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Neuropathic Pain

Neuropathic Pain

What is neuropathic pain?
Neuropathic pain can result after damage or dysfunction of the nervous system. Pain can rise from any level of the nervous system. These levels are the peripheral nerves, spinal cord, and brain. Pain centers receive the wrong signals from the damaged nerve fibers. Nerve function may change at the site of the nerve damage, as well as areas in the central nervous system (central sensitization).
Neuropathy is a disturbance of function or a change in one or several nerves. About 30% of neuropathy cases is caused by diabetes. It is not always easy to tell the source of the neuropathic pain. There are hundreds of diseases that are linked to this kind of pain.
What are some of the sources of neuropathic pain?
Alcoholism
Amputation (results in phantom pain)
Chemotherapy drugs (Cisplatin®, Paclitaxel®, Vincristine®, etc.)
Radiation therapy
Complex regional pain syndrome
Diabetes
Facial nerve problems
HIV infection or AIDS
Shingles
Spinal nerve compression or inflammation
Trauma or surgeries with resulting nerve damage
Nerve compression or infiltration by tumors
Central nervous system disorders (stroke, Parkinson’s disease, multiple sclerosis, etc.)
What are the symptoms of neuropathic pain?
Many symptoms may be present in the case of neuropathic pain. These symptoms include:
Spontaneous pain (pain that comes without stimulation): Shooting, burning, stabbing, or electric shock-like pain; tingling, numbness, or a “pins and needles” feeling
Evoked pain: Pain brought on by normally non-painful stimuli such as cold, gentle brushing against the skin, pressure, etc. This is called allodynia. Evoked pain also may mean the increase of pain by normally painful stimuli such as pinpricks and heat. This type of pain is called hyperalgesia.
An unpleasant, abnormal sensation whether spontaneous or evoked (dysesthesia)
Trouble sleeping
Emotional problems due to disturbed sleep and pain
Pain that may be lessened in response to a normally painful stimulus (hypoalgesia)
Diagnosis and Tests
How is neuropathic pain diagnosed?
Your doctor will take a medical history and do a physical exam. Neuropathic pain is suggested by its typical symptoms when nerve injury is known or suspected. Your doctor will then try to find the underlying cause of the neuropathy and then trace the symptoms.
Management and Treatment
How is neuropathic pain treated?
The goals of treatment are to:
Treat the underlying disease (for example, radiation or surgery to shrink a tumor that is pressing on a nerve)
Provide pain relief
Maintain functionality
Improve quality of life
Multimodal therapy (including medicines, physical therapy, psychological treatment, and sometimes surgery) is usually required to treat neuropathic pain.
Medicines commonly prescribed for neuropathic pain include anti-seizure drugs such as Neurontin®, Lyrica®, Topamax®, Tegretol®, and Lamictal®. Doctors also prescribe antidepressants such as Elavil®, Pamelor®, Effexor®, and Cymbalta®. A doctor’s prescription for anti-seizure drugs or antidepressants does not mean you have seizures or are depressed.
A topical patch (Lidocaine® or Capsaicin®) or a cream or ointment can be used on the painful area. Opioid analgesics can provide some relief. However, they generally are less effective in treating neuropathic pain. Negative effects may prevent their long-term use.
The pain can also be treated with nerve blocks given by pain specialists, including injections of steroids, local anesthetics, or other medicines into the affected nerves.
Neuropathic pain that has not responded to the therapies mentioned above can be treated with spinal cord stimulation, peripheral nerve stimulation, and brain stimulation.
Outlook / Prognosis
What is the outlook for people with neuropathic pain?
Neuropathic pain is difficult to get rid of, but is not life-threatening. Without rehabilitation and sometimes psychosocial support, treatment has a limited chance of success. With help from a pain specialist using the multimodal approaches listed above, your neuropathic pain can be managed to a level that improves your quality of life.
© Copyright 1995-2020 The Cleveland Clinic Foundation. All rights reserved.

Article Provided By: clevelandclinic
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

 

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Responding to Weather Changes When Caring for Neuropathy Patients

Responding to Weather Changes When Caring for Neuropathy Patients

September 11, 2019 by Ezekiel Lim In Columns, Rumination and Response – a Column by Ezekiel Lim.

Patients with familial amyloid polyneuropathy may find that changes in seasons increase discomfort. Colder temperatures require layers of clothing that may bother someone with peripheral neuropathy symptoms. A change to hotter temperatures may cause increased discomfort to someone already experiencing burning sensations due to nerve damage.
Caregivers can take steps to help manage the impact of weather changes on neuropathy patients.

