Condition: Neuropathic Pain
Neuropathic pain is caused by damage or dysfunction in one or more nerves, causing pain signals to be sent to the brain.
Around 7 in 100 people in the UK suffer from chronic neuropathic pain. Neuropathic pain is less responsive to traditional painkillers than other types of pain.
Neuropathic pain is typically described as shooting, burning, tingling or like an electric shock. The pain may be constant or intermittent.
There may be additional symptoms:
- Allodynia – where pain is caused by a stimulus that would not typically cause pain.
- Hyperalgesia – an exaggerated response to a stimulus that usually causes mild pain.
- Paraesthesia – painful or unpleasant sensations (e.g. pins and needles) in the absence of a stimulus.
A number of conditions may cause neuropathic pain:
- Systemic conditions – Diabetes mellitus, thyroid disease, renal disease, rheumatoid arthritis, cancer, multiple sclerosis;
- Nutritional deficiencies/toxins – Alcohol excess, vitamin B12 deficiency, chemotherapy;
- Infections – Shingles, HIV infection;
- Trauma/compression – Nerve compression/entrapment/injury, trigeminal neuralgia;
- Others – Complex regional pain syndrome, phantom limb syndrome, spinal cord injury, stroke.
Nerve conduction studies and electromyography (EMG) are frequently used to identify which nerves are affected. Magnetic resonance imaging (MRI) scans can be used to further investigate the cause of nerve compression.
Neuropathic Pain Treatment
A holistic approach is often needed to treat neuropathic pain. Physiotherapy, modifications to work and home environment, and psychological therapies are important aspects of patient care.
Medical therapy is dependent on the underlying cause of pain, as addressing the underlying cause is an important component of treatment.
Regular painkillers are ineffective in neuropathic pain. Recommended first line neuropathic pain treatment is with antidepressants (e.g. amitriptyline and duloxetine) or antiepileptics (e.g. gabapentin and pregabalin).
Other treatments include topical therapies (e.g. capsaicin or lidocaine) and nerve blocks. Medicinal cannabis can be considered when first line therapies have not achieved adequate symptom control.
Arrange a Referral
At Sapphire London we operate on a doctor to doctor referral basis. We accept referrals from GP’s and consultants. This is to ensure that the patient’s condition has been fully assessed by a qualified physician and all other treatment options have been attempted.
For doctors to refer a patient to us, please click here to fill and securely submit a referral form.