What is peripheral neuropathic pain?
Before explaining what peripheral neuropathic pain is, we must talk about nerves. “Nerves are comparable to electrical cables: they deliver messages from the brain and nervous system to different areas of the body in the form of electrical impulses. ” explains Dr. D’ans, algologist.
The nerves are thus involved in the feeling of pain. An example: in the event of a burn, it is the nerves which will transport the various warning signals (heat, etc.) to the nervous system: this will then create pain, which will travel along a nerve until to reach the burned area. And that’s where it hurts!
” When an electrical cable is damaged, it produces small sparks. This is exactly what happens with a damaged nerve: the “electric sparks” are responsible for pain that does not respond to painkillers – this is peripheral neuropathic pain. “
Peripheral neuropathic pain: what causes, what symptoms?
It has been said: peripheral neuropathic pain appears when a nerve is damaged – compression, rupture, etc. It can be temporary (that is to say: disappears on its own) or chronic (it is i.e.: to settle down in time).
We can therefore encounter peripheral neuropathic pain in the following cases:
- “phantom limb”: after an amputation, the patient feels pain in the missing limb (arm, leg, etc.),
- in diabetic patients: pain is felt in the feet and hands (we speak of distal polyneuropathy),
- in the event of a surgical procedure during which a nerve may have been damaged. It should be noted that a post-operative scar can lead to the appearance of peripheral neuropathic pain.
- neuralgia of the trigeminal nerve or facial neuralgia,
- algodystrophy,
- herniated disc (even after surgery).
The symptoms of peripheral neuropathic pain vary depending on the situation. In the area concerned, we can notably observe:
- A feeling of “electric shock”,
- A burning sensation,
- Itches,
- tingling,
- Allodynia: the patient cannot tolerate contact on the area concerned (for example: clothing),
- A painful “cold” feeling,
- A sensation of painful anesthesia: the patient no longer “feels” the area concerned but it is nonetheless painful.
To know : Symptoms of peripheral neuropathic pain are likely to worsen in emotionally difficult situations – for example: during bereavement, a period of unemployment, divorce, etc.
Peripheral neuropathic pain: on the treatment side
To know : Unlike other cells in the body, nerves do not regenerate. In the case of peripheral neuropathic pain, it is therefore not possible to “repair” the damaged nerve: treatments therefore only aim to treat the symptoms.
What treatments are available? Peripheral neuropathic pain is unique since it is resistant to “classic” analgesic medications. To soothe the pain, the doctor will therefore prescribe a local anesthetic (lidocaine). Anti-epileptic and/or anti-depressant treatment may also be implemented.
If the pain is chronic, the doctor may also prescribe transcutaneous electrical stimulation (TENS) sessions: this involves “blocking” the transmission of pain in the epidural area of the spinal cord ” specifies Dr. D’ans.
Peripheral neuropathic pain: 3 new techniques
Three new techniques are now available for peripheral neuropathic pain:
- Peri-nervous catheterization. This involves locally placing anesthetics at the root of the damaged nerve to relieve pain and symptoms. The catheter is placed under the skin using a small surgical procedure through the skin.
- Placement of an electrode (same: thanks to a surgical intervention) at the level of the spinal cord in order to reduce the transmission of pain: ” it is more effective than TENS since the electrode is directly in contact with the epidural area of the spinal cordresponsible for the pain ” says Dr. D’ans.
- Transcranial magnetic stimulation. If the word can be frightening, it simply involves placing a magnetic coil (like a “headphone”) on the patient’s head, at the level of the cerebral cortex, to “reprogram” the brain cells which have memorized the pain peripheral neuropathy, thus preventing it from disappearing.
Thanks to Dr. Violaine D’ans, anesthesiologist and algologist.
Read also :
⋙ Arnold’s neuralgia: how to relieve the pain?
⋙ Neuralgia: how to relieve pain?
⋙ When my nerves hurt, what do I do?