Cold weather and neuropathy
Patients with peripheral neuropathy symptoms experience a slowing of blood flow to nerve endings, causing numbness and tingling. Colder temperatures may make it difficult for patients to measure their bodies’ response to the climate.
My family lives in an area known for weather extremes. When spending time with my mother-in-law during the winter months, it is important for us not only to make sure she has adequate layers of clothing, but also to know when the bundled clothing is causing her discomfort.
Following are some tips for caregivers who are managing the daily care of a loved one during a change to colder weather:

Make sure the patient is wearing warm, comfortable clothing that isn’t too heavy.
Protect the patient’s hands and feet with warm gloves and neuropathy socks.
Massage areas where circulation may be lacking.
Limit the time spent outside in the cold.
Limit caffeine and alcohol intake as they may respectively narrow blood cells and cause vitamin deficiency.
Managing symptoms in heat
Hotter temperatures may exacerbate the tingling and burning sensations that neuropathy patients experience. During a transition from cold winters to mild or hot months, caregivers must gauge their loved one’s peripheral symptoms. Just as in winter months, patients may have difficulty measuring their bodily responses to temperature.
For caregivers managing responses to hotter temperatures, following are some tips for ensuring patient comfort:
Keep time spent outside to a minimum and, if needed, stay indoors all day.
Make sure air conditioning is adjusted to a comfortable level to avoid interacting with symptoms of numbness.
Make sure your loved one is adequately fed and hydrated.
Understand the patient’s comfort level and make sure they are wearing lighter layers of clothing.
Try using topical treatments and cooling products when the patient begins to feel too hot.
The pain caused by humidity and summer heat may cause increased discomfort in those suffering from peripheral neuropathy symptoms. By ensuring the patient has a comfortable indoor environment, the change in temperature will not exacerbate chronic pain.

***
Note: FAP News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of FAP News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to familial amyloid polyneuropathy.

Article Provided By: fapnewstoday

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

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Exercises for Peripheral Neuropathy

Exercises for Peripheral Neuropathy

Alternative treatments for peripheral neuropathy
About 20 million people across the country live with a form of peripheral neuropathy. Peripheral neuropathy is nerve damage disorder that typically causes pain in your hands and feet. Other common symptoms of this disorder include:
muscle weakness
numbness
tingling
poor balance
inability to feel pain or temperature
Treatment options typically focus on pain relief and treating the underlying cause. However, studies show that exercise can effectively preserve nerve function and promote nerve regeneration.
Exercise techniques for peripheral neuropathy
There are three main types of exercises ideal for people with peripheral neuropathy: aerobic, balance, and stretching.
Before you start exercises, warm up your muscles with dynamic stretching like arm circles. This promotes flexibility and increases blood flow. It will boost your energy, too, and activate your nerve signals.
Aerobic exercises
Aerobic exercises move large muscles and cause you to breathe deeply. This increases blood flow and releases endorphins that act as the body’s natural painkillers.
Best practices for aerobic exercising include routine activity for about 30 minutes a day, at least three days a week. If you’re just starting out, try exercising for 10 minutes a day to start.
Some examples of aerobic exercises are:
brisk walking
swimming
bicycling
Balance training
Peripheral neuropathy can leave your muscles and joints feeling stiff and sometimes weak. Balance training can build your strength and reduce feelings of tightness. Improved balance also prevents falls.
Beginning balance training exercises include leg and calf raises.
Side leg raise
Using a chair or counter, steady your balance with one hand.
Stand straight with feet slightly apart.
Slowly lift one leg to the side and hold for 5–10 seconds.
Lower your leg at the same pace.
Repeat with the other leg.
As you improve balance, try this exercise without holding onto the counter.
Calf raise
Using a chair or counter, steady your balance.
Lift the heels of both feet off the ground so you’re standing on your toes.
Slowly lower yourself down.
Repeat for 10–15 reps.
Stretching exercises
Stretching increases your flexibility and warms up your body for other physical activity. Routine stretching can also reduce your risk of developing an injury while exercising. Common techniques are calf stretches and seated hamstring stretches.
Calf stretch
Place one leg behind you with your toe pointing forward.
Take a step forward with the opposite foot and slightly bend the knee.
Lean forward with the front leg while keeping the heel on your back leg planted on the floor.
Hold this stretch for 15 seconds.
Repeat three times per leg.
Seated hamstring stretch
Sit on the edge of a chair.
Extend one leg in front of you with your toe pointed upward.
Bend the opposite knee with your foot flat on the floor.
Position your chest over your straight leg, and straighten your back until you feel a muscle stretch.
Hold this position for 15 – 20 seconds.
Repeat three times per leg.

