Neuropathic pain overview

Pain caused by nerve damage or dysfunction

Neuropathic pain describes any pain caused by some sort of injury to or dysfunction of one or more nerves. The pain can take a few different forms – it can feel like an electric shock, or like a burning or a cold sensation. It can also be a numbness or tingling or itching sensation. It is sometimes simply referred to as ‘nerve pain’.

It is often a chronic condition (i.e. ongoing over a long period of time) and can be challenging to treat successfully.

Some types of neuropathic pain which are covered in more detail elsewhere on this site include:

  • Diabetic neuropathy
  • Trigeminal neuralgia
  • Phantom limb pain
  • Post-herpetic neuralgia (linked to shingles)
  • Complex Regional Pain Syndrome

Approximately 5% of the population of Australia is affected by some form of neuropathic pain.

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Common causes of neuropathic pain

What can damage or affect the nerves?

The direct cause of neuropathic pain is damage to what is called the ‘somatosensory nervous system’ which is the component of the nervous system dedicated to the transmission of sensation back to the brain, for example touch and temperature, as well as ‘nociception’, which is the transmission of pain signals to the brain.

The following factors are known to cause neuropathic pain:

  • Diabetes
  • Compressed nerve/s
  • Infections
  • Other medical conditions
  • Chemotherapy
  • Injury, including injury to the spinal cord
  • Vitamin deficiency, especially B1 ‘thiamine’ and B12.
  • Tumour or osteophyte (bone spur) putting pressure on a nerve.

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Neuropathic pain symptoms

How nerve pain can feel

As described above, neuropathic pain generally involves the following symptoms:

Electric shock or shooting pain

Sudden sharp or shock-like pain along the affected nerve.

Burning or cold sensation

Pain that may feel unusually hot, burning or cold.

Numbness or tingling

Reduced sensation or pins and needles in the affected area.

Itching sensation

Persistent itching associated with nerve dysfunction.

Night-time pain

Pain that may become more noticeable or severe at night.

Intermittent or constant pain

Pain may remain present or come and go over time.

Hypersensitivity

Increased sensitivity to temperature or touch, where even light contact can be painful.

Neuropathic pain tests and diagnosis

How neuropathic pain is assessed

The first step in the diagnosis of neuropathic pain is a review of medical history and of current symptoms. The next step is an examination where the nerves in the affected areas are checked, by for example testing sensitivity to various types of touches and light pinpricks, along with sensitivity to different temperatures.

If an initial diagnosis flags a possible neuropathic cause, further tests may be recommended, such as blood tests, a nerve conduction study (to test if there is any nerve dysfunction) and an MRI scan. In some cases, a biopsy (tissue sample) may also be recommended.

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