Neuropathic pain stands out from various other types of pain. If an individual breaks a bone, discomfort signals are sent via nerves from the site of the trauma to the mind. With neuropathic discomfort, nevertheless, discomfort signals come from the nerves themselves. That is the reason they are more painful.
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How Neuropathic Pain Develops
In many cases, the nerves become damaged or dysfunctional after responding to an injury or trauma, causing hypersensitivity to pain. The nerves then send faulty signals of pain even when the injury has healed. The initial injury can occur in either the peripheral or central nervous system.
Neuropathic pain, or neuropathy, is a chronic condition, meaning it does not go away. Instead, the pain becomes the disease process. The terms sensory peripheral neuropathy and peripheral neuritis are sometimes used to describe neuropathy affecting the peripheral nerves.
An estimated 7 to 10% of people have neuropathic pain.1 This article examines neuropathy and chronic back pain, and how the two conditions are related.
When Back Pain Causes Neuropathy
Neuropathy can result from any type of pain that compresses or impinges on a nerve. A herniated disc, for example, could press against a nearby nerve, causing pain. Neuropathic pain originating from the back or spine may include:
- Chronic pain radiating down the leg (lumbar radiculopathy, or sciatica)
- Chronic pain radiating down the arm (cervical radiculopathy)
- Pain following back surgery that starts gradually and persists, commonly called failed back surgery syndrome
Diabetes and regional pain syndrome (RPS), are common causes of neuropathy. Additional causes of include injury, disease, infection, exposure to toxins, and substance abuse. It is not always possible to pinpoint the cause.
Why Early Treatment is Crucial
Early treatment is important, since more aggressive treatment may be needed if symptoms are not addressed soon.
Over time, exposure to significant pain can cause changes to the central nervous system that make the body become more sensitive to even slight touch—a phenomenon known as central sensitization.
As with other types of chronic pain, delays in treatment may also make other health problems more likely. Depression, anxiety, difficulty sleeping, and an inability to work and take part in other activities are some health issues associated with untreated neuropathy.
Neuropathic pain symptoms are often unpredictable, and vary significantly from person to person. Pain may be triggered by a specific stimulus, or occur on its own. In the case of a sudden impact, the area surrounding the site of the trauma may be affected in addition to the immediate area.
Neuropathy May Limit Daily Functioning
Neuropathic pain often makes movement painful, leading an individual to limit mobility. Being sedentary can cause muscles to weaken, further restricting physical functioning. Many people with neuropathy are unable to work.
Back pain or other pain caused by neuropathy is typically described in the following terms:
- Severe, sharp, electric shock-like, shooting, lightning-like, or stabbing
- Deep, burning, or cold
- Persistent numbness, tingling, or weakness
- Pain that travels along the nerve path into the arms, hands, legs, or feet
Skin in the painful area may be discolored, appearing more pink or red than usual. In some cases, the skin may have a blue or mottled appearance. Changes in color are usually related to changes in blood flow. Some individuals also experience swelling.
Many people with neuropathic pain also experience sleep difficulties and depression, both of which can increase the perception of pain. A multifaceted pain management approach may be beneficial to address all aspects of the person’s health.
- Van hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain. 2014;155(4):654-62.