Outlook
Exercise can reduce pain symptoms from peripheral neuropathy. Be sure to stretch after any workout to increase your flexibility and reduce pain from muscle tightness.
Mild pain is normal after stretching and regular activity. However, if your pain worsens or if you develop joint swelling, visit your doctor.

Article Provided By: healthline
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

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Hyperalgesia

Hyperalgesia: It Hurts Everywhere!!

Christina Lasich, MD
Health Professional
March 2, 2013

Imagine if a paper cut felt like a red, hot poker stabbed you. Imagine if a small bruise felt like a sledge hammer hit you. If you are able to imagine these examples or maybe have even felt this way, then you know what it is like to have hyperalgesia. This term means that the tissue involved has an increased sensitivity to painful stimuli. The small hurts hurt even worse. The minor injuries feel ten times worse. And it seems to hurt everywhere.

Where does hyperalgesia come from? And why does it happen? Increased sensitivity to pain can occur in damaged or undamaged tissue. Remember, pain does not necessarily mean that something is damaged. But pain does mean that the brain is interpreting signals from the body that seem threatening. Sometimes those signals are amplified because of the superactivation of the pain pathways. And sometimes those signals are amplified because of the suppression natural pain-relieving pathways in the body. Whether you have over-activity of pain pathways or suppression of pain-relieving pathways or both, all these roads can lead to an increased sensitivity to pain.

A classic example of hyperalgesia is felt when someone is experiencing opioid withdrawals. The sudden discontinuation of pain medications leaves a person with a non-functioning natural-pain relieving system while at the same time, the pain pathways deep within the nervous system become extremely active. This perfect storm of hyperalgesia causes a person to feel achy and sensitive everywhere. (1)

 

Another example of an increased sensitivity to pain is getting more and more notoriety because of the overuse of short-acting opioid medications for the treatment of chronic pain. This condition is called opioid-induced hyperalgesia. Pain medication can cause more pain if the user is experiencing a frequent cycle of withdrawals. As already mentioned, opioid withdrawals are well known to cause hyperalgesia. Furthermore, the frequent cycle of withdrawals sensitizes the nervous system. (2)

Nervous system sensitization is probably the most common reason for someone to experience an increased sensitivity to pain. Common conditions like fibromyalgia, headaches and sciatica are all conditions that typically have a component of hyperalgesia associated with that experience. Furthermore, each of those conditions is also related to a nervous system that has been altered in some way to be overactive and wound-up. The nervous system is your alarm system. When your alarm system overreacts to painful stimuli, all the little hurts feel HUGE.

And that might be the reason why you hurt everywhere. Hyperalgesia is not only an increased sensitivity to pain; it is also an indicator that someone’s alarm system might be dysfunctional because of the sudden withdrawal of medications, the overuse of medications or the sensitization of the nervous system. The hyperalgesia process can be reversed. It’s a matter of resetting the alarm. Allowing the body’s natural pain-relieving system to turn back on, eliminating the frequent cycles of withdrawals and desensitizing the nervous system are all ways to treat the increased sensitivity to pain. Unfortunately, resetting your alarm system is easier said than done.

Pain. 2013 Jan 11. pii: S0304-3959(13)00011-0

Cephalalgia. 2013 Jan;33(1):52-64

 

Article Provided By: Healthcentral

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

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Diabetic Neuropathy, Pain Relief, Peripheral Neuropathy, Pain Management, Nerve Pain Treatment, Carolina Pain Scrambler, Greenville South Carolina

