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Neuralgic Pain: Understanding Neuralgia
Additional Information
Neuralgia is a stabbing, burning, and often quite severe pain that occurs along a damaged nerve. While this damaged nerve can be located anywhere in the body, it is most frequently found in the face and neck. Causes of nerve damage may include diseases like diabetes (diabetic neuropathy) or multiple sclerosis, infections such as shingles, or simply the effects of aging. Treatment for the pain associated with neuralgia varies based on its underlying cause, and many patients benefit from interventional pain management approaches.
Types of Neuralgia
Neuralgia can manifest in various parts of the body and can be attributed to different causes.
Trigeminal Neuralgia: This form of neuralgia is linked to pain stemming from the trigeminal nerve, which transmits sensations from the brain to the face. The pain is often believed to be caused by a blood vessel compressing the trigeminal nerve at its junction with the brainstem. Trigeminal neuralgia typically results in unilateral facial pain and is more prevalent in older adults. Effective trigeminal neuralgia treatment may include non-surgical pain treatment options such as medications or nerve blocks.
Postherpetic Neuralgia: This type arises as a complication of shingles, a viral infection characterized by a painful rash and blisters. Neuralgia can develop in areas where shingles has affected the skin and can vary in severity, being either persistent or intermittent. Treatments such as regenerative pain therapy may be beneficial for managing this condition.
Glossopharyngeal Neuralgia: Less commonly, this type of neuralgia affects the glossopharyngeal nerve located in the throat, producing pain in the neck and throat regions.
Causes of Neuralgia
The primary cause of any form of neuralgia is nerve damage. Each nerve in the body is insulated by a protective myelin sheath, and damage to this sheath can lead to the intense, shock-like pain characteristic of neuralgia. Various factors, including aging, can contribute to myelin damage, and in many cases, the specific cause of neuralgia remains unknown.
Infection: Postherpetic neuralgia is directly caused by shingles, an infection from the chickenpox virus, with its risk increasing with age. Other infections such as Lyme disease, HIV, and syphilis can also lead to neuralgia.
Multiple Sclerosis: This disease is marked by the degradation of myelin, and neuralgia is a common symptom experienced, particularly in facial areas.
Pressure on Nerves: Nerves can also sustain damage due to pressure from surrounding structures such as bones, ligaments, blood vessels, or tumors. In trigeminal neuralgia, a swollen blood vessel often exerts this pressure.
Diabetes (Diabetic Neuropathy): Many individuals with diabetes experience some form of neuralgia since elevated glucose levels can harm the myelin sheath.
Less Common Causes: If neuralgia cannot be linked to infections, MS, diabetes, or nerve pressure, it may stem from rarer factors such as chronic kidney disease, porphyria, certain chemotherapy medications, surgical trauma, or chemical irritation.
Neuralgic Pain Treatment Options
Medications: Various medicines can help alleviate neuropathic pain. Commonly prescribed options include:
- Over-the-counter pain relievers like aspirin or ibuprofen
- Antidepressants
- Anti-seizure medications
- Topical creams containing capsaicin
Nerve Blocks: Procedures like nerve blocks (e.g., trigeminal nerve block) involve injections aimed at specific nerves or nerve groups to reduce inflammation and pain.
Chemical Neurolysis (Alcohol / Phenol Injections): These injections are frequently utilized to provide substantial relief for trigeminal neuralgia.
Radiofrequency Ablation: RF ablation is often employed to numb the pain-generating structures associated with trigeminal neuralgia and mitigate pain intensity.
Neuralgic Pain Treatment Options available at our clinic include:
- Physical therapy and lifestyle modification counseling
- Medication
- Nerve blocks
- Radiofrequency ablation
Specific Disease-Related Treatment
- TRIGEMINAL NEURALGIA: We offer Gasserion ganglion RF ablation and balloon compression of the Gasserion ganglion.
- ATYPICAL FACIAL PAIN: Sphenopalatine ganglion interventions are available.
- POST HERPETIC NEURALGIA: Radiofrequency ablation is an option, along with treatments for complex regional pain syndrome and sympathetic axis block/RFA.
