The countless nerves in our body send signals to the brain including the signal for pain. Pain has a very important function of protecting our body against external damage. But this signaling does not work properly in people with nerve pain. They might get the sensation of pain but without understanding its cause. Nerve pain, which is also known as peripheral neuropathy or peripheral neuritis, usually occurs due to some physical damage or disease.
Cancer and other tumors can cause neuropathic pain as the tumors tend to press on the surrounding nerves. Chemotherapy drugs can also cause nerve pain as they can damage the nerves. One of the first symptoms of a person suffering from HIV is nerve pain in the hands and feet. A diabetic person is prone to nerve pain as high levels of glucose in blood can damage the nerves. A person can suffer from severe nerve pain if he/she suffers from postherpetic neuralgia. Nerves can also get severed, compressed or crushed due to some physical injury and this may cause nerve pain.
The treatment for nerve pain depends on the age of the patient, underlying cause, costs and potential side effects. A person will have to undertake treatment for the underlying disease in such cases. However the different treatments options for nerve pain include use of topical treatments, anticonvulsants, anti-depressants, pain killers, electrical stimulation and, in some cases, surgery.
The treatment for nerve pain involves the use of anticonvulsants and tricyclic anti-depressants such as Amitriptyline, Nortriptyline and Desipramine. There are also other prescribed anti-depressants such as Venlafaxine and bupropion which are very effective for some people. Doctors may also prescribe Selective Serotonin Reuptake Inhibitors (SSRI) like Paroxetine and Citalopram. Sometimes, a person may also be given non-steroidal anti-inflammatory drugs (NSAIDs) such as Aleve or Motrin to deal with nerve pain.
Sometimes topical treatments like creams, gels, lotions and patches help to deal with nerve pain. A doctor can recommend anticonvulsants together with anti-depressants to a patient suffering from nerve pain. Tricyclic antidepressants can help to deal with nerve pain caused due to diabetes, HIV or cancer chemotherapy. People suffering from severe nerve pain or from nerve pain due to cancer generally opt for opioid painkillers. Furthermore, some treatments like transcutaneous electric nerve stimulation (TENS) and repetitive transcranial magnetic stimulation (rTMS) use electrical impulses to block the pain signals sent by the damaged nerves.When all other treatments fail, a doctor may recommend anesthetic injections to ease the pain. The doctor may also recommend surgery. Sometimes alternative therapy like meditation, acupuncture and massaging the affected nerve can produce favourable results. Making some changes in lifestyle also help to deal with nerve pain.
A person suffering from nerve pain can experience symptoms of pain, a pin-and –needle sensation, numbness and weakness. A person may feel a burning or tingling and sharp sensation while the main areas where a person may experience pain are back, hands, thigh, foot and face. A person may also experience poor balance in his/her entire body and have tingling fingers of feet and slow reflexes. A person experiencing these symptoms is eligible for treatment. Nerve pain can affect a person badly and without any apparent reason. In such cases, a person can seek treatment.
A person suffering from pain due to cuts, bruises and or some injury is not eligible for treatment of nerve pain. A person suffering from some chronic disease or some mental ailment should consult a doctor before taking any medications for treating nerve pain.
The side-effects associated with the use of tricyclic antidepressants are blurred vision, sweating, dry mouth, restlessness, drowsiness, dizziness and racing heartbeat. The anticonvulsants used to treat nerve pain can cause drowsiness, dizziness, swelling in the legs and feet and confusion. The possible side-effects of selective serotonin reuptake inhibitors can be dry mouth, drowsiness, nausea, nervousness, agitation, diarrhea and even sexual problems like reduced sexual appetite. Anesthetic injections can cause swelling, bruising, itching or redness in the area where the injections have been administered. They may also cause mild dizziness and nausea.
A doctor will generally advice a patient to take rest and to adopt a healthy diet so that he/she can keep nerve pain at bay. Light exercises may also be recommended to ease the pain. A person will also have to regularly monitor his/her blood sugar levels as high blood sugar levels can cause nerve damage. A person should incorporate foods rich in Vitamin B12 and anti-oxidants as they help to build up nerves.
A person suffering from nerve pain due to nerve damage will take a lot of time to recover. Some damaged nerves can be surgically repaired and a person will take about 3-6 months to recover from that. However, in case of nerve pain due to not so serious a cause, a person can recover within a week or two with the help of medications. However, in some cases, the nerve damage can be irreversible and a person can suffer for his/her lifetime.
The cost of treatment for nerve pain varies greatly depending on the diagnosis, methods of treatment and the type of interventions used. If you have a minor neuropathic pain that can be treated with drugs, it may cost between Rs 5000 and Rs 20000. However, for surgical and related procedures, a person may have to pay 6-15 lakhs depending on the hospital and the city.
