What is Neuralgia?
Neuralgia is a stabbing, burning, and often severe pain due to an irritated or damaged nerve. Neuralgia can affect any part of the body, causing mild to severe pain. Certain medications and surgical procedures can effectively treat neuralgia.
Severe neuralgia can interfere with a person’s ability to perform everyday tasks and may impact their quality of life.
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Read more about : Treatment for trigeminal neuralgia
Before Neuralgia Treatment
Symptoms of Neuralgia
In general, neuralgia causes intense and distinct symptoms, including:
. Sudden episodes of extreme shooting or stabbing pain that follows the path of a damaged or irritated nerve.
. Persistent aching or burning pain
. Tingling or numbness
. Muscle weakness
. Loss of muscle mass, or atrophy
. Involuntary muscle twitching or cramping
When to seek medical help
The pain of neuralgia is usually severe and sometimes debilitating. If you have it, you should see your doctor as soon as possible.
You should also see your doctor if you suspect you have shingles. Besides neuralgia, shingles also causes a red, blistering rash. It’s usually on the back or the abdomen, but it may also be on the neck and face. Shingles should be treated as soon as possible to prevent complications. These can include postherpetic neuralgia, which can cause debilitating and lifelong pain.
Causes of neuralgia
The cause of some types of nerve pain is not completely understood. You may feel nerve pain from damage or injury to a nerve, pressure on a nerve, or changes in the way the nerves function. The cause may also be unknown.
. Infection
An infection can affect your nerves. For example, the cause of postherpetic neuralgia is shingles, an infection caused by the chickenpox virus. The likelihood of having this infection increases with age. An infection in a specific part of the body may also affect a nearby nerve. For example, if you have an infection in a tooth, it may affect the nerve and cause pain.
. Multiple sclerosis
Multiple sclerosis (MS) is a disease caused by the deterioration of myelin, the covering of nerves. Trigeminal neuralgia may occur in someone with MS.
. Pressure on nerves
Pressure or compression of nerves may cause neuralgia. The pressure may come from a:
. Bone
. Ligament
. Blood vessel
. Tumor
The pressure of a swollen blood vessel is a common cause of trigeminal neuralgia.
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. Diabetes
Many people with diabetes have problems with their nerves, including neuralgia. The excess glucose in the bloodstream may damage nerves. This damage is most common in the hands, arms, feet, and legs.
. Less common causes
If the cause of neuralgia isn’t infection, MS, diabetes, or pressure on the nerves, it may be from one of many less-common factors. These include:
. Chronic kidney disease
. Medications prescribed for cancer
. Fluoroquinolone antibiotics, used to treat some infections
. Trauma, such as from surgery
. Chemical irritation
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About Iranian Surgery
Iranian surgery is an online medical tourism platform where you can find the best Surgeons to treat your Neuralgia in Iran. The price of treating a Neuralgia in Iran can vary according to each individual’s case and will be determined by the type of treatment you undergo and an in-person assessment with the doctor. So if you are looking for the cost of Neuralgia treatment in Iran, you can contact us and get free consultation from Iranian surgery.
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What to expect at a doctor’s appointment
When you see your doctor for neuralgia, you can expect to be asked a series of questions about your symptoms. Your doctor will want you to describe the pain and to tell them how long the pain has been a problem. You will also need to inform them of any medications you take and any other medical issues you have. This is because neuralgia may be a symptom of another disorder, such as diabetes, MS, or shingles.
Your doctor will also perform a physical exam to pinpoint the location of the pain and the nerve that’s causing it, if possible. You may also need to have a dental exam. For example, if the pain is in your face, your doctor may want to rule out other possible dental causes, such as an abscess.
To find an underlying cause of your pain, your doctor may order certain tests. You may need to have blood drawn to check your blood sugar levels and kidney function. A magnetic resonance imaging (MRI) test can help your doctor determine if you have MS. A nerve conduction velocity test can determine nerve damage. It shows how fast signals are moving through your nerves.
During Neuralgia Treatment
Types of neuralgia
Healthcare professionals divide neuralgia into categories depending on the areas of the body it affects. The following are some common types of neuralgia:
. Trigeminal neuralgia
Trigeminal neuralgia (TN) involves the trigeminal nerve in the head. It has three branches that send signals from the brain to the face, mouth, teeth, and nose.
TN falls into two subdivisions: type 1 and type 2.
Type 1 TN causes a painful burning or electric shock-like sensation in parts of the face. People with type 1 TN experience irregular episodes that come on suddenly.
The duration of these episodes varies among people but can last up to 2 minutes.
Type 2 TN produces a constant, dull aching sensation in the face.
The exact cause of TN remains unclear. However, pressure from an enlarged blood vessel can irritate or even damage the trigeminal nerve.
Multiple sclerosis (MS) can give rise to TN. MS is a neurological disorder that causes inflammation that damages the myelin sheath surrounding nerve fibers in the central nervous system.
