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What is nerve pain?
The term neuralgia stands for pain, which is usually limited to the area of spread of a nerve. However, several nerves can also be affected at the same time. With neuralgia, recurring excruciating, stinging pain arises, which can almost drive those affected insane. Since the pain is triggered directly by the nerves and radiates from them, those affected are perceived as particularly intense and differ from all other types of pain. Here is a brief overview of nerve pain:
- definition: Neuralgia refers to pain that comes directly from the nerves. Usually, the nerves are used as pain management. With nerve pain, however, the pain system itself is affected.
- frequency: According to estimates, around 300,000 people in Germany suffer from neuralgia.
- Symptoms: Sudden onset of pain and / or burning pain, sensitivity to touch, discomfort such as tingling or numbness are typical. The pain is felt in the affected body region or radiates from it.
- causes: The causes of nerve pain can be varied in nature. On the one hand, certain diseases such as shingles or Lyme disease can trigger neuralgia. On the other hand, nerve pain can also result from operations, herniated discs, tumors, poisoning or even psychological stress.
- treatment: The therapy depends on the cause of the neuralgia. Medications such as antiepileptics, muscle relaxants and local anesthetics are often used. In some cases, surgery is also required. Naturopathic procedures can support the healing process.
Since the nerves themselves are affected in neuralgia, the pain differs fundamentally from all other types of pain such as tumor, head or back pain. The nerve pain is felt in the diseased region of the body. This can occur so suddenly that the patient flinches or even cries out in pain. Typical for a neuralgia are:
- Sudden onset, shooting, drilling pain,
- burning constant pain,
- Touch sensitivity of the affected region,
- Discomfort such as tingling in the limbs, numbness in the legs or falling asleep in the hands.
The causes are many. Mostly there is an irritation of the nerve. But pressure, displacement or inflammation can also lead to nerve pain. An inflammatory process that takes place right next to the nerve, such as tooth root conduction, can also be mentioned as a possible trigger for neuralgia.
Other possible causes
A tumor that presses on the nerve, swelling, or the intervertebral disc that hinders the course of the nerve are all potential causes of nerve pain. Other triggers are so-called bottleneck syndromes. These are physiologically narrow places in the body where a nerve is pinched relatively often. They are located in the elbow, on the wrist or in the inguinal canal, among other things. In addition, poisoning, stress and mental stress can lead to nerve pain.
Diseases as a cause
Almost every nerve that is damaged can trigger nerve pain. Some common diseases that cause nerve pain are examined in more detail below.
Lyme disease as a trigger
Neuralgic symptoms are possible in connection with Lyme disease. The bacterium Borrelia burgdorferi can be transmitted through a tick bite. After an incubation period of days to weeks, this triggers an infection that is noticeable in the skin, lymph nodes, heart, joints and also in the nervous system. Especially with the late form of Lyme disease, neuralgic complaints such as burning, stinging and tingling can occur in almost any part of the body and especially at night.
Shingles as a trigger
Shingles is another of these diseases, which in some cases can be followed by a so-called post-zoster neuralgia. Those affected have already experienced the acute phase of shingles (viral disease caused by the varicella zoster virus). Once you have had chickenpox, the viruses remain in your body and can become active again when your immunity declines.
Patients with shingles develop a painful, itchy rash, fever and a general feeling of illness. As a complication, postzoster neuralgia can develop later. Older patients in particular suffer more from nerve pain. This creates shooting, burning, sometimes unbearable pain in the affected area. This form of neuralgia can persist for years.
A rare cause of violent, shooting pain is the pudendal neuralgia. The perineal, genital and anal regions are affected. The cause of this neuralgia is mechanical or inflammatory damage to the nerve. This disease can also occur secondary to shingles. Patients suffering from diabetes can also be affected.
Trigeminal neuralgia takes its name from the nerve that is damaged in the process, namely the trigeminal nerve. This is the fifth cranial nerve, consisting of three branches that supply the forehead, upper jaw and lower jaw. Trigeminal neuralgia is caused by compression of the trigeminal root in tumors or inflammation. It mostly affects people who are older than 50 years or patients who already suffer from neurological diseases such as multiple sclerosis.
Those affected suffer lightning-like pain attacks that last only a short time, but are extremely uncomfortable and can occur every few minutes. The pain is triggered by chewing, speaking, or light touch and is mostly one-sided, with the second and third branches of the trigeminal nerve most commonly affected. Because of the unbearable pain, many sufferers avoid eating and therefore lose weight.
Pinched sciatic nerve
With sciatica, irritation of the sciatic nerve leads to neuralgic pain, triggered by various causes. For example, in the event of a herniated disc in the lower area of the spine, the sciatic nerve can be pinched by pressing the gelatinous nucleus of the intervertebral disc and a corresponding neuralgia can be triggered. But tumors, swellings or metastases can also compress the sciatic nerve and cause sciatic pain.
If the vertebrae are destroyed, this can also result in a squeeze of the sciatic nerve. In addition, during the birth process there is a risk for the mother to develop a neuralgia here. The unborn baby's head is near the sciatic nerve at birth, and compression can severely affect the nerve.