Nerve pain generally occurs to some disease or physical damage. Nerve pain causes a person to get the sensation of pain without understanding the cause. It is a complex scenario and the results depend on the condition and also the treatment that is given to the patient. When nerve pain occurs due to conditions like HIV or diabetes, a person may have to deal with the disease first. The person will recover completely only after he/she has successfully dealt with the disease. A person suffering from nerve pain due to nerve damage has a hard time recovering completely.
Nerve pain due to diabetes can be managed by following a healthy diet, managing the blood glucose levels, exercising lightly and also by quitting smoking and drinking. A person suffering from nerve pain in his/her foot can treat it by checking the feet regularly, going to a podiatrist and wearing comfortable shoes. The easiest and least expensive home treatment for nerve pain is a warm bath.
Rs 5000 - Rs 15 lakhs
Minimally invasive spinal surgery is a quicker and safer alternative to open surgery. The spinal discs, vertebrae and nerves are present deep inside the body. A small incision is made and the surgical instruments and a camera is inserted which push aside the muscles and reach the problem area.
Which medical conditions can be addressed with minimally invasive spine surgery?
1. Degenerative Disc Disease (osteoarthritis of the spine)
2. Herniated Disc (the disc protrudes from its right place)
3. Spinal Tumours
4. Vertebral compression fractures (collapse of the vertebra)
5. Lumbar spinal stenosis (narrowing of the space near the spinal cord)
6. Scoliosis (the spine curves sideways)
7. Spinal infections
8. Spinal instability
What are the goals of minimally invasive spine surgery?
1. Decompression: this procedure eases the pressure being exerted on the spinal cord or the nerve roots. This pressure can be the cause of pinched nerves.
2. Stabilization: sometimes, a segment of the spinal cord that has come loose can be the source of pain. A stabilizations surgery fuses the segment to the rest of the structure.
The three most common methods of minimally invasive spine surgery are-
1. Tubular: it is also called ‘muscle splitting’ surgery. A tubular retractor passes through the muscles of the back and reaches the spine.
2. Mini-open: it is a lot like open surgery but with fewer risks and blood loss. The possibility of post-operation infection goes down significantly.
3. Endoscopic: it is also called a keyhole surgery. A small camera is introduced through a small incision and guided to the spine. The camera gives an internal view of the spine to the doctors.
The three types of Minimally Invasive Spinal Surgery are-
1. Microdiscectomy: involves the removal of the intervertebral disc that is putting pressure on the spinal cord.
2. Foraminotomy: spinal conditions can lead to narrowed foramen (the area where the spinal nerve exits the spine). The aim of the surgery is to expand the foramen.
3. Microlaminectomy: this is yet another type of decompression surgery. The aim is to relieve pain caused pinched nerves or a segment of the bone pressing down on the nerves.
What are the benefits of minimally invasive spine surgery?
• Speedy and pain-free recovery after surgery
• A patient is discharged the same day
• Very little loss of blood
• Reduced chances of infection
• Less scarring because the operation is done through small incisions
• Less muscle damage
Are there any risks attached to minimally invasive spine surgery?
No surgery is free of risks or side effects. Some common problems in the aftermath of minimally invasive spine surgery are-
Minimally invasive spinal surgery incorporates the latest advances in the world of technology. It is the relatively hassle-free procedure and convenient for both doctors and patients.
Trigeminal Neuralgia is basically a nervous disorder that can affect any person. The condition is caused mainly due to the trigeminal nerve or the 5th cranial nervebeing pressed against by a blood vessel. Cases have been reported without such specific underlying causes as well. The condition can cause light to severe pain and is treated through a combination of medication and other external stimulations.
Things you need to know about Trigeminal Neuralgia
Nerve pains can become unbearable sometimes and have to be treated immediately. The best way is to first take a combination of drugs to control the pain and then use electric stimulation and other methods of external applications to remove the pain.
Trigeminal neuralgia is specified by the condition of a chronic pain that influences the trigeminal nerve. This nerve transfers sensation from one’s face to his/her brain. If a person is suffering from trigeminal neuralgia, then a gentle stimulation of face (sourced from brushing teeth or applying makeup) might generate a fright of agonizing pain. The affected person might experience short and mild attacks initially. However, the trigeminal neuralgia might progress and generate more-frequently and longer attack of severely critical pain. Women get affected by this situation more than men get and it is more prominently occur in individuals older than 50 years.
Trigeminal neuralgia does not mandatorily mean that you need to experience a lifelong pain. Various types of treatment alternatives are available and so doctors can usually handle the particular condition effectively by taking help of injections, medications or surgery. Various types of triggers might cause the pain regarding trigeminal neuralgia, such as eating, drinking, shaving, brushing teeth, touching face, smiling, washing face etc.
The symptoms of trigeminal neuralgia might comprise of one or more patterns and some of these are described below:
How does Radiofrequency Ablation treat Trigeminal Neuralgia?
Trigeminal Neuralgia is a chronic and painful condition that involves the trigeminal nerve. There are two separate trigeminal nerves on both sides of the face, which carry the sensations like pain from the face to the body. Each nerve has three branches- forehand, midface and chin and trigeminal neuralgia can cause intense pain in any of these areas.