. Postherpetic neuralgia
Postherpetic neuralgia (PHN) is a painful condition that affects the nerves in the skin.
PHN is the most common complication of shingles, affecting about 10–13% of people who develop it.
Shingles is a viral infection that causes blisters and a painful skin rash. The varicella-zoster virus, which causes chickenpox, remains dormant in the nervous system and reactivates later in life, causing shingles.
When the virus reactivates, it can cause inflammation in the nerve fibers. This inflammation can lead to permanent nerve damage that causes pain, even after the infection subsides.
. Occipital neuralgia
This form of neuralgia affects the occipital nerves, which originate in the neck and send signals to the back of the head.
Occipital neuralgia causes a throbbing or shooting pain that starts near the base of the skull and radiates along the scalp. Occipital neuralgia pain can flow to the back of the eyes.
Occipital neuralgia has numerous potential causes, including:
. Sudden head movements
. Tense neck muscles
. Lesions or tumors in the neck
. Inflamed blood vessels
. Infections
. Gout
. Diabetes
. Neck injuries
. Peripheral neuralgia
Peripheral neuralgia, or peripheral neuropathy, refers to pain that occurs due to nerve damage in the peripheral nervous system. This includes all nerve fibers outside of the brain and spinal cord.
Peripheral neuralgia can affect a single nerve or entire nerve groups.
Sustaining damage to the peripheral nervous system can affect nerves that control muscle movements, transmit sensory information, and regulate internal organs.
Peripheral neuralgia can cause pain or numbness in the hands, feet, arms, and legs. Other symptoms may include:
. Involuntary muscle twitching or cramping
. Loss of coordination
. Difficulty performing complex motor tasks, such as buttoning a shirt or tying shoelaces.
. Hypersensitivity to touch or temperature
. Excess sweating
. Gastrointestinal problems
. Difficulty eating or swallowing
. Difficulty speaking
. Intercostal neuralgia
Intercostal neuralgia affects the nerves that sit just below the ribs. Doctors call the muscles in this area the intercostal muscles.
Several potential factors may contribute to intercostal neuralgia, such as:
. Injuries or surgical procedures that involve the chest
. Pressure on the nerves
. Shingles or other viral infections
Intercostal neuralgia causes a sharp, burning pain that affects the chest wall, upper abdomen, and upper back. Certain physical movements, such as breathing, coughing, or laughing, can worsen the pain.
Additional symptoms may include:
. Tightness or pressure that wraps around the chest
. Tingling or numbness in the upper chest or upper back
. Muscle twitching
. Loss of appetite
Treatments
Treatment options for neuralgia vary depending on the type and severity of the condition.
Topical ointments, local nerve block, and steroid injections may offer temporary pain relief for mild neuralgia.
Treating severe neuralgia pain may require prescription medications, surgical procedures, or both.
Medications
Pain relievers tend not to be very effective at controlling neuralgia pain. Medications that can treat the underlying causes of neuralgia include:
. Anticonvulsants, such as carbamazepine, topiramate, and lamotrigine
. Antidepressants, such as amitriptyline
. Muscle relaxants, such as baclofen
. Membrane-stabilizing medications, such as gabapentin
Surgery
Some surgical procedures can help relieve neuralgia pain when the condition does not respond to medication.
Examples of surgical procedures that can help treat neuralgia include:
. Microvascular decompression: This helps remove an enlarged blood vessel pressing on a nerve. The procedure involves placing a soft pad between the blood vessel and the affected nerve.
. Stereotactic surgery: This is a noninvasive procedure that delivers highly concentrated radiation beams to the root of a damaged nerve. The radiation disrupts the transmission of pain signals to the brain.
. Balloon compression: This involves inserting a small balloon into the affected nerve. The balloon inflates, resulting in controlled, intentional nerve damage. This procedure prevents the affected nerve from sending pain signals to the brain. However, the effects of the procedure usually wear off after 1–2 years.
After Neuralgia Treatment
Recovery
If you have had surgery for neuralgia, the recovery process depends on the type of surgical procedure.
Take for example, Microvascular decompression surgery often provides rapid pain relief. You may have to take medication for two to four weeks after the procedure to ease any discomfort and swelling and to guard against infection. Your doctor slowly decreases your use of these medications after about a month. Stitches at the incision site are typically removed about 10 days after the procedure. Most people are able to return to work and daily activities about a month after surgery.
Although no procedure is guaranteed to cure neuralgia, all three types of neuralgia surgery have the potential to stop pain for many years, if not permanently. Some surgical procedures can also be repeated if the pain returns. If pain does return after surgery, it may be more easily treated with medications.
Outlook for neuralgia
There is no cure for neuralgia, but treatment can help improve your symptoms. Some types of neuralgia improve over time. More research is being done to develop better treatments for neuralgia.