Everyone has pain. Pain is important and can be useful. It can warn us that something in our body is damaged or overloaded. It can indicate an injury, inflammation or illness. Pain causes you to take measures to protect yourself and to fight the cause of the pain.
In nerve pain, there is damage or inflammation of a nerve. Often only on one side of your body, so left or right.
Nerve pain in both legs at the same time is often due to a narrowing of the spinal canal at the bottom of your back. The long nerves that travel to your legs via the spinal canal can get trapped by this narrowing.
Sometimes the cause is unclear and searching for a cause does not make sense.
Nerve pain often goes together with “normal” pain. The pain is (very) annoying but is not dangerous in itself.
With A Nerve Pain, You Will Feel A Tingling, Pungent, Burning Pain That Is Sometimes Stabbing Or Shooting.
The Pain Often Lasts For A Long Time (Several Weeks).
Nerve Pain Is Sometimes In A Certain Skin Area, Which Often Feels Deaf Or Painful When Touched.
The Pain Responds Poorly To ‘Regular’ Painkillers Such As Paracetamol.
Sometimes You Also Have Itching Or Tingling In That Area In Addition To The Pain.
The Area Can Also Feel Cold.
Rubbing On The Spot Often Makes The Pain Worse.
Inflammation or a disease, such as diabetes mellitus, can damage a nerve. That gives pain in a skin area. Sometimes this is caused by an infection, such as with shingles. But also a nerve can become trapped, such as a hernia or carpal tunnel syndrome.
There is not always a clear cause. For example, there is often no explanation for facial pain.
Is the pain intense, does it last long, does it increase, or does it keep coming back? Then go to your doctor. Together you can see what the cause is and treat the cause if possible.
Nerve pain can worsen or give pains when touched, cold or rubbed. Try to avoid this as much as possible.
Some people find it pleasant to warm the painful spot or cold. That can help to reduce the pain, but it does not heal faster.
Distraction and relaxation can reduce pain. The pain does not go away, but you have fewer problems with it.
Try to continue with your daily activities. If necessary, divide your activities throughout the day.
Keep moving, as far as possible, even with pain. If this increases the pain, stop. This way you stay fit and you keep your muscle strength.
The pain is annoying but cannot hurt
(i) Nerve pain is difficult to treat. It often takes days to weeks for the medicines to start working. It can also happen that a drug does not work and you have to try another drug.
(ii) Often, drugs for nerve pain have immediate side effects. You, therefore, start with a low dose and build it up carefully, in consultation with your doctor. This gives you less chance of unpleasant side effects.
(ii) The best remedy for nerve pain is amitriptyline (or, if you are older) nortriptyline. It is better not to use this in heart problems, dementia, urinary problems or epilepsy. The most important side effects are dry mouth and drowsiness. In the first 10 weeks of taking these medicines, contact your doctor if you have a sore throat and/or fever (for blood tests).
(iv) Carbamazepine works best with face pain. You can get dizzy and sleepy here.
(v) If that does not help, you can still try gabapentin . Here too you can become dizzy and drowsy.
(vi) With local nerve pain such as shingles, a plaster with lidocaine-5% cream or ointment can help. This can temporarily give a numb feeling.
(vii) Morphine-like painkillers such as tramadol do not recommend doctors with nerve pain. These drugs have many side effects and are quickly addictive.
(viii) If a medicine does not work or you get serious side effects, contact your doctor.
Do the medicines work inadequately or do they have too many side effects? Then the doctor can look with you at other possibilities to combat the pain.
(i) Sometimes a patch is used with capsaicin (a substance from pepper). This makes the place numb after 1 to 2 weeks. The application of the patch is painful and burning.
(ii) Sometimes an injection with an anti-inflammatory can help.
(iii) Medications can also be given through a tube in the spinal cord.
(iv) In some cases, a pain specialist (anesthesiologist) can ‘block’ the nerve with an injection, for example with a hernia.
(v) The GP will discuss with you which treatments are possible and refer you if necessary.
Nerve pain is very annoying and can last for weeks to months. Often it also disappears again. You can check with your doctor when you can reduce or stop the medication.
Try to keep the daily things as good as possible. Remember that pain is not a sign of damage, it is not dangerous. Distraction helps: the pain is not gone but you have less problems with it.
Completely disappearing from the pain is often not possible. But improving your options and the quality of life.
If the pain does not decrease and continues to exist for a long time, discuss with your doctor whether you can tackle the chronic pain differently.