Neuropathic pain is a companion of many diseases in humans. The cause of its appearance may be damage to various parts of the nervous system. Such damage affects very different levels: from small nerves located deep in the tissues, to nerve trunks, plexuses and even individual parts of the spinal cord and brain. Since a person is pierced by nerves, their damage at any level and site can lead
If you have ever struck with an elbow, or a dentist “touched a nerve” with boron during dental treatment, you understand what neuropathic pain is. People with chronic neuropathic pain experience this feeling daily. At the first manifestations, patients describe this pain as uncomfortable sensations, burning sensation, shooting through
Causes of occurrence
Neuropathic pain can be caused by very different factors, including fractures, metabolic disorders, and nerve damage during surgery. Also, its cause may be a stroke, amputation of a limb, spinal cord injury.
Neuropathic pain occurs as a result of a violation of the structure and function of the nerve. And it is worth mentioning separately about nerve compression, for example, when a benign neoplasm puts pressure on the walls of adjacent organs and causes pain due to overstretching of walls.
Component or disease
Neuropathic can occur as an independent disease or accompany other diseases, for example, diabetes mellitus or coronary heart disease – then doctors talk about the neuropathic component.
Several types of pain can occur simultaneously. For example, neuropathic and nociceptive together. If a person broke his arm, events can develop in different scenarios. The first case, when a fracture occurs, and a stretching of muscles and ligaments occurs nearby – a person feels only typical nociceptive pain, which he describes as acute, aching and throbbing. Another case is when a nerve bundle is stretched during a fracture or a nerve breaks.
Even when the bone grows together and the person has no external reasons to worry, this damaged nerve may hurt. If the area of damage was large, most likely, the nerve will remain damaged forever, and the person will deal with chronic neuropathic pain.
Stages of pain
With damage to the nervous system, the pain develops rather slowly and gradually. A typical situation is the appearance of tunnel syndrome: nerves are compressed in narrow places by tendons, muscles or other structures located nearby. This can happen on the neck, arms, legs due to an uncomfortable posture, tight shoes or clothing. Tunnel syndromes often occur in office workers working in the same position at the computer.
Another situation is irritation of the nerve with a hernia of the intervertebral disc, to which aseptic inflammation is usually attached, edema. At this stage, the nerve is only irritated or slightly compressed, but these effects do not pass without a trace and can cause severe pain and discomfort.
With the progression of the disease, the second stage of neuropathic pain occurs . The nerve is compressed so that it ceases to fulfill its functions. In the zone of innervation of the squeezed nerve, numbness appears, a person’s surface sensitivity is impaired.
The third stage is the loss of deep sensitivity. Muscle weakness appears, muscles that are innervated by damaged nerves refuse to work. As a result, muscle atrophy occurs.
You may have heard the phrase “the leg is dry” or “the hand is dry” – this, in essence, is muscle atrophy.
When a doctor observes a deficiency of nerve function in a patient, he understands that emergency release of this nerve is necessary – decompression. The more time a person is left without treatment, the less likely they are to restore nerve functions after decompression. And even if the doctor perfectly performs the technical intervention, a person who has suffered this pain for a long time can stay with her for life if the nerve does not recover.
Nerve repair after damage
The nervous system is a very delicate, delicate and complex structure. Its imbalance is quite simple to cause, and self-healing of this structure occurs slowly, if at all. The regenerative abilities of the nervous system are severely limited, and any damage to the nerves is difficult to treat.
Most often, doctors are faced with a situation where a complete cure is impossible, and we are only talking about controlling the symptoms, in fact, adapting to neuropathic pain. In this case, the task is to ensure an acceptable quality of life for a person and relieve pain as much as possible so that a person can sleep, communicate, and lead a social life.
Damage to the nerve, as a rule, leads to its restructuring. Secondary changes occur around the site of damage, and then further and further affect the overlying parts of the nervous system. If in the early period you cannot cope with this pain in the immediate focus of damage, there is a very high risk that the changes will go higher and lead first to peripheral sensitization (a pathological process in the nervous tissue) and then to central sensitization with the formation of a certain level of excitation in central sensory neurons . Because of this, weak pain and non- pain stimuli begin to be perceived by the brain as severe pain.