Understanding Nerve Pain

Pain comes in many varieties; from the ache in your back after slouching all day, to the burning in your muscles after a hard work out, to pain in your head after a day spent squinting at your computer screen.

What is nerve pain? 

Another type of pain has a less obvious cause – nerve pain.

In many ways, nerve pain is one of the worst types of pain because it strikes right at the source of all sensation. Many people say that nerve pain is the most intense type of pain you can feel. In some instances, it’s possible to identify the exact cause of nerve pain e.g. pressure on the sciatic nerve. Other times, it has no obvious cause which doctors call idiopathic.

Your nervous system

Your nervous system comprises of your brain, spinal cord, and all the peripheral nerves that branch off it.

All nerves carry information in the form of electrical impulses. Motor nerves carry signals from your brain to your muscles and organs, telling them to carry out certain functions, such as moving your fingers or walking. Sensory nerves take information from receptors around your body to your brain, carrying information such as temperature and texture.

Nerves also transmit the sensation of pain. That’s good if you have just touched something really hot, because it will mean you move away from the source of heat and prevent potentially serious injury.

However, sometimes things go wrong and nerves send the pain signal even if there is no actual injury or obvious cause of pain.

Not all sources of nerve pain are unknown and can include:

• Nerve injury – for example, an impact that compresses, crushes, or even severs a nerve
• Nerve impingement – pressure on a nerve from a bony prominence or other tissue such as sciatica
• Cancer and tumors – unregulated tissue growth can press against a nerve, causing pain
• Diabetes – high levels of blood glucose can cause damage to nerves, especially in the legs. This is called diabetic neuropathy and is common in badly managed diabetics and a leading cause of amputations
• Vitamin/mineral deficiencies
• Immune system disorders
• Hormonal disorders
• Motor neuron disease
• Shingles – can cause a secondary medical condition called post-herpetic neuralgia which causes sudden onset nerve pain
• HIV – one-third of HIV suffers will experience nerve pain. Antiviral medication, used to treat HIV, can also exacerbate nerve pain
• Surgery – many operations involve operating near nerves, or even cutting through them. This can cause ongoing nerve problems including nerve pain

It’s also important to understand that, sometimes, there is no obvious cause to nerve pain; it just happens. This tends to be more common in older people but can happen at any age.

What does feel like?

Nerve pain symptoms vary from one person to another, and can even change from one day to next. In some cases, it results in hypersensitivity – where a small source of pain like a pin prick is amplified and becomes much more severe. Other time, something that doesn’t normally cause any pain becomes unbearable, such as the weight of a blanket resting on your legs.

The amount of pain can vary from day to day, and from person to person, and is most likely linked to the severity of the underlying cause. Nerve pain can be described in many different ways including stabbing, like an electric shock, shooting, throbbing, and burning.

As well as causing pain, damage and problems with the nerves can also cause:

• Numbness
• Tingling
• ‘Pins and needles”
• Loss of reflexes
• Muscle weakness
• Loss of muscle mass
• Partial or complete paralysis
• Insomnia
• Stress
• Depression
• Loss of bladder control
• Loss of balance and/or coordination

What to do if you experience nerve pain 

The first thing to do if you experience any kind of nerve pain i.e. pain with no obvious source or cause, is to go and see your doctor. While your pain might be something as simple as sciatic nerve pain, caused by a bulge in your lumbar vertebrae, it might also be something more serious.

I’m not a doctor and my advice is not meant to replace that of a doctor; if you suspect you have nerve pain, get it checked out by a medical professional.

To diagnose nerve pain, your doctor will usually perform a variety of assessments and tests. He may order MRI and CT scans and X-rays, and will also do things like movement tests, strength tests, and blood tests. He may also recommend a nerve biopsy. He’ll also look for areas of skin where you might have loss of sensation, that does not perspire normally, and that appears white or feel clammy.

What can be done?

If your doctor discovers an underlying cause to your nerve pain, you should follow his proposed course of treatment. This will involve dealing with the medical conditions that are responsible for the nerve pain e.g. diabetic neuropathy.

As well as treating any underlying causes, the nerve pain itself needs to be addressed. In most cases, the treatment for all types nerve pain is very similar and can include any of the following:

• Topical treatments – creams, lotions, gels, sprays, and patches to alleviate pain
• Anticonvulsants – this type of medication reduces some varieties of nerve pain
• Antidepressants –antidepressant medications have been shown to be helpful for reducing some types of nerve pain
• Pain killers
• Electrical stimulation – TENS (transcutaneous electrical nerve stimulation) machines pass a mild electrical current though nerves to block and alleviate pain without the use of medication
• Anti-inflammatory injections – to reduce swelling of any tissue pressing against the affected the nerve
• Massage
• Acupuncture
• Ice – reduces inflammation and blocks nerve pain
• Heat – increases circulation and eases muscle tension
• Physical therapy
• Lifestyle changes – losing weight, becoming more active, quitting smoking, eating more healthily, and learning to relax and reduce stress can all help reduce nerve pain
• Surgery – in a few cases, the source of nerve pain will be treated with nerve-blocking surgery

How can you heal it?  

Severe nerve damage, such as a severed nerve, can be irreparable. That’s why people who experience injuries such as a completely severed spinal cord suffer irreversible paralysis. However, less severe nerve damage can often heal, although that process may take a long time.

In contrast, nerve irritation and inflammation, as in sciatic nerve pain, can heal quite quickly – in a matter of weeks – once the source of irritation is removed i.e. adopting better posture so the impinging disk no longer presses on the sciatic nerve.

If you have been diagnosed with nerve pain, you should follow your doctor’s treatment plan. You should also do the following:

Eat healthily – foods that cause inflammation can make nerve pain worse. That includes alcohol, sugar, and processed foods. Eating a diet that is rich in vitamins, minerals, water, and healthy fats, and low in inflammatory foods can help reduce nerve pain.

