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Specialists in the Field of Neuropathic Pain
Kliniken Schmieder Allensbach and Heidelberg
Acute Neurology, Neurological Early Rehabilitation and Rehabilitation, Neuroradiology and Radiology
Information About the Field of Neuropathic Pain
What is Neuropathic Pain? Where Can it Occur?
Neuropathic pain, also called nerve pain, is a unique form of pain triggered by direct compression or damage to the nerves. It often occurs in the context of some diseases such as diabetes mellitus , post-zoster neuralgia, or other regional pain syndromes. Nerve pain manifests in different ways. At the beginning, there may be similar to tingling or be associated with mild numbness. However, depending on the severity of the underlying condition, even a light touch to the affected region can trigger disproportionately severe pain at a later stage. The extremities are most commonly affected, although nerve pathways in other body areas can trigger nerve pain.
What Are the Causes of Nerve Pain?
Common causes of nerve pain are diseases that can lead to nerve damage. For example, diabetes mellitus causes nerve damage in the feet and legs in the long term, primarily if blood sugar levels are poorly controlled. Shingles (medically "herpes zoster") can also result in neuralgia, i.e., nerve pain. In addition, a pinched nerve, such as carpal tunnel syndrome , can also be painful even though it is uninjured. Because of the many causes of neuropathic pain, an extensive examination and a detailed interview are necessary to provide a correct diagnosis.
How Does Neuropathic Pain Manifest?
As mentioned above, neuropathic pain can express in many different forms. Initially, it often manifests as tingling, tickling, or regional numbness. The longer the causative disease persists, the pain character usually changes to an initially burning or throbbing pain. In particularly severe diseases, the pain increases to such an extent that at some point, it occurs in extreme forms, even with a light touch. For example, wearing clothes on the affected parts of the body leads to pain.
It is important to note that continuous nerve damage is often completely symptom-free at the beginning and only becomes noticeable later in the disease.
How Can Nerve Pain Be Detected?
The sensation of pain is subject to the affected person's perception and can only be partially examined or assessed by others. Neurological functional deficits such as numbness, tingling, or disturbed temperature sensation can be an early indication of nerve damage and often remain unnoticed. A doctor should be consulted if the neuropathic pain symptoms described above repeatedly occur, especially in the hands, feet, and legs. They can usually provide information on whether the pain is caused by the nerves or triggered by other causes.
Therapy Options for Neuropathic Pain
At the beginning of therapy, the cause of the pain should be determined and treated. In mild forms of nerve pain, this causative therapy is already sufficient. Depending on the severity of the pain, treatment with analgesics, antidepressants, and antiepileptics may be helpful. If there is a long-term condition, inpatient rehab with occupational and physical therapy is also a good therapy option. In exceptional cases, such as pinched nerves or severe nerve damage, surgery may be necessary to repair the damage. Therefore, it is important to have a holistic therapy that does not only focus on treating the pain but also treats the causative disease to prevent the recurrence of nerve damage.
Prognosis: Is Neuropathic Pain Curable?
Yes, depending on the cause, neuropathic pain is curable. In most cases, much can be achieved with targeted therapy of the causative conditions, especially in cases of mild nerve damage. However, chronic forms of pain and severe damage to the nerves are more challenging to treat and have a much poorer chance of recovery. That is why early recognition of symptoms and early initiation of treatment is important for the success of therapy.
Which Doctors and Clinics Are Specialized in the Diagnosis and Treatment of Neuropathic Pain?
The first contact for the treatment of neuropathic pain is the general practitioner. They can already make an initial assessment of the pain cause and, if necessary, provide a referral to other specialists. Since neuropathic pain is caused by damage to the nerve, treatment is often pursued by neurologists. However, depending on the cause, consultation with other specialists, such as gastroenterologists, diabetologists, dermatologists, or rheumatologists, may be necessary and helpful.
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