Neuralgia

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Latest Edit: Hector 2014-05-15 (EDT)

Neuralgia, or nerve pain, is a common symptom that results in sharp shooting pain and heightened sensitivity to painful and non painful stimuli along the path of an irritated or damaged nerve.

Neuralgia
Neuralgia.jpg

Neuralgia
Causes Posture, Injuries, Infections, Occupational Factors
See Also Neurological Conditions, Musculoskeletal Conditions, Carpal Tunnel Syndrome, Tendonitis, Sciatica, Multiple Sclerosis
Books Books on Neurological Conditions
Articles Articles on Neurological Conditions

Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. There are many factors, especially those that relate to posture and alignment and environmental factors, that contribute to the onset of neuralgia. A detailed assessment is required to determine which factors are contributing to neuralgia.

Lifestyle

  • Decreased consumption of fruits and vegetables have been shown to increase the risk of neuralgia in conditions such as herpes zoster (shingles).[1]
  • Poor posture whether standing, sitting, sleeping or walking is a common cause of nerve impingement and neuralgia.
  • Good quality sleep is associated with decreased neuralgia discomfort and better quality of life.[2]
  • Neuralgia pain often disrupts sleep, which in turn can worsen the problem and the prognosis.

Social

  • Increased stress can increase susceptibility to the development of shingles - a leading cause of neuralgia.

External

  • Occupation
  • There are many occupational factors that increase the risk of neuralgia. They include:
  • repetitive tasks that involve limited movement, such as data-entry or holding a tool in position for a long period of time.
  • sitting for long periods of time, such as with computer work or truck drivers.
  • painting or other activities that require the arms to be over the head for long periods of time.
  • activities that must be performed in a confined space.
  • activities that involve lifting heavy objects, especially when rotation of the body is involved and when done improperly.
  • Trauma
  • Accidents, falls and injuries that impinge a nerve can cause neuralgia.
  • Sleeping with the arms above the head can result in neuralgia symptoms down the arm.

Environmental

  • The most common infection associated with neuralgia is herpes zoster which causes shingles and often results in postherpetic neuralgia.
  • Other common infections that can result in neuralgia include HIV, Lyme disease, and syphilis.
  • Underlying sinus infection may cause trigeminal neuralgia.[3]
  • The connection between infections and neuralgia is becoming more apparent. It is important to identify and address any underlying infection, especially when neuralgia symptoms do not resolve with normal treatment.

Medical Interventions

  • Pharmaceutical Medications
  • Exposure to chemotherapeutic agents including cisplatin, paclitaxel, vincristine, and to isoniazid, metronidazole may contribute to the development of neuralgia. [4]

Common Questions

  • When did the pain start?
  • Did the pain come on suddenly or gradually?
  • What underlying health issues, such as diabetes do you have?
  • What were you doing prior to the onset of pain or numbness?
  • Any recent injuries, falls or accidents?

Diagnostic Testing

Neuralgia.jpg

The diagnosis includes a thorough history taking and physical examination with an emphasis on musculoskeletal range of motion and overall function.

The following diagnostic tests may also be required:[4]

  • Imaging tests such as: MRI (brain, spinal cord, nerve roots, lumbar spine), nerve conduction study with electromyography, rectal or abdominal fat biopsy, spinal tap (lumbar puncture).

Related Symptoms and Conditions

There are a number of medical conditions that have neuralgia as a symptoms, including:[4]

  • Herpes Zoster or Shingles (postherpetic neuralgia)
  • Trigeminal Neuralgia
  • HIV
  • Diabetes
  • Chronic renal insufficiency
  • Fabry disease
  • Sjorgen's syndomre
  • Polyarteritis nodosa
  • Multiple Sclerosis
  • Amyloidosis

Characteristics

Neuralgia is characterized by heightened sensitivity to nonpainful and nonpainful stimuli. Patients report:[4]