Idiopathic Neuropathy

Idiopathic Neuropathy

What is idiopathic neuropathy?
Neuropathy is when nerve damage interferes with the functioning of the peripheral nervous system (PNS). When the cause can’t be determined, it’s called idiopathic neuropathy.
The PNS carries information from the central nervous system (CNS), or brain and spinal cord, to the rest of the body.
There are three kinds of nerves within the PNS. Sensory nerves relay messages from the senses to the brain. This allows sensations of temperature and touch. Motor nerves transmit signals from the brain to the muscles. This helps the brain control the muscles. Autonomic nerves control body functions like heart rate, breathing, and digestion.
Damage to nerve cells can affect how the PNS communicates with the rest of the body. Symptoms can include numbness, pain, and balance issues.
It’s called acute neuropathy when symptoms develop suddenly. Alternately, it’s called chronic neuropathy when symptoms start slowly and increase over time.
Diagnosis involves physical examination and review of medical history. Diagnostic testing may include blood tests, nerve testing, and imaging tests.
There is no cure for idiopathic neuropathy. Treatments including medication, physical therapy, and lifestyle modifications can help you function and feel better.
What are the symptoms of neuropathy?
Symptoms can be vague at onset and are similar to those of other conditions. Symptoms vary depending on which nerves are damaged.
Symptoms of sensory neuropathy may include:
numbness, tingling, and burning sensation, particularly in hands and feet
vague or strange sensations (paresthesias)
pain, or inability to feel pain, touch, or temperature
lack of coordination or loss of reflexes
Symptoms of motor neuropathy may include:
muscle weakness or loss of muscle control
trouble with balance and coordination
muscle twitching, cramping, or spasms
difficulty walking or moving limbs
Symptoms of autonomic neuropathy may include:
dizziness, or fainting
sweating abnormalities
nausea, vomiting, or diarrhea
abnormal heart rate or blood pressure
sexual dysfunction
Symptoms may progress quickly and then slowly get better over time in some forms of acute neuropathy. Some chronic neuropathies cause periods of relapse followed by periods of remission.
What are the causes of neuropathy?
Some conditions that cause neuropathy are hereditary. Other things that can cause it include:
injury or infection
nutritional or hormonal imbalances
chemotherapy or exposure to toxic substances
autoimmune diseases such as Lyme disease, lupus, and rheumatoid arthritis (RA)
systemic diseases like diabetes, kidney disorders, and certain cancers
vascular disorders
tumors
Approximately 30 percent of neuropathy cases are due to diabetes, according to the Cleveland Clinic. Between 30 and 40 percent of the remaining cases are idiopathic.

Who is at risk for neuropathy?
The National Institute of Neurological Disorders and Stroke estimates that approximately 20 million Americans have peripheral neuropathy. Anyone can develop neuropathy, but risk increases with age.

How is neuropathy diagnosed?
There is no one definitive test for neuropathy. Testing begins with a physical examination and a complete medical history. Tell your doctor about any symptoms you’re experiencing. Be sure to let them know about over-the-counter and prescription medications you’re taking. It’s also important to mention if you’ve been exposed to toxins on the job or at home.
Diagnostic testing may include:
blood work
urinalysis
nerve conduction studies (NCS)
electromyography (EMG)
skin, nerve, and muscle biopsies
Imaging tests may include a CT scan, X-rays, or magnetic resonance imaging (MRI).

How is neuropathy treated?
Peripheral neuropathy can cause permanent damage to nerves if untreated. Treatment will target the cause if it can be determined.
Treatment of idiopathic neuropathy revolves around symptom management. Options include over-the-counter and prescription medications, physical therapy, and occupational therapy.
Mobility aids can help you move around safely if you’re having trouble with balance or walking. These may include special shoes, braces, and canes.
Lifestyle choices can help to improve day-to-day functioning. It’s important to maintain a healthy weight through a balanced diet rich in vitamins and nutrients. It’s also important to get plenty of rest and exercise to tone and strengthen your muscles. Quitting smoking and keeping alcohol consumption to a minimum is healthy and may also help with your neuropathy.
Living with a chronic illness can lead to anxiety and stress. It can be helpful to talk with someone who lives with the same condition. Your doctor can refer you to a local neuropathy support group for additional support.

What is the long-term outlook for neuropathy?
The general prognosis for idiopathic neuropathy is good, even if your symptoms are permanent. There are many effective treatments available for keeping your symptoms in check and helping you lead a comfortable, happy life. Working with your doctor to treat any underlying condition you may have, along with your symptoms, is the ticket to your best outcome in the short and long term.

Article Provided By: Healthline
Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com

 

 

 

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Knee Nerve Damage

What are the Symptoms of Knee Nerve Damage?

 

Patti Kate
Last Modified Date: July 03, 2020
There can be a number of different symptoms of knee nerve damage, but the most common include pain, numbness and tingling, and feelings of burning on or around the kneecap. Some people may also find that they have a hard time moving the joint, or they may feel stiffness or a dull ache when the leg bends in certain ways. Discoloration around the site of the damage is common, too, particularly if the nerve damage was caused by some sort of trauma. A number of different nerves run through the knees, but diagnosing damage can be somewhat tricky. Symptoms are often really similar to other joint problems, including cartilage damage and issues related to arthritis. In general, medical professionals recommend that anyone who suspects they may be suffering from knee nerve damage get evaluated and treated.

