- Understanding Nerve Pain
What is nerve pain?
Pain that is experienced as a result of direct injury or damage to the nerve fibres themselves, is called neuropathic pain.1
Neuropathic pain is typically chronic and intense3, identified by shooting, stabbing or burning pain sensations.4 It may be intensified by factors that typically should not cause pain, for example, contact with clothing or light touch.
Before nerve pain can be effectively managed, a primary care physician will determine:
- Where the pain may be coming from
- Whether there are any underlying causes of the pain to address, for example, diabetes
- The functional limitations that arise as a result of the pain
- Whether depression, anxiety or sleep imbalances may be heightening pain sensations
- The impact of the pain on quality of life
Managing neuropathic pain is based on considering the person as a whole and may include a combination of medication and non-drug treatments.
There are several options for drug therapy that may help to manage the symptoms associated with nerve pain.
There are three approaches to drug treatment for nerve pain:7,
- Antidepressant or antiepileptic medication.
Each approach to pain is an attempt to improve a patient’s quality of life by reducing pain and increasing activity levels.
Medicines alone may not resolve the pain completely and non-drug approaches to managing neuropathic pain is also important due to the complex nature of the pain experience.
Supporting yourself with psychological tools will help you to focus on aspects of functioning despite having pain rather than placing focus on pain completely resolving before you can function.
The types of psychological tools offered by a registered psychologist, is based on the individual’s needs, and is aimed at addressing the pain-related distress and disability.8
For example, nerve pain that is a common symptom of uncontrolled diabetes, called diabetes neuropathy, may be significantly reduced with better management of the diabetes. 9
Any persistent pain warrants investigation. With the correct assessment and diagnosis, there is a far better likelihood of obtaining the best approach to your treatment and overall care.
- Global Year Against Neuropathic Pain. 2014-2015. International Association for the Study of Pain. Available at https://s3.amazonaws.com/rdcms-iasp/files/production/public/AM/Images/GYAP/Epidemiology%20of%20Neuropathic%20Pain.pdf. Accessed on 22 June 2020.
- Management of Neuropathic Pain. 2nd Edition. 2012. Malaysian Association for the Study of Pain. Available at https://www.masp.org.my/index.cfm?menuid=21. Accessed on 22 June 2020.
- Nociceptive and neuropathic pain: What are they? Medical News Today. 2017. Available from https://www.medicalnewstoday.com/articles/319895. Accessed on 22 June 2020.
- Healthdirect. Nerve pain (neuralgia). July 2020. Available from: https://www.healthdirect.gov.au/nerve-pain. Accessed on 29 September 2021.
- Healthline. Neuralgia. Healthline. 2018. Available at: https://www.healthline.com/health/neuralgia. Accessed 19 July 2020
- Colloca L, Ludman T, Bouhassira D, et al. Neuropathic pain. Nat Rev Dis Primers. 2017;3:17002.
- Managing neuropathic pain: a stepwise approach. Australian Government. Department of Veterans' Affairs. Veterans’ Medicines Advice and Therapeutics Education Services. June 2013. Available at https://www.apsoc.org.au/PDF/Publications/Veterans_MATES_35_Neuropathic_Pain_TherBrief_JUN13.pdf. Accessed on 22 June 2020.
- Sturgeon, J. Psychological therapies for the management of chronic pain. Psychol Res Behav Manag.2014; 7: 115–124. Available from https://www.dovepress.com/psychological-therapies-for-the-management-of-chronic-pain-peer-reviewed-article-PRBM Accessed on 26 June 2020.
- How Is Diabetic Nerve Pain Treated? WebMD. Available from https://www.webmd.com/diabetes/guide/peripheral-neuropathy-treating-nerve-pain. Accessed on 26 June 2020.
How do I know whether I have nerve pain?
It is often more difficult to determine the source of the pain when it comes to nerve involvement, which is particularly true for neuropathic-type of pain.
To estimate the probability that your pain is originating from your nerves, answer yes or no to each of the four questions below.
|Does your pain have any of the following characteristic(s)?|
|Painful cold-like sensation|
|Do you feel one or more of the following symptoms in the same area as the pain?|
|Pins and needles|
|Are either of the following sensations dulled in the area of the pain?|
|When you brush the area of the pain with a soft brush or ball of cotton wool, is the sensation painful or pain increases?|
For every ‘YES’ answer, allocate 1 point. For every ‘NO’ answer, allocate 0 points.
The score out of 10 will reveal the possibility that the pain is from a source relating to a nerve. The higher the score, the more likely the correlation is. This is not a diagnostic tool but an opportunity for you to discuss these results with your doctor.
Bouhassira D et al. Comparison of Pain Syndromes Associated With Nervous or Somatic Lesions and Development of a New Neuropathic Pain Diagnostic Questionnaire (DN4). Pain 2005 Mar;114(1-2):29-36.