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Neuropathic Pain: Treatment, Procedure, Cost and Side Effects

Last Updated: Apr 25, 2024

What is the treatment?

Neuropathic pain occurs when the nerves are unable to transmit sensation to the brains. It is often a result of an injury or disease. It is a very common symptom but only few people go on to experience pain that is called neuropathic pain. There are lots of ways to treat neuropathic pain, the most common of them are anticonvulsants and tricyclic anti depressants such as Amitriptyline, Nortriptyline and Desipramine. There are also other prescribed anti depressants which are very effective for some people such as Venlafaxine and bupropion. There are also selective Serotonin reuptake inhibators (SSRI) like Paroxetine and Citalopram that is also used by many medical practitioners. Some doctors prefer pain killers as well in treating neuropathic pain especially the non-steroidal anti-inflammatory drugs (NSAID) such as Aleve or Motrin. In very extreme cases which are difficult to treat with drugs, pain specialist may also use an implantable device to manage the pain. Another very common drug in treating neuropathic pain is anti-seizure medicines such as Carbamazepine, Phenytoin, Gabapentin and Lamotrigine. There are also medicines for topical application but are given only to those who have minor pains. Lidocaine and Capsaicin are the most common topical application medicines.

How is the treatment done?

The greatest challenge that the doctors go through in treating neuropathic pain is to diagnose and detect the underlying cause. The treatment of neuropathic pain is done mostly by pharmaceutical drugs. Anticonsulvants and tricylic anti depressants are the most common form of drugs used by doctors. In minor cases of neuropathic pain, certain medicines are given for topical application either in gel or patch forms. Certain injections are also available in the market to treat neuropathic pain such as Steroid injections and Opinoid injections. In some cases local anesthetics is also used. Nerve blocks are the last resort for treating neuropathic pain. In this procedure, medicine is injected to the affected part of the body which disrupts the pain signal. In very extreme cases of neuropathic pain, there are other surgical mode such as neurolytic blocks using cryzogenic freezing, radio frequency ablation, surgical nerve block and radio surgery.

Who is eligible for the treatment? (When is the treatment done?)

All person who is diagnosed with neuropathic or even show the symptoms can go for a checkup and treatment. There can be very minute symptoms which can be hard to detect initially. Tingling and numbness are also related with neuropathic pain which is ignored by most people. It is better to go for a medical and nerve checkup in order to get a proper diagnosis and treat neuropathic pain.

Who is not eligible for the treatment?

If a person experiences pain due to certain injury, then it is not neuropathic pain. However, if that pain continues for a long period or becomes chronic then you need a checkup.

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Are there any side effects?

The side effects of neuropathic pain treatment vary greatly depending on the mode of treatment. Like any other drugs and its side effects, the drugs used in treating neuropathic pain also has some side effects such as constipation, dizziness, blurred vision and stomach upset. The side effects of nerve block can be identified as elevated blood sugars, weight gain, and soreness at the site of injection, rash and itching. Steroid and opinoid injections may increase your body temperature, blood sugar, anxiety and sleeplessness. Respiratory depression, nausea and somnolence are some side effects related to surgical and anesthetics treatment of neuropathic pain.

What are the post-treatment guidelines?

One of the most important post treatment guidelines is to take proper and complete rest in order to recover from the pain and also to prevent the pain from becoming chronic. Exercising can be a part of the post-treatment guidelines or sometimes be a continuation of the treatment. Checking the blood sugar level daily is also prescribed and finally changing your eating habits can prove to be beneficial as well. Vitamin B12, anti-oxidants and anti-inflammatory foods are very effective in nerve building. Increasing the amount of water that a person consumes daily also helps in quick recovery.

How long does it take to recover?

Neuropathic pain treatment is a slow and gradual process even if you are opting for surgical nerve blocks. The reason for that is nerve takes a very long time in healing completely. As it is very delicate and complex at the same time, treatment of neuropathic pain can last quite long. On an average, minor neuropathic pain may take at least 3 to 6 months for proper healing. Severe neuropathic pain requires a lot more time especially if it is chronic, it can take a lifetime to recover.

What is the price of the treatment in India?

The price of treatment 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 INR 5000 up to INR 20000. However, for surgeries and other advance mode of treatment, the total cost may fall between 6 lacs to 15 lacs depending on the hospital and your city.

Are the results of the treatment permanent?

Neuropathy is a very delicate and complex study as it deals with nerves and so are the problems and treatments related to it. There is always a chance of neuropathic pain becoming chronic. So the results are not permanent in many cases. Proper diagnosis and treatment of the cause of origin may have permanent result.

What are the alternatives to the treatment?

Treating neuropathic pain is an ancient thing so there are lots of natural remedies and alternative for treating neuropathic pain. Turmeric is very much effective in treating nerve pain. Green juices which include vegetable such as cucumber, parsley, spinach, and broccoli heal nerve pain. Ginger and some wild herbs such as wild lettuce and vervain are also used in some parts. Other important natural intake should include water, Vitamin B6 and B12, anti oxidants and anti inflammatory rich foods. Apart from these natural remedies, acupuncture and yoga has proven to be very effective against neuropathic pain.

References

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Written ByDr. Arun Sharma MBBS,MS - General Surgery,MCh - Neuro SurgeryNeurology
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