  • Increased sensitivity of the skin along the path of the damaged nerve, so that any touch or pressure is felt as pain
  • Numbness along the path of the nerve
  • Sharp, stabbing pain
  • The pain may come and go or be constant and burning
  • Movement may aggravate the pain or numbness
  • Weakness or lack of movement of muscles supplied by the affected nerve

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Lifestyle

Lifestyle recommendations include:

  • Exercises especially those that involve stretching and working the joints through their full range of motion are recommended. It is best to have a naturopathic doctor or other trained professional provide you with an exercise regimen that is specific to you.
  • Mindfulness meditation may decrease pain quality and increase symptom related quality of life in individuals with neuralgia associated with diabetic peripheral neuropathy.[6]

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for neuralgia include:

  • Acupuncture is a very effective treatment for neuralgia.[9]
  • Acupuncture is beneficial in treating severe pain associated with herpes zoster (shingles).[10]
  • Local hydrotherapy at the point of pain can alleviate symptoms and speed healing time.
  • Transcutaneous Electrical Nerve Stimulation (TENS) is a safe, non-invasivebe, effective treatment for different types of neuralgia including trigeminal neuralgia.[1], [11]
  • Physical therapies that address musculoskeletal issues aggravating neuralgia are beneficial including manipulation, massage and ultrasound.

Specialized Naturopathic Therapies

Specialized therapies that are used to treat neuralgia include:

References

Reviewed by Iva Lloyd, BScH, RPE, ND [1]

  1. 1.0 1.1 1.2 1.3 Roxas M (2006) Herpes Zoster and Postherpetic Neuralgia: Diagnosis and Therapeutic Considerations. Alt Med Rev;11(2)102-13.
  2. Perez-Lloret S, Rojas GM, Menoni MC, Ruiz G, Velásquez C et al. (Jan-Feb 2012) Pregabalin beneficial effects on sleep quality or health-related quality of life are poorly correlated with reduction on pain intensity after an 8-week treatment course. Clin Neuropharmacol.;35(1):21-4. PMID: 22156921.
  3. Maschio M, Mengarelli A, Girmenia C, Vidiri A, Kayal R, Gallo MT, Prignano G, Dessanti ML, D'Andrea M, Petti MC (Oct 2011) Trigeminal neuralgia as unusual isolated symptom of fungal paranasal sinusitis in patients with haematological malignancies. Neurol Sci PMID: 21979557.
  4. 4.0 4.1 4.2 4.3 4.4 Ferri (2012) Ferri's Clinical Advisor 1st ed Neuropathic Pain Mosby
  5. McCarberg B (Dec 2003) Managing the comorbidities of postherpetic neuralgia. J Am Acad Nurse Pract.;15(12 Suppl):16-21; PMID: 15055385.
  6. Teixeira E. (Sept 2010) The effect of mindfulness meditation on painful diabetic peripheral neuropathy in adults older than 50 years. Holist Nurs Prac;;24(5):277-83.
  7. Hershoff Asa (2000) Homeopathic Remedies, A Quick and Easy Guide to Common Disorders and their Homeopathic Treatments, Avery Publishing Group, New York
  8. Ullman Robert, Reichenberg-Ullman Judyth (1997) Homeopathic Self-Care, the quick and easy guide for the whole family. Prima Publishing
  9. Pan C, Tan G (Sept 2008) Forty-two cases of greater occipital neuralgia treated by acupuncture plus acupoint-injection. J Tradit Chin Med.;28(3):175-7. PMID: 19004197.
  10. Ursini T, Tontodonati M, Manzoli L, Polilli E et al. (Jun 2011) Acupuncture for the treatment of severe acute pain in herpes zoster: results of a nested, open-label, randomized trial in the VZV Pain Study. BMC Complement Altern Med.;11:46. PMID: 21639941.
  11. Singla S, Prabhakar V, Singla RK (Jul 2011) Role of transcutaneous electric nerve stimulation in the management of trigeminal neuralgia. J Neurosci Rural Pract.;2(2):150-2. PMID: 21897677