Drugs to Treat Neuropathic (Nerve) Pain
Many types of pain can occur in the body. Each type of pain is treate differently. Pain can range from uncomfortable to intolerable. It seems the most complicated of all is nerve pain. Nerve pain, medically called neuropathic pain, occurs when messages are not transmitte correctly in the body.
The pain originates in the brain and spinal cord, but it is cause by a breakdown in communication between the nerves of the central nervous system. Pain in the extremities or elsewhere in the peripheral nervous system is known as peripheral neuropathy. Trigeminal neuralgia, or facial nerve pain, is another kind of nerve pain. Pain caused by shingles (herpes zoster) travels down the path of a spinal nerve.
Pain in the nerves may result from trauma, compression, pinching, or disconnection of nerve fibres inside the nerve body or between nerves. The condition may develop as a response to injury or illness. Amputation, viruses like shingles, infections, cancers, or malformations of blood vessels are only few of the various causes of neuropathic pain.
A number of drugs have been show to cause nerve damage. There is a link or increased risk of neuropathy with the use of certain drugs, but taking them does not guarantee that you will get neuropathy. Talk to your doctor about the warning symptoms of neuropathy if you’re on any of these drugs, but don’t freak out.
Neuropathic pain is a unique experience for each individual. There are similarities in cases, but two cases are rarely the same. This type of pain can range in intensity from a minor inconvenience to excruciating. The pain may be just in one body location, such as a toe or a location somewhere on the thigh or arm. However, it can be anywhere on the body. Neuropathic pain can include an entire body part, such as an entire leg, arm, and/ or torso. It can also be inside the body, such as a damaged spleen.
Pain might be numbness, tingling, electric shocks, cramping, weakening, prickling, sharp, jabbing, searing, throbbing, buzzing, humming, or itching. Light touch, clothes or bed linen weight, or even heating or cooling system breeze might cause neuropathy.
In severe circumstances, neuropathic pain may prohibit a person from doing their typical activities because they fear re-injuring the wounded body part.
Abdominal pains, impair balance, and weakness are additional symptoms of a disruption in internal bodily function.
Reducing neuropathic pain includes treatment of metabolic issues, such as maintenance of blood sugar in diabetes care, and stopping alcohol or drug use, including nicotine, and other toxic chemicals, such as vaping. Medications may be change to reduce or improve neuropathy. Eating a healthy, well-balanced diet and hydrating as your medical issues allow is important. Gentle exercise may be of benefit, and strenuous exercise is not helpful as overstimulation can trigger neuropathic pain.
There are medications that have been create specifically to treat neuropathic pain. These include gabapentin (Neurontin, Gralise, Horizant) and pregabalin (Lyrica). Both medications are starte at a low dose and increased over time to effectiveness. When the body adjusts, both will likely need to be increased. These drugs cause blurred vision, dizziness, and swallowing in 25% of users for 8–9 days. Once the 8-9 days are complete, these side effects resolve. Taking these medications before bed can reduce noticing some of the side effects.
Gabapentin and pregabalin are not interchangeable. If you want to switch, you must entirely taper off the one you’re on and titrate onto the other. Stopping these drugs abruptly might exacerbate discomfort and make the following medication less effective.
Both gabapentin and pregabalin treat neuropathic pain and seizures. Gabapentin also is use to treat shingles, restless leg syndrome, and diabetic neuropathy. Pregabalin is also use to treat fibromyalgia and anxiety. Both reduce the way messages of pain are sent to the brain, which reduces the perception of pain.
Prior to taking these medications, tell your healthcare professional all the other medications you take including over-the-counter and supplements. Both gabapentin and pregabalin, which are used to treat nerve pain, are very variable in their interactions with other drugs. Magnesium, for instance, may interfere with the effectiveness of gabapentin and pregabalin, so you may need to either avoid taking it or take it at least two hours before taking these drugs. Your healthcare provider will help you manage your medications, but they need to know everything you take.
There are other drugs that help nerve pain. Other anti-epileptic (anti-seizure) medications can be use to treat nerve pain, for example, Pregabalin 150 mg (Carbatrol, Tegretol). Antidepressants also help treat nerve pain, such as amitriptyline and Pregalin 50 mg and others. Both anti-epileptic and antidepressants are given in lower doses for nerve pain treatment. These lower doses may not be effective treatments for seizures and depression. It is interesting to note that individuals who already take the medication in doses needed for seizures and depression treatment have less nerve pain.
Treatments applied directly to the skin over the area of nerve pain can be helpful. These include capsaicin cream (a product made from chili peppers that numbs the area) and lidocaine (anesthetic) patches. In mild cases of nerve pain, this may be the chosen treatment to reduce the pain in a particular area. Transcutaneous electrical nerve stimulation (TENS) is a low-level electrical stimulation delivere through a patch on the skin that breaks the pain message. As the intensity is low, individuals with sensation can use this treatment for nerve pain. Percutaneous electrical nerve stimulation (PENS) is a low-level electrical stimulation but with more intensity as it includes a needle in the area of the nerve pain.
Other therapies include acupressure and acupuncture to treat the pain. These also help to break up the stimulus of pain. Nerve blocks, the injection of an anesthetic into the painful nerve source of pain, will stop pain for a short period of time. This lasts for hours or, in some procedures, days. A pain pump consists of a small tube under the skin to deliver anesthetic for several days. Nerve blocks also block function by the nerve. As a result, when a nerve block is perform, the affect body part may become less active until the anaesthetic wears off.
As nerve pain can disrupt your daily life, some individuals will use biofeedback to learn to relax their muscles. Others will use distraction and relaxation techniques to help control their pain. You can use these approaches along with other treatments.
Nerve pain is unusual in that, over time, it can resolve. Sometime when people taper off a drug, they find their nerve pain is gone. Then they do not need to start a new medication. There is no predicting if or when this will happen, but it is comforting to know that it can. Most likely, the medication has re-educated the nervous system not to recognize the pain. And that is a good day.
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