Each year, the U.S. Pain Foundation hosts KNOWvember, a month-long event held throughout November that explores a different area of pain management through events, social media content, and more.
This year’s KNOWvember focuses on neuropathic pain—pain associated with the nervous system and touch.
Here’s what you need to know about this prevalent form of pain and its treatments.
What is neuropathic pain?
Neuropathic pain most commonly affects the limbs, lower back, and neck. The pain itself can be constant, intermittent, feel like shooting and burning, or accompanied by numbness or loss of sensation.
Sadly, neuropathic pain is widespread across the country. Studies have found that, according to best estimates, the prevalence of pain with neuropathic characteristics in the population may be between 6.9–10%. With chronic pain overall affecting 50 million Americans (over 20% of the population), neuropathic pain is a leading cause of pain in the U.S.
This form of pain is caused by damage to the various levels of the nervous system—the spinal cord, brain, and peripheral nerves. Damage specifically to nerves outside of the brain and spinal cord causes what is known as peripheral neuropathy.
Populations more likely to experience chronic neuropathic pain include women, people older than 50, people with less-formal education, manual workers or farmers, people unable to work, rural residents, and those who are economically disadvantaged.
The causes of neuropathic pain
There are four main causes of neuropathic pain, which includes:
Many diseases can cause neuropathic pain, but 30% of neuropathic pain cases are caused by diabetes. In fact, diabetic peripheral neuropathy affects nearly 50% of adults with diabetes during their lifetime
Other diseases include multiple sclerosis, Parkinson’s disease, complex regional pain syndrome, fibromyalgia, Sjogren’s syndrome, facial nerve problems such as trigeminal neuralgia (causes severe neuropathic pain to the face), lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, vasculitis, kidney disease, liver disease, connective tissue disorders, an underactive thyroid (hypothyroidism), multiple myeloma, alcoholism, other forms of cancer, and more.
Even after a tissue, muscle, or joint injury heals, or back, hip, or leg problems improve, damage to the nervous system can remain. Trauma from spinal injuries such as herniated discs and spinal cord compression can damage nerves around the spine as well, causing neuropathic pain. In addition, iatrogenic injuries—which occur when nerves are cut during surgical procedures either intentionally or unintentionally—are one of the leading causes of chronic neuropathic pain. Neuromas can also develop due to trauma and cause similar neuropathic pain.
Shingles, Lyme disease, syphilis, Epstein-Barr virus, hepatitis B and C, leprosy, diphtheria, and HIV or AIDS can also trigger neuropathic pain.
4. Limb loss
“Phantom limb syndrome” can take place after an arm or leg is amputated. The nerves near the amputation send incorrect signals to the brain, making it feel as though the missing limb is in pain. This can also be felt in fingers, toes, ears, or other parts of the body.
What treatments are available for neuropathic pain?
Treatment for neuropathic pain is varied and effectiveness largely depends on the cause of the pain. Always rely on the expertise of your medical provider when considering treatment options.
Some common examples of treatment include:
- Physical therapy, relaxation techniques (such as meditation), massage therapy, heat and cold therapy, acupuncture, and chiropractic treatment
- Antidepressant drugs can treat both pain and symptoms of depression caused by chronic pain
- Anticonvulsants can treat both seizures and symptoms caused by pain
- Nerve blocks, including steroids and local anesthetics, and
- Neuromodulation, including external and implantable devices that send electrical impulses to the brain, spinal cord, or nerves
- Opioids can be effective but aren’t always prescribed, along with topical pain relievers
- Surgery, including tumor removal, nerve repair, decompression, or graft, and motor cortex stimulation
When seeking providers who can help manage neuropathic pain, along with neurologists, neurosurgeons, and pain specialists, many people do not realize that microtrained orthopedic and plastic hand surgeons that can treat nerve injuries can also address this form of pain.
This campaign was created through support from Axogen, Inc. and Vertex Pharmaceuticals. U.S. Pain Foundation developed the content without review from sponsors. This information is educational only and should not be used as a substitute for advice from a health care professional.