the shingles rash. 1. postherpetic neuralgia 2. peripheral neuropathy, including Peripheral neuropathy diabetic neuropathy Peripheral neuropathy results from an 3. complex regional pain syndrome injury or disease that damages the (CRPS) peripheral nerves in the body. These are the nerves that branch away from the The treatment for these types of neuro brain and spinal cord toward your arms, pathic pain are similar (see the back side legs, hands, and feet. Peripheral neuro of this sheet). pathy can occur in one or more of these parts of the body. The nerve damage may be due to infection, trauma, or disease, such as diabetes.

Regional Health Education

this can lead to foot ulcers. It’s a good Treatment for neuropathic pain aerobics, walking, and biking—are the idea to protect and check your feet Research has shown that treatment best way to start. Start off slowly, but try every day. If anything is wrong with specifically tailored for you can help you to increase your activity over time. Try to your feet, call your doctor or other better manage your pain. You’ll want to aim for getting 30 to 60 minutes of exer medical professional. discuss all of your options with your cise most days of the week. Here are the symptoms for diabetic medical team to determine what sort of Cognitive-behavioral strategies neuropathy: treatment program is right for you. Cognitive-behavioral strategies and stress- • numbness, tingling, and burning in Depending on your specific needs, management techniques have been shown the feet and lower legs—especially at physicians, psychologists, or physical to help people better manage and cope night therapists may be involved in your treat with neuropathic pain. The cognitive- • burning, aching, and sharp pain in ment program. behavioral approach highlights how the feet, arms, or hands thoughts, ideas, and beliefs affect your • muscle weakness in the arms, legs, Treatment of neuropathic pain behavior and emotions. In cognitive- hands, and feet includes: behavioral therapy, you learn ways to • increasing physical activity change your thinking styles to decrease Complex Regional Pain • using cognitive-behavioral strategies suffering. When you increase your ability Syndrome (CRPS) and stress management techniques to to cope with the neuropathic pain, you CRPS refers to pain that occurs in the help with mood and functioning are more likely to feel better. Contact hand, foot, or face, but can occur in any • using medications to help with pain your doctor or other medical professional area of the body. The exact cause of and mood for more information. CRPS is not known. Current thinking is • managing stress that injury to the nerves or emotional • improving your blood pressure Medications trauma starts the pain and then can • quitting smoking Medications are given to decrease pain cause a cycle of suffering, inactivity, and • lowering your blood sugar levels and discomfort. You may discuss with disability. (if you have diabetic neuropathy) your medical team which medications Here are the symptoms of CRPS: Physical activity you need. Nonsteroidal Anti-Inflam • deep aching, burning, shooting pain, matory Drugs (NSAIDS) decrease mild The main goal of treating neuropathic or sensitive skin in any area of the to moderate pain and inflammation for a pain is to help improve your comfort in body—but particularly on the face, short period of time. Medications such as daily life. You may not be eager to be hands, or feet tricyclic antidepressants (TCAs) like active if you are in pain and feel tired. • swelling or sense of swelling in the amitriptyline, nortriptyline, and You may talk with a physical therapist to affected area desipramine help decrease pain and also plan an exercise program to help make • weakness in the affected body part help with sleep and mood. Capsaicin and you more flexible, fit, and make move • limited movement in the affected area Lidocaine cream may be prescribed to ment more comfortable. The activity • temperature or skin color changes to soothe skin sensitivity and relieve pain. should not bring on the pain or make the painful body part Take medications only after consulting the pain any worse. If you have new or • change in mood with your doctor or nurse practitioner. • extremely sensitive skin changing patterns of pain or discomfort, • sleep problems you should stop the activity. Physical activity—such as swimming, water Call Kaiser Permanente if you . . . • begin to increase your use of pain medication This information is not intended to diagnose health problems or to take the place of medical advice • feel that your activity level is or care you receive from your physician or other medical professional. If you have persistent health beginning to decline problems, or if you have further questions, please consult your doctor. If you have questions or need additional information about your medication, please speak to your pharmacist. Kaiser Permanente • are feeling anxious more often does not endorse any brand names; any similar products may be used. • are feeling depressed more often