For more information on healthy eating, especially cutting down on sugar, please see my article: 20 No Days Sugar Diet

Get active – although you may be limited by pain, it’s important to try and stay active. Moving works your muscles, and working your muscles exercises your nerves. Healthy muscles require and develop healthy nerves. Some nerve pain, specifically sciatica, is commonly attributed to inactivity and sitting for long periods of time.

Lose weight – being overweight puts more pressure on your muscles, bones, and joints, and can impact negatively on your nerves too. This is especially true for the nerves in your back and legs. 

Avoid repetitive movements – doing the same movements over and over can make nerve pain worse, and may even be the cause of your nerve pain. This is a common cause of a type of hand pain called carpal tunnel syndrome. If possible avoid repetitive movements or, if that is not possible, at least take regular breaks.

Avoid compressing nerves – too much pressure on nerves can cause nerve pain. For example, sitting on a narrow bicycle seat for a long time could affect the nerves in the pelvic region, leading to nerve pain in the groin and down the legs.

Different nerve pain symptoms

Nerve pain can affect any part of your body, but is most common in the hands, arms, legs, and back. As we all use these body parts all day, every day, it will be useful to discuss the common causes and symptoms of nerve pain in these areas.

Remember: I’m not trying to replace your doctor here, and if you experience any kind of nerve pain, you should go and see your doc right away. Don’t delay; do it today! But, by having an awareness of the causes and symptoms of nerve pain in various parts of your body, you should be able to recognize it more easily.

 

Nerve pain in the hand

Hand nerve pain can have many different causes, and some might surprise you. In some instances, hand pain starts way up in your neck. If a nerve in your neck becomes irritated, inflamed, or impinged, it can cause pain and weakness in your hand. Causes of this nerve pressure can include bone spurs, bulging disks in the neck, poor posture, and degenerative disk disease.

This condition causes a type of hand pain called cervical radiculopathy, and is characterized by a tingling, achy sensation that is said to be like falling asleep while lying on your arm. It may also feel like the hand is submerged in icy water.

The type and exact location of hand pain depend on where in the neck the nerve is affected, but can include:

• Pain on the thumb side of the hand and wrist and also the thumb itself
• Pain in the middle of the hand and wrist, and the index and middle fingers
• Pain on the small finger side of the hand and wrist, and the pinky and index fingers

Another common source of hand nerve pain is carpal tunnel syndrome. This is caused by the median nerve, that runs through the wrist and hand, becoming inflamed. This is often the result of repetitive movements of the hand and wrist such as typing, computer gaming, and weight lifting.

Carpal tunnel pain is typically felt on the thumb side of the hand and wrist, and may also be accompanied by pain and weakness further up the arm, including weakness in the biceps. Restriction of the wrist, as in waring your watch too tight, can also cause hand pain.

Nerve pain in the arm 

Like hand nerve pain, arm nerve pain can often originate in the neck. If the nerve that supplies the arm, the brachial nerve, is compressed, it will cause pain and weakness anywhere in the upper arm.

Common causes of upper arm pain include:

• Fracture of the humerus bone
• Movements that involve simultaneous gripping and swinging e.g. using a sledgehammer or
• Playing a lot of tennis or golf,
• Getting hit in the shoulder,
• Shoulder dislocation
• Neck injury
• Upper back injury.

Problems with the radial nerve can cause pain in the lower arm and also the hand. You have probably experienced a mild radial nerve injury if you have ever banged your “funny bone” and experienced pain not only in your elbow, but up and down your lower arm to your fingertips. The radial nerve is very close to the surface of your skin where it passes over your elbow, properly called the head of your humerus.

Causes of lower arm nerve pain include:

• Fracture of your ulna or radius arm bones
• Sleeping with your arm in an awkward position
• Impact to your lower arm or elbow
• Restriction of the wrist, as in too-tight jewelry

Nerve pain in the back

Nerve pain in the back is most commonly sciatica. This happens when the lumbar intervertebral disks bulge outward and irritate the sciatic nerve which runs down your lower back, buttocks and legs. This can cause a lot of back pain, but may also cause pain anywhere along the length of the sciatic nerve.

The most common cause of sciatic nerve pain is too much sitting and poor posture. When you sit and have poor posture, your lumbar intervertebral disks bulge outward and press against the sciatic nerve, which originates near the base of your spine at what is called the sacral plexus. This causes irritation, inflammation, and pain, which can stay in your back or may go all the way down to your feet.

Sciatic nerve pain can cause a dull ache, sharp shooting pain, throbbing, tingling, and/or weakness. It can be very debilitating. The best way to deal with sciatic nerve pain is to avoid it in the first place by sitting less, moving more, and adopting better posture. It may also require medical treatment.

You can read more about sciatic nerve pain in my articles Sciatica pain relief and What is the sciatic nerve.

Nerve pain in the leg

Nerve pain in the leg is often the result of problems with the sciatic nerve as it runs down from the lower back, through the pelvis, and then on down through the buttocks, thighs, and into your feet. Sciatic nerve pain is discussed at length in my articles Sciatica pain relief and What is the sciatic nerve.

Other causes of leg pain include:

• Impact to the side of the thigh – the so-called “dead leg” which is a common injury in contact sport
• Lumbar radiculopathy, which is similar to cervical radiculopathy that affects the hand
• Lumber degenerative disease.
• Spinal stenosis which is the narrowing of the space inside the vertebrae which puts pressure on the spinal cord.

Because leg nerve pain if often caused by problems of the spine, you should never ignore leg pain or weakness, and should get it checked out by your doctor as a matter of urgency.

Image credit: GuidelinesHealth.com.