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Neuropathic pain

Neuropathic pain is a type of pain where you experience specific symptoms which can feel unusual. These can be extremely sharp, burning, stinging, cold, crawling, electric etc. The neuropathic pain symptoms often last longer than the tissue damage we can see, such as scar tissue from surgery, trauma, or a trapped nerve.These symptoms may lead your pain management team to believe you may be experiencing neuropathic pain.

Neuropathic pain is caused not by damage to tissues such as your skin, muscles, or organs but instead, is due to actual damage to the nerves themselves – the ‘wiring’. These wires/nerves in your body are designed to protect you and warn you of danger and harm, but at times they can misfire, giving you unpleasant and unhelpful pain. When you touch your skin, the nerves usually send a signal to tell you what that touch is. It could be a hot poker; you may have zapped your finger on a battery or touched an ice cube.

Neuropathic pain

The problem is when these messages don’t work correctly. You may experience burning when gentle air brushes across your skin, or you might have an electrical sensation when your shirt touches your body. We call these sensations neuropathic pain. Common causes for neuropathic pain include damage to the brain, such as a stroke, seizure, or multiple sclerosis; damage to the spinal cord, such as quadriplegia; damage to our internal organs, such as from cancer or trauma/surgery, or it can occur on our skin and muscles such as in a car accident or even a virus such as shingles.

Unfortunately, neuropathic pain often lasts longer than tissue damage. You may well have recovered from your surgery long ago but still be left with burning, stinging or electric pains. Sometimes these nerves recover, and sometimes they don’t. We currently have no way of predicting this. To diagnose neuropathic pain, we will ask you about the injury, event or illness that triggered your pain. We will examine you – often testing sensations like cold, light touch, and pinprick, and we may organize imaging to try and look along the path of a nerve.

Sadly, imaging, such as an MRI, is not always helpful. These nerves are often small and difficult to see clearly. Also,the nerve might look normal but be damaged inside, just like the electrical wires in your house. The insulation/outside part of the wire may look ok, but the small metal wires inside may be broken. Treatment for neuropathic pain is often more difficult than if you have a sprained ankle or are recovering from a surgical scar with stitches.

Morphine-type medications do not work very well on this type of pain, and we have to use different drugs, which your team may talk to you about. Many of these medications, strangely, are also used for depression/anxiety. We are not using these for those reasons, though – but rather, the chemicals that work on the nerve cells in your brain are often the same chemicals that are not working correctly in a nerve.

If your condition is suitable, we may also offer you procedural options. These diagnostic block procedures may help locate a nerve that may be causing/contributing to your pain and then possibly apply a treatment to that nerve to dampen the pain signal as much as possible. Pulsed radiofrequency ablation is a minimally invasive procedural option that, for up to 70% of patients who get reduced pain from the block procedure/test, may reduce pain significantly within the affected nerve for 6-9 months and, in some cases,longer.

While this may sound like a short period of time, one of the issues for many people is that they cannot do rehabilitation, walk, run, or do the things they enjoy because of their pain. Sometimes if we can dampen your painfor a while, get you back to physical activity and normalise your life, people may not need a repeat procedure. If required, repeat procedures can be completed safely. Many people prefer this option over needing to take regular medications.

In-hospital infusions of medications can dampen pain that may be suitable for you, and your team may discuss these with you. As part of your ongoing rehabilitation, it is vital that you always do everything you can to maximize your health and give your body the best chance of reducing your pain. You can include regular exercise (as much as possible), appropriate nutrition, caring for your mental health, reducing stress, and having regular reviews with your General Practitioner. Your Resolve Pain team will discuss options appropriate for you and educate you further about neuropathic pain.

We have included some links below for you to do more reading and help you decide what therapies may be most appropriate for you. Please contact the clinic or ask your pain management team if you have further questions

Neuropathic pain information link - Australian Government HealthDirect

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