Dr. Vaishali

If you are suffering from burning pain or tingling sensation in hands or feet; sharp shooting pain in legs; numbness in hands or feet, then you might be suffering from Neuropathic pain.

What is neuropathic pain? 

Neuropathic pain is a special type of pain which occurs when there is damage to nerve fibers,which produces tingling or burning type of pain.It is of two types:

1. Peripheral Neuropathic pain: It occurs when there is injury to peripheral nerve fibers (A-delta or C-fibers)which carries pain sensation to brain (Thalamus) for interpretation. 

2. Central Neuropathic pain: It occurs due to sensitization of central pain interpreting mechanisms (Thalamus) to falsely feel pain, when peripheral nerve fibers are no longer sending pain impulses to them.

Worldwide-estimates of prevalence of neuropathic pain are 7% i.e. 7 persons out of 100 people are suffering from different types of neuropathic pain.

Symptoms:

a.Tingling sensation or feeling of ants crawling under skin

b.Burning sensation

c. Sharp shooting pain or electric current-like sensation 

d. Stabbing pain

e. Dull pain with numbness or heaviness

Reasons for neuropathic pain:

1. Diabetes mellitus: Most common cause worldwide due to uncontrolled blood sugar levels, causing damage to nerve fibers.

2. Alcohol consumption/Cigarette smoking: Damage to nerve fibers or damage to blood vessels supplying nerve fibers.

3. Neck pain/Low Back pain/ Glutei pain

4. Vit. B12 deficiency

5. Chemotherapy for cancer patients

6. Post-Herpes virus infection

7. Post-Spine surgery

8. Post-Amputation

9. Diseases like Spinal cord injury,multiple sclerosis, HIV, Lead toxicity, etc.

Special Neuropathies:

a. Carpal tunnel syndrome: Tingling, burning sensation in hand which occurs due to compression of median nerve in wrist area. It occurs in women especially due to pregnancy, hypothyroidism,diabetes, etc. and in men due to improper position of wrist during working on computers.

b. Cervical Radiculopathy: Pain in neck and shoulder region (which increases with neck movements), along with sharpshooting pain radiating from neck to hand occurs in cases of cervical radiculopathy. This is due to compression of cervical nerve root by disc prolapse, facet subluxation, muscle spasm, trauma,etc.

c. Lumbar Radiculopathy: Pain in lower back or glutei region with sharp shooting pain radiating from hip to leg/foot region, occurs in cases of Lumbar radiculopathy or Sciatica. This is due to compression of lumbar nerve root or sciatic nerve by disc prolapse, facet joint, trauma, hypertrophied ligamentum flavum, piriformis syndrome, etc.

d. Meralgia paresthetica: Tingling or burning sensation in front of thigh, occurs due to compression of lateral cutaneous nerve of thigh, near waist region. Usual causes are tight or constrictive clothing at waist region, prolonged sitting, protuberant abdomen,etc.

Prevention of Neuropathy:

a. AVOID Alcohol consumption and cigarette smoking.

b. Maintain ideal body weight / BMI (Body mass index)

c. Life-style changes: Daily exercises (>30 minutes per day) or brisk walking or swimming; Avoid prolonged sitting or standing (>30 minutes).

d. Food/Diet should have following components:

• Green vegetables e.g. spinach, fenugreek leaves (methi), radish,etc.
• Coloured vegetables e.g. Tomato, carrot, Capsicum (green/red), ladies-finger (bhindi).
• Milk products e.g.Milk, buttermilk, curd, cheese (paneer)
• Protein-rich foods e.g.  Fish, egg, chicken, pulses(daal)
• Fiber-rich foods e.g. Bran, oats, Brown-rice.
• Fruits e.g. Apple, orange, guava, papaya, pomegranate, Berries.

e. Blood sugar control (in diabetics)

f.  Care of feet:

• Regular inspection of feet (with mirror).
• Comfortable,well-fitted shoes.
• Regularconsultation with podiatrist.
• Treatmentof wounds, foot deformities

g.  Adequate sleep

h.  Warm water bath (increases blood flow to affected area)

Treatment:-         

• Consult Pain medicine specialist.
• Neuropathic pain killers e.g. Amitriptyllline, Pregabalin, Gabapentin, capsaicin,Duloxetine, etc.
• Vit.B12 supplements, Anti-oxidants, multi-vitamins.
• TENS
• Acupuncture
• Relaxation,Yoga
• NeuralProlotherapy

The usual full term for a pregnancy is usually around 39 to 40 weeks which varies slightly from woman to woman. However, if your baby is born before the 37th week, then he or she may be considered preterm or to have a premature birth. Premature babies are at a higher risk of infections and may also face a lot of other complications such as low birth weight, anemia, apnea or difficulty in breathing. Some pre-term babies may also end up developing hearing and vision impairments along with developmental problems, learning disabilities and other chronic health problems throughout their lives.

How to take care of your preterm baby?
Although your preterm baby may be predisposed to certain problems, if you take care of them well enough then none of the complications or health problems may occur and they will end up having a normal life like other babies who have been delivered after the full term. Initially, your baby may be kept in a NICU or Neonatal Intensive Care Unit for a few days until the doctors can describe them out of danger.

Some of the things that you can do as parents during that period are mentioned as follows:

1. Ensure a supply of breast milk: It is important for you to have an ample supply of breast milk stored as and when your baby needs it. Breast milk helps fight infections as well as provides important nutrients for your baby’s development. Your preterm baby may not be able to have breast milk initially and thus you may have to store them via refrigeration.
2. Ask for supplements to breast milk for your baby: Your preterm baby may not be able to have breast milk immediately after birth. It is thus important to discuss with the doctor about the right milk supplements which can be given to your baby to help with their nutrition and development.
3. If you have concerns, immediately bring them up: It is important to share any changes in your baby’s health with your doctor and bring up any concerns with them. They may not seem very significant, but it still makes sense to let the doctors know as it may indicate other serious problems that may develop.
4. Gather and stay on top of information: It is important to gather as much information as possible for the condition of your child and prepare yourself before you take your child home. Ask the doctors and other medical staff at hand what is being done and what you will need to do once your baby is discharged.
5. Connect with your baby: Even if your baby was born early, you can have skin to skin contact with him or her as long as the precautions have been properly followed. Also, sing and talk to your baby as you would to a normal child as this would help build closeness and emotional connect between the two of you. In case you have a concern or query you can always consult an expert & get answers to your questions!