Neuropathic pain is a pain condition that’s usually chronic. It’s usually caused by chronic, progressive nerve disease, and it can also occur as the result of injury or infection. If you have chronic neuropathic pain, it can flare up at any time without an obvious pain-inducing event or factor. Acute neuropathic pain, while uncommon, can occur as well. Typically, non-neuropathic pain (nociceptive pain) is due to an injury or illness. For example, if you drop a heavy book on your foot, your nervous system sends signals of pain immediately after the book hits. With neuropathic pain, the pain isn’t typically triggered by an event or injury. Instead, the body just sends pain signals to your brain unprompted. People with this pain condition may experience shooting, burning pain. The pain may be constant, or may occur intermittently. A feeling of numbness or a loss of sensation is common, too. Neuropathic pain tends to get worse over time. About 1 in 3 Americans experience chronic pain. Of those, 1 in 5 experience neuropathic pain. A 2014 study estimated that as many as 10 percent of Americans experience some form of neuropathic pain. Understanding the possible causes can help you find better treatments and ways to prevent the pain from getting worse over time.

What are the symptoms? Each person’s symptoms of neuropathic pain may vary slightly, but these symptoms are common: shooting, burning, or stabbing pain

tingling and numbness, or a “pins and needles” feeling

spontaneous pain, or pain that occurs without a trigger

evoked pain, or pain that’s caused by events that are typically not painful — such as rubbing against something, being in cold temperatures, or brushing your hair

a chronic sensation of feeling unpleasant or abnormal

difficulty sleeping or resting

emotional problems as a result of chronic pain, loss of sleep, and difficulty expressing how you’re feeling

How’s it treated? A goal of neuropathic pain treatment is to identify the underlying disease or condition that’s responsible for the pain, and treat it, if possible. An important goal is that your doctor will aim to provide pain relief, help you maintain typical capabilities despite the pain, and improve your quality of life. The most common treatments for neuropathic pain include: Over-the-counter pain medication Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve and Motrin, are sometimes used to treat neuropathic pain. However, many people find these medicines aren’t effective for neuropathic pain because they don’t target the source of the pain. Prescription medication Opioid pain medications don’t usually reduce neuropathic pain as well as they reduce other types of pain. Plus, doctors may hesitate to prescribe them for fear that a person may become dependent. Topical pain relievers can be used, too. These include lidocaine patches, capsaicin patches, and prescription-strength ointments and creams. Antidepressant drugs Antidepressant medications have shown great promise in treating symptoms of neuropathic pain. Two common types of antidepressant drugs are prescribed to people with this condition: tricyclic antidepressants

serotonin-norepinephrine reuptake inhibitors These may treat both the pain and symptoms of depression or anxiety caused by chronic pain. Anticonvulsants Anti-seizure medications and anticonvulsants are often used to treat neuropathic pain. Gabapentinoids are most commonly prescribed for neuropathic pain. It’s not clear why anti-seizure drugs work for this condition, but researchers believe the medications interfere with pain signals and stop faulty transmissions. Nerve blocks Your doctor may inject steroids, local anesthetics, or other pain medications into the nerves that are thought to be responsible for the wayward pain signals. These blocks are temporary, so they must be repeated in order to keep working. Implantable device This invasive procedure requires a surgeon to implant a device in your body. Some devices are used in the brain and some are used in the spine. Once a device is in place, it can send electrical impulses into the brain, spinal cord, or nerves. The impulses may stop the irregular nerve signals and control symptoms. These devices are typically used only in individuals who haven’t responded well to other treatment options. Lifestyle treatments Physical, relaxation, and massage therapies are all used to relieve symptoms of neuropathic pain. These forms of treatment can help ease muscles. Your healthcare provider can also teach you ways to cope with your pain. For example, some people with neuropathic pain may experience increased symptoms after sitting for several hours. This might make desk jobs difficult to perform. A physical therapist or occupational therapist can teach you techniques for sitting, stretching, standing, and moving to prevent pain.

How can this pain be managed? If your doctor is able to identify an underlying cause for the neuropathic pain, treating it may reduce and even eliminate the pain. For example, diabetes is a common cause of neuropathic pain. Proper diabetes care — which includes a healthy diet and regular exercise — may eliminate or reduce neuropathic pain. Taking care of blood sugar levels can also prevent worsening pain and numbness. Multimodal therapy A multipronged approach can be an effective way to manage the condition. A combination of medications, physical therapy, psychological treatment, and even surgery or implants may be used to bring about the best results.