Various procedures and medicines exist for the treatment. However, therapy for nerve pain is not always easy. The type of therapy depends on the causes of the nerve pain.
Therapy of trigeminal neuralgia
Trigeminal neuralgia is a challenge for the treating therapist. At the beginning, antiepileptics are often administered. These are drugs that are usually used to treat epilepsy, but also have a positive effect on neuralgia. Various active ingredients are on the market, which are used depending on their tolerance.
Muscle relaxants are also medicinal products that have their place in the treatment of trigeminal neuralgia. However, the medication can lead to a wide variety of side effects. Since the medicines mentioned can have an effect on the blood picture, this should be checked regularly during therapy.
The use of local anesthesia has also proven itself in the treatment. The injected local anesthetic blocks the affected nerves at the exit points. If all drug therapy attempts are unsuccessful, surgery is rarely required. For example, the affected nerve is damaged or obliterated with the help of a heat lesion.
Therapy of sciatica
In the case of neuralgia caused by sciatic irritation, the cause must be treated, i.e. the reason for the compression. If the trigger is a herniated disc, it is usually treated conservatively with pain relievers and suitable physiotherapy. If swelling and inflammation decrease, the irritated nerve is relieved and the neuralgia subsides.
Therapy for postzoster neuralgia
Therapy for postzoster neuralgia is sometimes associated with considerable difficulties. Here too, as with trigeminal neuralgia, anti-epileptics are used. The treatment regimen also includes certain antidepressants that are also effective for pain. They are also given in combination with neuroleptics. For external use, acetylsalicylic acid and capsaicin come into consideration. Therapeutic local anesthesia is discussed differently in the treatment of postzoster neuralgia.
Therapy of neuralgia caused by Lyme disease
If a neuralgia occurs in the context of Lyme disease, the anti-epileptics already mentioned in the other forms of neuralgia are also used. Another treatment option is an indwelling catheter in the form of a thin tube, over which a local anesthetic is given directly to the nerve over a period of ten to fourteen days.
Of course, the treatment of neuralgia belongs in the hands of an experienced doctor. However, this can be supported by the use of naturopathic procedures and the healing prospect can be improved.
Baunscheidt therapy is a frequently used method. As part of the treatment, the skin in the area affected is slightly scratched. The subsequently applied Baunscheidt animal oil means that the skin is better supplied with blood and the defense set in motion.
Whining with selected anthroposophic infection solutions brings relief. Since nerves rely on the supply of B vitamins, the injection of a vitamin B complex has proven itself. Oral application is also a way to do something good for the overwrought nerves.
Homeopathy for Neuralgia
St. John's wort, used both internally as a capsule and externally as an oil, can support the healing process. Complex preparations or individual remedies from homeopathy are also used for neuralgia. For example:
- Cantharis, the Spanish fly: For burning pain.
- Cedron, a bitter ash family: For the treatment of neuralgia and headache.
- Cyclamen, the cyclamen: for depressive moods and trigeminal neuralgia.
- Verbascum, the Mullein: For nerve pain, trigeminal neuralgia, but also for ear or toothache and rheumatism.
- Mezereum , the silk bast with increasing pain from bed warmth and touch
- Hypericum, St. John's wort for nerve injuries
Schüßler salts can also be used to combat neuralgia or neuralgic pain. For example, Schüßler salt is used more frequently:
- No.2 (Calcium phosophoricum),
- No.3 (Ferrum phosphoricum),
- No.5 (potassium phosphoricum),
- No.7 (Magnesium phosphoricum),
- No. 11 (Silicea).
Generally speaking, patients suffering from nerve pain are usually very sensitive and prone to stress. Meditations, yoga, autogenic training or other relaxation techniques can therefore contribute to the improvement.
Since the legalization of cannabis for the drug treatment of pain patients, this new method has also been available. Because cannabis reduces nerve pain, which offers special benefits when used in the context of neuralgia treatment. (sw, vb)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Susanne Waschke, Barbara Schindewolf-Lensch
- Professional associations and specialist societies for psychiatry, child and adolescent psychiatry, psychotherapy, psychosomatics, neurology and neurology from Germany and Switzerland: What is shingles and post-zoster neuralgia? (Accessed: 07/17/2019), neurologen-und-psychiater-im-netz.org
- German Pain Society: nerve pain (accessed: 07/17/2019), dgss.org
- Austria's public health portal: nerve pain (accessed: 07/17/2019), gesundheit.gv.at
- Mattle, Heinrich / Mumenthaler, Marco: Short Textbook Neurology, Thieme, 4th edition, 2015
- German Society for Psychological Pain Therapy and Research e. V .: Nerve pain (accessed: 07/17/2019), dgpsf-verein.de
- National Health Service UK: Overview - Trigeminal neuralgia (accessed: 07/17/2019), nhs.uk
- Mayo Clinic: Trigeminal neuralgia (accessed: July 17, 2019), mayoclinic.org
- National Institute of Neurological Disorders and Stroke: Trigeminal Neuralgia Fact Sheet (accessed: July 17, 2019), ninds.nih.gov
- German Society for Neurology (DGN): S1 guideline for neuropathic pain, diagnostics, as of September 2012, detailed view of guidelines
ICD codes for this disease: G44, G50, G52, M79ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.