Neuropathic Pain

Last week, we learned that we have special receptors, called nociceptors, on the ends of our nerves that send pain signals through the nerves to the spinal cord to the brain.  These signals warn us about temperature, injury, irritation, or potential injury.  Today, we'll  cover neuropathic pain - what it is and how it's treated.

Neuropathic pain comes directly from the nerves, not the nociceptors.  Nerves from the peripheral nervous system or the central nervous system may be affected.  One or more nerves may be injured, damaged, irritated, 'pinched' (compressed from inflammation, disc material, or other matter), or functioning improperly.  If you herniate a disc in your spine, some of the jelly-like material (the nucleus pulposus) may squirt into and block the passage designed for the nerves that are exiting from the spinal cord and going into an arm or leg.  When that happens, the nucleus pulposus may touch or compress the nerve bundle which can cause severe neuropathic pain.  Excessive repetitive motion, or a disease like Diabetes, can cause damage to nerves so that they function improperly and cause pain that may tingle and burn (called peripheral neuropathy).    Phantom limb pain also falls in the category of neuropathic pain.  Neuropathic pain is more likely to be chronic and can be more difficult to treat.

While OTC analgesics can help with nociceptive pain, they do very little (if anything) to relieve neuropathic pain.  Finding and resolving the cause of such pain is the first step in treating it.  However, if the cause is known but cannot be remedied, other steps become necessary.  Stronger medications, like opioids will probably be prescribed, but may or may not help.  Using devices like TENS Units or Spinal Cord Stimulators may help block neuropathic pain signals from reaching the brain.  For the naturalist, aromatherapy and herbal remedies may be the answer.  

What I find in my own case is that a combination of therapies is most effective.   I have both nociceptive pain from osteoarthritis (all joints), and neuropathic pain from multiple bulging, herniated, degenerative, and fused discs.  Opioids are not an option for me because they make me violently ill.  Herbs and essential oils do help, and in combination with spinal cord stimulators, I get enormous relief.  Because the stimulators interrupt the pain signals, they provide significant relief for both types of pain.  The most important thing for those of you who suffer with neuropathic pain is to work with your health care practitioner to find the best therapies for your individual case.

Sources:

1.  Dresden, Danielle, Nociceptive and neuropathic pain:  What are they?, Medical News Today, Last reviewed November 2, 2017
https://www.medicalnewstoday.com/articles/319895.php
Accessed June 19 - 25, 2019

2.  Smith, Yolanda, What is the Difference Between Nociceptive and Neuropathic Pain? , News-Medical Life Sciences,  Last updated August 23, 2018, 
https://www.news-medical.net/health/What-is-the-Difference-Between-Nociceptive-and-Neuropathic-Pain.aspx
Accessed June 19 - 25, 2019

3.  Booth, Keley John, MD, Understanding Nociceptive and Neuropathic Pain, Pain-Health, Last updated September 27, 2018,
https://www.pain-health.com/conditions/chronic-pain/understanding-nociceptive-and-neuropathic-pain
Accessed June 19 - 25, 2019

4.  Webberley, Helen, Dr., What is peripheral neuropathy?,  Medical News Today, Last updated November 27, 2017
https://www.medicalnewstoday.com/articles/147963.php​
Accessed June 19 - 25, 2019