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Nerve pain, or neuralgia, is a riot of nerves that signal with pain that something is wrong. Anything else is bothering you in the neck? This pain is sometimes sporadic, but sometimes it occurs quite often? It could be neuralgia. Find out about the most common types of neuralgia, their symptoms and treatments.

Nerve pain (neuralgia)is pain in an area of ​​the skin, mucosa, a muscle innervated by one nerve. Our entire body is filled with an intricate network of nerve fibers. They carry information about the disease to the brain, and it then feels like pain. It happens, however, that the nerves themselves rebel and send such a signal, and then we talk about the so-calledneuralgia , meaningneuralgia .

Neuralgia is a fairly common condition. Neuralgia isparoxysmal pain , usually very severe. The nerve itself is almost unchanged, and it is sometimes even hard to discover what caused it to hurt. There may not be inflammation around, fractures about which the nerve is supposed to alert with pain.

Trigeminal neuralgia

Trigeminal neuralgiamost often affects women over 35. The three branches of this nerve are responsible for, inter alia, sensory innervation of one half of the face. The cause of neuralgia is not known (it is said to be associated with injuries, inflammation around the teeth and sinuses, compression by abnormal blood vessels).

Symptoms:the primary symptom ispain attackrushing or burning, lasting 1-15 minutes or more. The frequency of seizures varies from a few a day to several a month. Sometimes the pain is accompanied by twitching of the muscles of the face and jaw, and watery eyes. However, the feeling on the diseased side of the face doesn't diminish.

As a rule,pain begins in the same place , e.g. within the lip or gums, and radiatesalong the affected branch of the nerve . Seizures often occur, e.g. when we talk, eat, brush our teeth. They are rare at night. There are no abnormalities between attacks, but patients are often tired and afraid of pain recurrence. After a few weeks, the pains disappear or occur sporadically, but there are relapses even after years.

Treatment:Doctors usually recommend drugs that contain carbamazepine, which is used as a psychotropic, anticonvulsant, and stabilizing drugmood. They are effective in more than half of the cases. When the drug does not help, either clonazepam - a psychotropic drug with strong and long-lasting anticonvulsant and anxiolytic effects, or Baclofen - a spasmolytic drug used to treat spasticity, a derivative of γ-aminobutyric acid (GABA), is administered.

Acupuncture and physical therapy (e.g. diadynamic currents) are also beneficial. In the most resistant cases, blockages with ethyl alcohol or surgical cutting of the nerve branch are used, as well as irradiation with X-rays.

Shoulder nerve neuralgia (shoulder neuralgia)

Shoulder nerve neuralgia (shoulder neuralgia)has no clear cause. Perhaps the pain is caused by degenerative changes in the cervical spine or abnormalities in the structure of the surrounding muscles. It happens, however, that the nerve hurts because it likes (this is called spontaneous neuralgia).

Symptoms:the onset of the disease is usually acute. The pain appears in the shoulder or shoulder blade area, and from there it spreads over the entire arm. In half of the casesthe pain is dull, diffuse , in the second -sharp, root . It is worsened by head movements, coughing and sneezing. It hurts when the doctor puts pressure on the surrounding muscles, but the skin itself is less sensitive.

Treatment:Treatment turns out to be effective in most cases. Non-steroidal analgesics (containing ibuprofen, paracetamol, etc.) are administered, as well as carbamazepine - an organic chemical compound used as a psychotropic, anticonvulsant and mood stabilizing drug or pilocarpine. You can also use heat, massage, novocaine blockades, diadynamic currents, ultrasounds. Sometimes it is necessary to use X-ray irradiation, surgical removal of the cervical rib, surgical procedures on the cervical spine, e.g. removal of an intervertebral disc hernia.

Intercostal neuralgia (intercostal neuralgia)

Intercostal neuralgiacan be caused by, among others, compression of the intercostal nerve (e.g. by a tumor), trauma to the area supplied by the nerve, drug-induced nerve damage (e.g. drugs used to treat tuberculosis), connective tissue disease, Lyme disease.

Symptoms:the pain is located in the intercostal spaces, the sternum. This is pain asrushing, stinging or jerkingor as an "unpleasant pressure on the chest area". It usually comes on suddenly for no apparent reason. Pain worsens during physical exertion, when you bend your torso forward or breathe in deeply. An additional symptom may be paresthesia (sensations such as numbness, tingling, etc.) within the cagebreast.

Treatment:painkillers are used. Warming ointments or patches applied to the painful area of ​​the cage can help. The operation can be performed if, for example, a tumor pressing on a nerve root needs to be removed.

Arnold's Suboccipital Neuralgia (back of the head)

Arnold's Neuralgiais a pain that is located on the back of the head.

Symptoms:this isone-sided, sudden and severe painthat goes from the nape to the forehead towards the eyebrow. It is often accompanied by nausea and visual disturbances, as well as photophobia, tinnitus, sensitivity to touch, discomfort with neck movements.

Treatment:painkillers and antidepressants are used. In some cases, the doctor may suggest surgical treatment.

Glossopharyngeal neuralgia

Glossopharyngeal neuralgiais probably caused by compression of the glossopharyngeal nerve root near the brainstem (dorsal root entry zone) by a tortuous blood vessel (artery or vein).

Symptoms: pain is usually one-sidedand may be felt in one or all of the following locations: ear, tongue root, back throat (especially the tonsil crypt) and below the angle mandible. It can radiate down the neck. The pain isshooting, stabbing or penetrating , the patient feels as if he has been electrocuted. Each attack of pain lasts from a few seconds to 2 minutes.

Treatment:pharmacological treatment is initially applied. If unsuccessful, surgical methods may be considered.

Post-herpetic neuralgia (PHN) postherpetic neuralgia (PHN)

Shingles are associated with intense pain in most patients. It tends to subside over time, and in a certain percentage of cases (10-15%) it persists despite the disappearance of visible skin lesions, taking the form of chronic neuropathic pain. Pain in the site of shingles, occurring at least 3 months after the healing of shingles skin lesions, which may persist for many years, ispost-herpetic neuralgia .

Treatment:is treatment specific to the underlying disease and symptomatic treatment - local (regional) and systemic (systemic). One method of topical treatment is to lubricate the area of ​​chronic pain felt under the skin with capsaicin. The patient is also given tricyclic antidepressants (amitriptyline, desipramine, clomipramine).

Parsonage-Turner syndrome (amyotrophic neuralgia)

TeamParsonage-Turner (amyotrophic neuralgia)is a disease of the peripheral nervous system that leads to weakness in the upper limb, which is usually preceded by a period of severe pain in the shoulder and arm.

Symptoms:the syndrome manifests itselfsudden and severe painin the shoulder girdle and arm, radiating to the distal part of the upper limbs, which may last from several hours to several weeks, accompanied by muscle weakness and atrophy. This is followed by weakness and paresis of the muscles of the upper limb.

Treatment:Painkillers and anti-inflammatory drugs are used, some recommend corticosteroids. Rehabilitation plays an important role.

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Category:

Neurology