Can acupuncture help with nerve damage

Neuralgia (nerve pain) | Causes, Symptoms & Treatment

Nerve pain, also known as neuropathic pain or neuralgia, is caused by damage to the "sensory fibers" of the nervous system. This is where they differ fundamentally from all other types of pain such as headache, back pain or tumor pain. Responsible for such complaints is an activation of the pain pathway triggered by the nerve damage, a nerve ending responsible for the perception of pain.

What is nerve pain and what causes it?

By definition, neuralgia is pain that spreads to one or more nerves radiate and at the same time be triggered by them. Typical symptoms include:

  • constant burning pain
  • Abnormal sensations
  • Hyperpathies and hyperesthesia
  • Tenderness of muscles and nerves
  • sock- or glove-shaped sensitivity disorders

Nerve pain can occur due to various types of damage to the nerves. A herniated disc, for example, is a common trigger. Another type of nerve damage is a simultaneous disease of many nerves, the polyneuropathy. Among other things, this leads to burning nerve pain in the feet in the case of diabetes mellitus (diabetes). In this case, the permanently increased blood sugar level is the cause of the damage to the fine nerve endings. Herpes zoster is also a possible cause of neuralgia. The pain in the skin results from the reactivation of viruses that have remained in the cranial nerves and the nerve roots of the spinal cord after infection with chickenpox. If they become active again through stress or as a result of an immune system that is weaker with age, the nerves can still hurt weeks and months after the shingles subsided.

Nerve damage or severance in accidents or operations also often results in nerve pain. The same applies to the clinical picture of phantom pain, which cannot be fully explained to this day. This involves feeling pain in parts of the body that were removed as part of an amputation. In addition, neuralgia can occur after strong squeezing of the nerves, the so-called bottleneck syndrome. For example, the carpal tunnel syndrome of the wrist should be mentioned here, which is associated with nerve pain, but also with deficits such as numbness or muscle paralysis. In older people who suffer from sensitivity disorders, a vitamin B12 deficiency can also be the cause of the symptoms. This is caused, among other things, by certain drugs such as proton pump inhibitors. Disturbed digestion is also a possible reason for neuropathic pain. Early symptoms are poor concentration, fatigue and depression.

What treatment options are there?

In order to be able to treat nerve pain appropriately, an adequate diagnostic work-up is first necessary. The more indications in the course of the questioning and examination of the patient indicate neuropathic pain according to the definition, the more reliably a corresponding diagnosis can be made. The diagnosis should include both a physical and a clinical-neurological examination, including testing skin sensitivity, muscle strength and reflexes. It can be extended to include pain questionnaires, a pain drawing and other special tests such as neurography (determination of nerve conduction velocity), QST (quantitative sensory test to test skin sensitivity), SEP (somatosensitive evoked potentials to test the entire emotional pathway from the skin to the brain).

In addition, modern imaging methods are often used, for example computed tomography (CT) or magnetic resonance tomography (MRT, magnetic resonance imaging). These can make nerve damage directly visible. If the affected nerve cannot be relieved by an operation, the treatment of neuralgia is often difficult. Complete freedom from pain is rarely achieved. Therefore, realistic therapy goals are discussed in cooperation with the patient before the start of therapy in order not to arouse too high expectations. According to the guidelines for the therapy of neuropathic pain published by the German Pain Society (DGS), the following goals are considered realistic:

  • pain reduction by> 30 to 50 percent
  • the improvement of the quality of life
  • the improvement of the quality of sleep
  • maintaining the ability to work
  • maintaining social activities and relationships

The treatment of neuropathic pain is based on drug therapy tailored to the particular situation. This serves to alleviate the symptoms until the damaged nerves have regenerated as much as possible. Different active principles, possibly also in combination, are used here. It usually starts with medication such as pain relievers, antidepressants and anti-epileptic agents, which help to make the symptoms more bearable.

The antidepressants used for nerve pain are dosed in lower doses than those used to treat depression. The reason for this is the different effect of these remedies in connection with pain. In the case of rapidly shooting pain, anticonvulsants or opioids are commonly used. If, on the other hand, the pain is persistent, antidepressants or classic painkillers in a suitable strength are used. However, this does not combat the cause, nor does anyone want to have to swallow tablets permanently.

Osteopathy and physiotherapy can also help. In trigeminal neuralgia in particular, surgery can sometimes help relieve the pain. During this procedure, the nerve roots are cut to stop the nerve pain. More and more doctors are also using homeopathic medicines. Acupuncture is also an option, as the fine needles release tension and reduce pressure on the nerve. Since nerve pain can also be a sign of overload, internal compensation can also help to make it disappear permanently. As soon as a burning pain emanates from the nerves, it is also advisable to refrain from cigarettes and alcohol. Heat packs and the general avoidance of colds and hypothermia have also proven helpful.

What are the physical and psychological consequences of neuralgia?

In addition to the physical limitations it causes, the disease of neuropathic pain leads to further unpleasant effects on the musculoskeletal system. Those affected take more care of themselves in order to reduce the symptoms to a tolerable level. However, after a short period of time, this restoration causes a reduction in the muscles and stamina and thus reduced performance. This in turn has an unfavorable influence on the pain disorder, from which a vicious circle can develop. If the pain in the nerves does not want to stop, the mind and psyche are affected in addition to the body.

The nerve pain affects the whole mental state and the whole person. It makes a big difference when, where and how long the symptoms appear - whether they disturb the rest phase or whether they are there non-stop, whether they become noticeable depending on certain postures, activities or overuse, or whether they come into attacks . Especially when the pain starts to attack like an attack, it can dominate the entire personality and destroy any further thoughts or any other activity. Often unpleasant phenomena such as swelling and reddening of the painful parts of the body, sweating, dizziness, nausea, vomiting or feelings of weakness are added, some of which are just as stressful as the pain itself. The disturbance of night sleep is particularly agonizing, especially if during the day the full use of forces is required again.

Some patients find it helpful to avoid contact with other people and to withdraw during periods of severe pain. They'd rather be alone than worry about making others helpless and unhappy with their pain. In addition, staying in crowds of people entails the risk of being clumsily touched or pushed. Many sufferers find themselves changed as a person by the nerve pain. They report an increase in their irritability, displeasure, depressive moods, aversion and listlessness. Refraining from previously important things and activities, such as sports, maintaining a circle of friends and leisure activities, also restricts the joy of life and the quality of life. Above all, renouncing cherished activities and friends can create a lot of bitterness.