Numbness associated with knee nerve damage may radiate to the upper leg.
Nerve Damage Basics

The body’s nervous system is a complex series of chemical signals that course along the nerve pathways bringing messages about sensation and pain to and from the brain. Damage can happen almost anywhere, and is usually a result of injury or trauma. Nerves can get pinched, severed, or twisted, and moving joints like the knee provide many different opportunities for this sort of injury. Local nerves can be pinched or squeezed fairly easily between the bones and ligaments that together form the joint.

The pain associated with knee nerve damage may be alleviated with physical therapy.
Some damage is obvious right from the start. This isn’t always true, though, since the damage may not be immediate. Certain knee injuries build on themselves over time. A person may feel as though he or she has healed, but may not realize till later that that healing has actually compromised the nerve structure, for instance; or, a person may not even realize that there’s been an injury at all till certain signs of nerve damage begin appearing.

Knee nerve damage can make standing from a seated position painful or difficult.
Pain
Pain that seems to radiate out of the knee is one of the most common symptoms of localized nerve damage. This often comes in varying degrees, and can alternate between throbbing and mild, dull aching. Sometimes moving the leg or changing the knee’s position can alleviate pressure, but not always. A lot has to do with whether the nerve damage is accompanied by inflammation or swelling at the site, and how seriously the nerves were impacted.

Knee pain may be a sign of nerve damage.
Nerves are usually responsible for carrying signals to indicate pain, and when they’re damaged they can respond in exaggerated ways — in some cases transmitting signals of pain that are disproportionate with the extent of the actual injury. Pathways that have actually been severed, on the other hand, sometimes fail to transmit any signals of pain, even if it would otherwise be warranted.
Numbness and Burning
Anther major sign of knee nerve damage is numbness or a lack of sensitivity. Numbness may be localized in the knee, or it might radiate to the upper or lower leg. Some people also describe the discomfort as a prickly “pins and needles” sensation. Tingling tends to come and go, but is usually most common after periods of inactivity.
People who have suffered these sorts of injuries sometimes also describe a feeling of burning just below the skin. Some of this is just perception, but in certain cases there are actual local skin temperature fluctuations that go hand-in-hand with these sensations. The patient’s knee may feel warm to the touch, or in some cases colder than usual.
Restricted Movement
In many cases nerve damage can also restrict a person’s movement. Quick kicks, sharp bends, and other extreme or rapid movements may be delayed or too painful to perform. This is usually a result of muscle constrictions that happen in response to nerve signals indicating damage — which is to say, it isn’t caused directly by the nerves, but it is nonetheless closely related.
Patients with nerve damage to the knee may also experience weakness and immobility. This weakness may involve the knee or the entire leg. In some instances, the leg may buckle under and the patient may feel unsteady or lose his or her balance
Skin Discoloration
It’s also possible for the skin along the top or backside of the knee to become discolored. A bluish tinge surrounding the knee may indicate nerve damage, although the condition does not always cause this. Color changes are most common when the damage has been caused by a trauma that has otherwise left bruising on the skin, and in these cases it can be tough to distinguish between specific causes.
Diagnosis and Treatment Options
Injury to the soft tissue of the knee does not necessarily mean nerve damage has occurred. Ligaments or tendons may have been torn, yet surrounding nerves may be left undamaged. Although a physician or other healthcare expert may recommend a magnetic resonance imaging (MRI) test to determine if there are tears of tendons or ligaments, nerve damage will not always show up on this imaging, and as such still more testing may be required. In most cases these sorts of extreme measures are only taken if there’s no other way to treat a patient’s symptoms.
Care providers often recommend diagnostic tests if symptoms of peripheral neuropathy are present, which are basically more systemic nervous system problems. A test known as an electromyography (EMG) can determine if symptoms are related to knee nerve damage. From there, medical teams can come up with treatment plans. Sometimes physical therapy and rehabilitation can bring a person back to normal, but in other cases more invasive therapies like surgery are necessary. It’s not always possible to reverse nerve damage, and a lot of times the best that can be done is to mitigate the problem and stop it from spreading or getting worse.

Article Provided By: Wisegeek

Carolina Pain Scrambler Logo, Chronic Pain, Greenville, SCIf you would like to discuss what Carolina Pain Scrambler do to help relieve your chronic pain symptoms or receive more information on our treatment process, please do not hesitate to call us at 864-520-5011 or you can email us at info@carolinapainscrambler.com