The pain can be mild and for a shorter duration or it can happen frequently for longer durations. Some experience the pain in cycles where it can come and go for days or even for weeks. Gradually the intensity of the pain lessens.
Cure by Radio-frequency Ablation
The treatment of trigeminal neuralgia is often a challenging process in clinical practice. When medicines do not prove as effective, surgery is the desired option.
How Effective is Radio-frequency Ablation?
The pain is cured almost in 98% of the patients. 50% of patients report recurrence of pain after about two years. Hence the procedure can be repeated in the same patient if necessary.
Typical Trigeminal Neuralgia and Atypical Trigeminal Neuralgia.
The typical form or this disorder results in certain episodes of severe, sudden, shock-like pain in one side of the face, which lasts for seconds to few minutes.
Trigeminal Neuralgia may have symptoms which include one or more of patterns like the following:
A person might come across spontaneous attacks of pain or even attacks which might get triggered by certain things like touching the face, chewing, speaking or even while brushing the teeth.
When trigeminal neuralgia occurs, the trigeminal nerve’s function gets disrupted. The problem occurs through a contact between an artery or a vein and the trigeminal nerve at the base of one’s brain. This contact puts pressure on the nerve, thus causing it to malfunction.
Trigeminal Neuralgia can occur due to people getting aged or due to any kind of disorder that causes damage to the myelin sheath that protects certain nerves. A number of triggers can lead to the pain of trigeminal neuralgia, which include:
What Is Radiofrequency Ablation for Trigeminal Neuralgia?
Radiofrequency Ablation or RFA is a technique by way of surgery, which helps to direct high-frequency heat on to the targeted areas of the body, such as tumors and tissues. When a person suffers chronic pain that means the high-frequency heat is getting targeted to the nerves.
A person suffering from trigeminal neuralgia, would have his or her doctor, who is a neurosurgeon, uses radiofrequency ablation to hit the trigeminal nerve, thereby destroying the nerve’s ability to get the pain signals transmitted to one’s brain.
Medication is the first line of treatment for trigeminal neuralgia by a neurosurgeon, to see how the patient reacts. If that person suffers from severe pain in the face and does not show any improvement through medication, then the doctor might recommend him/her to go for radiofrequency ablation surgery.
How Is The Procedure Conducted?
During the radiofrequency ablation for trigeminal neuralgia, people remain awake and asleep at different times. The process includes:
When the patient is asleep under the influence of general anaesthesia, a neurosurgeon would carefully place a needle through the corner of one’s mouth in order to reach the trigeminal nerve, which lies at the base of the skull. Then, once the X-rays confirm the needle is right in place, the neurosurgeon would wake the patient up, stimulate the nerve and ask the patient if he or she could feel the stimulation exactly at the place where the pain is experienced. This particular step confirms that the doctor has hit the right location. Once, the patient gets back to sleep, the doctor uses radiofrequency heat to minimally injure the nerve, sufficiently enough to induce a numb feeling on the face along with tingling, thus take the pain away.
The condition of persistent pain in the body, where an outbreak of the Varicella Zoster virus has caused Shingles, is termed as post-herpetic neuralgia. It is a debilitating complication of the herpes zoster virus. The blisters that occur in shingles develop a crust formation and neuralgia begins after these crusts are formed. It may also occur in people who do not produce the crustaceous lesions. A burning pain that is long-lasting, even after the rash and the blisters disappear, is observed. There is a criteria of the pain to be persistent for around three months for the confirmation of post herpetic neuralgia.
The cause of this condition is damage of the sensory nerves that can occur due to the movement of the reactivated Herpes Zoster virus from the nerves to the skin. In an individual affected with chickenpox, the infection can involve dorsal root ganglia, where the virus lies dormant. Under conditions like stress due to infection or in an immuno-compromised individual, after a period of time, reactivation of the virus takes place. This reactivation causes production of Shingles on the body. The dormant virus reaches the skin and reactivates to produce lesions.
With an increase in age, the chances of developing post-herpetic neuralgia also increase. It primarily affects older individuals in the age group of 60 to 70 years. Treatment is aimed at pain management and providing symptomatic relief, with improvement of the neuralgia over a period of time. Symptoms of this condition are limited to the area of shingles’ outbreak. Trunk is commonly affected on a unilateral site. It can also occur on face. Common symptoms include pain lasting 3 months or longer after healing of the shingles rash, allodynia, numbness over the affected area and itching. Even a slight touch of cloth over the affected area can cause alleviated pain to the individual. Disturbed sleep and development of clinical depression is usually associated with post herpetic neuralgia. The medications given for post herpetic neuralgia are aimed at pain relief and resolving of symptoms. Management of chronic pain can be brought about by the use of a combination of pain relieving drug classes.
Some commonly used drugs for treatment of post-herpetic neuralgia are as follows:
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