Neuralgia
What is it?
Neuralgia is sharp, severe, shooting pain along a nerve
or group of nerves. The pain of neuralgia usually comes
and goes.
Who gets it?
Neuralgia can affect adults of any age, although some
types are more common after middle age.
What causes it?
Neuralgia is caused by irritation or damage to a nerve,
although the cause of the irritation is often not known.
The type of neuralgia that occurs depends upon which nerve
is affected and the reason it is irritated. Irritation can
be caused by an infection, such as tooth decay, the herpes
zoster virus (shingles), or nasal infections; eye strain;
systemic diseases; arthritis; exposure to cold; a pinched
nerve; injury; or even poor diet.
What are the symptoms?
The symptoms of neuralgia include a sharp, shooting
pain, which may feel like a burning sensation. The pain,
while severe, is usually brief. The location of the pain
depends on the condition that causes it and the location
of the nerve that is irritated. For example, if neuralgia
occurs after a patient has had a virus called shingles,
the pain occurs in the area that had been affected by the
virus, usually around the lower trunk of the body. This is
called postherpetic neuralgia. Occipital neuralgia occurs
when the occipital nerve is pinched, which causes
numbness, tingling, or pain around the base of the skull.
The pain of glossopharyngeal neuralgia occurs along the
path of the glossopharyngeal nerve - in the back of the
throat or tongue, and often in the ears. This pain is
often triggered by chewing, yawning, swallowing, or
talking. Trigeminal neuralgia is a disorder of the
trigeminal nerve, the 5th cranial nerve that carries
sensations of touch, pain, pressure, and temperature from
the face to the brain. People with trigeminal neuralgia
experience episodes of sharp, piercing pain that can
affect the cheek, lips, gums, or chin on one side of the
face. Trigeminal neuralgia is also called tic douloureux,
which is French for “painful twitch.” Facial pain is also
associated with migraine neuralgia. This pain is peculiar
in that it occurs at the same time each day, and lasts for
anywhere from 30 minutes to one hour.
How is it diagnosed?
To diagnosis neuralgia, your doctor will take a
complete medical history and perform a physical
examination. He or she will suspect neuralgia based upon
the location of your pain and its characteristic symptoms.
Your doctor will look for an underlying cause of your
symptoms. For example, if you have facial pain, your
doctor will evaluate other possible causes such as
problems with the jaw, teeth, or sinuses. He or she will
also check whether a tumor or aneurysm is putting pressure
on a nerve.
What is the treatment?
Antiseizure drugs, such as carbamazepine and phenytoin,
are often used to suppress pain associated with
glossopharyngeal, trigeminal, and postherpetic neuralgias
because they slow down the nerve signals at certain nerve
terminals. Postherpetic neuralgia can also be treated with
antidepressants, topical pain relievers, transcutaneous
electrical nerve stimulation (TENS), or a drug called
capsaicin. In cases where drug treatment is not effective,
the trigeminal nerve can be deadened with gamma rays,
radio frequency waves, or glycerol injections. The nerve
can also be cut or permanently destroyed. If neuralgia is
caused by an artery or tumor compressing the nerve, or a
pinched nerve, surgery may be needed to free the nerve
from the source of pressure and permanently relieve the
pain. Your doctor will also address any dietary
deficiencies that could be causing your pain. Alternative
treatments include B-complex vitamin therapy, acupuncture,
and herbal remedies that have been found to have
anti-inflammatory effects. Always discuss any alternative
treatments with your doctor first.
Self-care tips
Although there is no way to prevent neuralgia, you can
take steps to avoid attacks if you know what triggers
them. For example, if your pain is in the facial or mouth
area, avoid very cold or very hot food and drinks, don’t
chew your food on the side that is painful, don’t eat
extremely hard or crunchy foods, avoid splashing your face
with very hot or cold water when washing, and rinse your
mouth with water after every meal instead of using a
toothbrush. If you have shingles, seeking treatment as
soon as possible can reduce your risk of developing
postherpetic neuralgia.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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