Neuropathic pain occurs when nerves in the peripheral nervous system are injured or become damaged. The nerve fibers themselves are actually damaged, dysfunctional or injured, which makes them send false signals to pain centers in the brain. In addition, nerve function changes, both at the site of the injury and in areas around the injury. Neuropathy is most common in people who have diabetes, and it is caused by damage to the cells as a result of the disease. It can also result from injury, infection, some medications, and toxins.
In most cases, neuropathy affects peripheral nerves, which are nerves outside the brain and spinal cord. Nerves in any area of the body can be affected and the condition may affect a single nerve, a group of nerves or all the nerves in an extremity. Autonomic nerves (nerves that control functions like breathing and digestion), motor or movement nerves and sensory nerves can all be affected.
Damaged nerves can't transmit signals correctly. They may respond to a light touch (which would normally not cause pain) by sending a message of severe pain. Mild heat or cold may also be interpreted as pain. The damage to the nerve cells may also cause pain intrinsic to the nerve, and a chronic burning sensation is not uncommon in neuropathy. In addition, neuropathy can cause muscle wasting and paralysis or other symptoms like itching, tingling, or numbness.
It’s important to recognize that neuropathy is not a condition that can be cured. Treatment is aimed at symptoms and a wide variety of medications may be used; among these are opioid pain medications, antidepressants, anti-seizure medications, and medications used to treat heart rhythm disturbances. Topical medications in creams, ointments and gels include lidocaine — a local anesthetic — and capsaicin, a substance found in hot peppers. Transcutaneous electrical nerve stimulation (TENS) may be helpful in some cases. Massage therapy, braces to compensate for weakness, and (rarely) surgery may also be used.
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