Neuropathies: More than Just the Pins and Needles in Your Feet

What is neuropathic pain?

It is pain is most often a result of nerve injury. This could be compression of a nerve such as in carpal tunnel syndrome or a pinched nerve in your neck, back, or sciatica. Damage of the nerve(s) can also occur from multiple medical conditions, medications, and trauma.

Neuropathic pain is different from other types of pain. It is often described as burning or shooting.  It is often associated with changes in sensation in a limb area such as pins and needle sensation like when your foot falls asleep after sitting on it incorrectly and you try to wake it up or the sensation you get hitting your funny bone in your elbow. The only difference is that the pain and symptoms don’t stop. There could be associated numbness in an area or even an area that is painful to the touch or be brushed against. Sometimes even weakness will be present.

Neuropathic pain is most common in the extremities such as the feet or hands but can occur any place in the body.

What causes neuropathy?

There are many conditions that can cause you to get a neuropathy including but not limited to:

  • Poorly controlled Diabetes
  • Excessive drinking of alcohol
  • Shingles from prior chicken pox
  • Thyroid problems
  • Nerve compression from a herniated disc in your spine
  • Carpal tunnel disease
  • Chemotherapy treatments
  • Amputation
  • Multiple sclerosis
  • Prior spine surgery
  • HIV

How can neuropathic pain be treated?

Neuropathic pain is notoriously difficult to treat and may be resistant to many forms of therapies, however, there are several successful ways to treat and manage it.

  • Control the offending condition: If your diabetes is not well controlled, check your sugar more often. Keep it under tighter control. This will halt the progression or at least slow the progression of the neuropathy.  Moderate drinking alcohol.  Have your carpal tunnel decompressed. 
  • Over the counter Medications: medications such as Tylenol, ibuprofen, or naproxen may help but are often insufficient by themselves in helping with this type of pain. Topical creams with capsaicin can often help as well.  Lidocaine patches can also control pain from neuropathies.
  • Antidepressant and Anticonvulsants: Medications such as pregabalin (Lyrica), gabapentin (Neurontin), duloxetine (Cymbalta), and venlafaxine (Effexor) can be very helpful at reducing nerve irritation and neuropathic pain. There are some older medications such as amitriptyline and nortriptyline (Pamelor) that have a bit more side effects but can also help.
  • Electrical stimulation with TENS or implanted stimulators: Whether you chose to use a TENS unit or will need an implantable device often depends on where the neuropathy is and how extensive of an are is involved. There are several peripheral nerve stimulators available as well.
  • Nerve blocks: may help locate which nerve is causing the problem. An available option is to do Pulsed Radio Frequency Ablation to turn the nerve off temporarily for up to 3 months.
  • Infrared LED Phototherapy: According to this study, it may be associated with a short-term improvement in plantar tactile sensitivity not sustained over time and probably related to no effect on neuropathic pain relief. The study doesn’t support its use for neuropathy currently.
  • Several other options may be available to help with damaged nerves including a spinal cord stimulator and peripheral nerve stimulator.

Be careful using heat or cold therapy on your feet if you have lost sensation. It is easy to cause burns or frostbite.

We would be happy to discuss these and other options to help you with you at Southwest Pain Management.

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