Prevention
Treating related disorders such as diabetes and renal insufficiency may prevent some neuralgias. Strict control of blood sugar may prevent nerve damage in people with diabetes. In the case of shingles, there is some evidence that antiviral drugs and a herpes zoster virus vaccine can prevent neuralgia.
Causes
Causes of neuralgia include:
- Chemical irritation
- Diabetes
- Infections, such as shingles, HIV, Lyme disease, and syphilis
- Pressure on nerves by nearby bones, ligaments, blood vessels, or tumors
- Trauma (including surgery)
In many cases, the cause is unknown.
Neuralgia is more common in elderly people, but it may occur at any age.
Symptoms
- Increased sensitivity of the skin along the path of the damaged nerve, so that any touch or pressure is felt as pain
- Pain along the path of the nerve that is sharp or stabbing, in the same location each episode, comes and goes (intermittent) or is constant and burning, and may get worse when the area is moved
- Weakness or complete paralysis of muscles supplied by the same nerve
Diagnosis
Your doctor or nurse will examine you and ask questions about your medical history and symptoms, including:
- When did the pain start?
- Did you injure yourself recently?
- Have you had any health changes?
The exam may show:
- Abnormal sensation in the skin
- Reflex problems
- Loss of muscle mass
- Lack of sweating (sweating is controlled by nerves)
- Tenderness along a nerve, often in the lower face and jaw and rarely in the temple and forehead
- Trigger points (areas where even a slight touch triggers pain)
Treatment
Your doctor will:
- Discuss ways to reverse or control the cause of the nerve problem (if found)
- Recommend pain medicines
Treatment varies depending on many things, including the cause, location, and severity of the pain.
Strict control of blood sugar may speed recovery in people with diabetes who develop neuralgia.
Other treatments may include:
- Shots with pain-relieving (anesthetic) drugs
- Nerve blocks
- Physical therapy
- Procedures to reduce feeling in the nerve (such as nerve ablation using radiofrequency, heat, balloon compression, or injection of chemicals)
- Surgery to take pressure off a nerve
- Alternative therapy, such as acupuncture or biofeedback
Recovery
Most neuralgias are not life threatening and are not signs of other life-threatening disorders. However, pain can be severe. For severe pain that does not improve, see a pain specialist so that you can explore all treatment options.
Most neuralgias will respond to treatment. Attacks of pain usually come and go. However, attacks may become more frequent in some patients as they get older.
Sometimes, the condition may improve on its own or disappear with time, even when the cause is not found.
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