Neuropathic Pain Types

Neuropathic pain is often the result of nerve damage or a malfunctioning nervous system that sends pain signals to the brain even if there is no trigger, such as an injury or inflammation. In some patients, sensory signals simply get crossed and are interpreted as pain.

Neuropathic pain can present as shooting and burning pain or tingling and numbness. Sometimes, it might be triggered by simply touching the skin. Symptoms may come and go, but if the pain lasts consistently for more than two months, it is referred to as chronic neuropathic pain.

Patients with this condition often have difficulty sleeping and can suffer from depression and anxiety.

What Causes Neuropathic Pain?

Neuropathic pain can be difficult to diagnose initially, especially if there is no obvious cause such as an injury. But the patient’s physical examination and medical history may give clues, especially if they have or had:

• Amputation (phantom limb syndrome)
• Chemotherapy
• Diabetes
• HIV
• Multiple Sclerosis
• Spine Degeneration or Herniated Discs
• Shingles
• Spinal Surgery

Different Types of Neuropathic Pain

There are several different forms of neuropathic pain:

• Diabetic neuropathy can develop when uncontrolled high levels of blood sugar (glucose) injure nerves in the body, although it usually affects nerves in the legs and feet.
• Peripheral neuropathy occurs when the nerves that connect the brain and spinal cord to the muscles, skin and internal organs become damaged or diseased.
• Radiculopathy involves the neck or lower back and arises when a nerve root is compressed or irritated in the spinal column. Patients often experience shooting pain in their arms or legs.
• Complex regional pain syndrome (CRPS) might develop after a significant injury, but it also can be caused by a relatively minor trauma, like a sprain or strain. CRPS can lead to debilitating pain. 

Treatment Options

For less severe cases of neuropathic pain, patients may get relief from over-the-counter topical patches or ointments as well as non-steroidal anti-inflammatory drugs (NSAIDs). If those are ineffective, prescription medications including anti-seizure formulations or antidepressants may be considered.

The pain can also be treated with nerve blocks which involve injecting local anesthetic and anti-inflammatory steroids directly to the area of the affected nerves.

But difficult cases of neuropathic pain can be treated by experienced specialists who are trained to perform minimally invasive procedures known as spinal cord stimulation and peripheral nerve stimulation. These interventions involve implanting a small device under the skin which delivers precise electrical pulses to interrupt pain signals before they reach the brain.

These treatments may also be combined with physical therapy and behavioral therapy to improve function and quality of life.

Dr. Skaribas is fellowship-trained and double board certified in Pain Medicine and Anesthesiology. He performs minimally invasive treatments to address all types of neuropathic pain.