Characteristics of pain in peripheral neuropathy

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You can have torn nerves not only figuratively but also literally. When the nerves that make up the peripheral nervous system become inflamed or damaged, the body reports it through a series of specific and unpleasant sensations. The nerve disorder is called neuropathy.

Where does nerve damage come from?

The human nervous system consists of the central nervous system (spinal cord and brain) and the peripheral nervous system (somatic and autonomic nervous systems). The somatic nervous system consists of nerve fibers responsible for receiving stimuli from the outside of the body, and its action depends on our will, while the autonomic system innervates internal organs. Nerve fiber damage can occur for many different reasons:

– the vast majority of neuropathies are caused by the consumption of alcohol,

– it is very often a complication of diabetes – here the symptoms are most often hypoaesthesia or hyperesthesia of pain and sensory paresthesia in the feet and hands,

– as a result of a mechanical injury: a fall, impact or surgery,

– as a result of poisoning with chemical substances, e.g. lead,

– with vitamin deficiencies, especially from group B,

– as a complication of infectious diseases, e.g. Lyme disease, shingles, AIDS,

– in atherosclerosis,

– after receiving radiotherapy or chemotherapy to treat cancer.

Neuropathic pain can result from damage to the peripheral and central nervous systems, and is almost always associated with impaired sensation.

In the treatment of neuropathy, doctors have pharmacological facilities at their disposal, including drugs that are anti-inflammatory and can at least reduce pain. Pharmacology is effective, for example, in diabetic or toxic neuropathy. Quitting alcohol will do the same. Most often, however, the result of treatment is a reduction in symptoms, but not a full recovery, because nerve regeneration is a complicated process. Massage and physiotherapy are used in the treatment of neuropathy.

How does the pain hurt?

How to describe neuropathic pain caused by damage to the peripheral nervous system? According to the patients’ reports, it is a continuous, stinging or burning sensation, numbness, tingling, sudden current flow or a strong and unexpected feeling of heat or cold. It occurs spontaneously or under the influence of movement. It is often accompanied by a dull or cramping pain somewhere deep in the tissues, and sometimes a lot of pressure.

There are also short-term, but very strong and piercing sensations, comparable to an electric shock. They can also occur when the patient is at rest or when making a gesture.

Other pain sensations include hyperalgesia, also known as hyperalgesia. We deal with it when the patient feels pain much greater than the one that the given stimulus should cause, e.g. a pinprick or a slight scratch with a fingernail is very painful. The extreme form of hyperesthesia is allodynia – in this case the patient feels it as a painful sensation which cannot result in even minimal pain, e.g. touch, stroking, heat or cold.

In turn, hyperpathy is an inadequate pain reaction that appears with a delay, radiates beyond the area of ​​the damaged nerve and lasts long after the irritation process is over. Another sensory disorder is hypoalgesia, which is characterized by a reduced sense of touch or temperature.

Not only perceptible, but also noticeable symptoms of nerve damage are disorders of skin sweating, changes in its color and temperature.

All the described symptoms are not only painful or at least unpleasant, but also dangerous, because the nervous system has a problem with signaling dangerous situations to us: damaged nerves will not transmit a pain signal or alert you to too high or low temperature.

Text: Julia Wolin

Medical consultation: Dr. Justyna Młodzikowska-Albrecht, neurologist

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