Nerve pain (neuralgia)

Nerve pain is also called neuralgia or neuropathic pain. It occurs when there is damage to your nerves, due to disease or injury.

Nerve pain can feel different from other kinds of pain. It can be acute (short-term) or chronic (ongoing) pain.

Some examples of nerve pain are:

• post-herpetic neuralgia — which is ongoing pain after you've had shingles (herpes zoster)
• peripheral neuropathy — pain due to damage to your peripheral nerves (nerves that that connect your brain and spinal cord to the rest of your body), which can be caused by diabetes, autoimmune diseases and other conditions
• trigeminal neuralgia — which causes severe, short episodes of pain in your jaw or cheek

Nerve pain has been described as feeling like:

• shooting or stabbing pain
• a burning sensation
• an electric shock
• pins and needles
• tingling

You may also become more or less sensitive to touch or temperature. You may experience pain from touch that would not normally be painful, such as something lightly brushing your skin.

Nerve pain is often worse at night. It can be mild or severe.

Nerve pain is usually caused by an injury or disease that affects your nervous system.

Nerve pain may be due to:

• an injury to your nerves or pressure on your nerves
• poor blood supply to your nerves
• heavy alcohol use
• phantom limb pain after an amputation
• vitamin B12 or thiamine (vitamin B1) deficiency
• some medicines

Conditions that can cause nerve pain include:

• infections, such as shingles and HIV/AIDS
• multiple sclerosis
• diabetes
• stroke
• cancer and its treatment with radiation, surgery or chemotherapy
• carpal tunnel syndrome
• sciatica

Your doctor will ask about your symptoms and examine you. They will want to know about your general health and any medicines or other treatments you are taking.

When they examine you, they will test your nerves by checking your:

• muscle strength and coordination
• reflexes
• sensitivity to touch, pain and temperature

Your doctor may also refer you for tests including:

• blood tests to look for underlying conditions
• nerve conduction studies, which measure how quickly your nerves carry electrical signals
• a CT scan or an MRI scan to look for a cause of your pain

Your doctor may refer you to a specialist doctor or another healthcare professional for further assessment and treatment.

Nerve pain can be difficult to treat. The first step is to try to find and treat the underlying cause.

The aim of treatment is to relieve or improve your pain and improve your quality of life. Your doctor may recommend several different treatments, including:

• lifestyle measures
• medicines
• other treatments

It may take time to find the strategies that work for you. If you have chronic (ongoing) pain, you may find it helpful to attend a multidisciplinary pain clinic. This is where health professionals can prepare a personalised pain management plan for you. Your doctor can refer you to a pain clinic.

You can find a list of pain services on the Pain Australia website.

Lifestyle measures

A healthy lifestyle can improve your quality of life and general feeling of wellbeing.

• Try to eat a balanced diet and exercise regularly.
• Stay as fit and active as possible, to keep your flexibility.
• Plan daily tasks in small steps rather than trying to do them all at once (pacing).

If pain is disturbing your sleep, ask your doctor about things that may help.

Medicines for nerve pain

Nerve pain is different from other types of pain. Pain-relief medicines may not fully work.

Prescription medicines that may be helpful for nerve pain can include:

• some antidepressant medicines
• some medicines that are used to treat epilepsy or seizures

Different people respond to medicines in different ways. Your doctor will talk with you about the benefits and risks of different treatments, including side effects.

Other treatments

There are other treatments that can be helpful in treating nerve pain.

• Educating yourself about nerve pain and how to manage it.
• Relaxation techniques to help with your pain and with sleeping.
• Psychological treatments, such as cognitive behavioural therapy (CBT).
• Yoga and meditation.

Occasionally, surgery may be recommended for specific types of nerve pain. In most cases, it's not helpful.

Ongoing pain that is not properly treated can affect many parts of your life, including:

• sleep
• work
• exercise
• relationships
• social interactions
• sex

Nerve pain can also affect your mood, and may lead to anxiety or depression.

It may be possible to prevent or reduce your chance of getting some types of nerve pain. For example, by:

• getting vaccinated against shingles and getting early treatment for shingles to prevent post-herpetic neuralgia
• controlling your blood sugar levels to help prevent peripheral neuropathy related to diabetes

Visit Pain Australia for information on pain or support groups.

Chronic Pain Australia has information on chronic (ongoing) pain and support services.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.