What Are the Different Treatments for Chronic Nerve Pain?

Neuralgia is one of the common symptoms in neurology. This kind of pain refers to the pain that is felt without external stimuli. It is also called spontaneous pain. There are many types of spontaneous pain. According to the site of the disease, it can be divided into peripheral neuropathic pain and central neuropathic pain. Those with unknown etiology are called primary neuralgia, and those with clear etiology are called secondary (or symptomatic) neuralgia. The lesion can be in the nerve root, plexus or nerve trunk. Often named after the peripheral nerve involved in the lesion. Local pain caused by other local lesions stimulating peripheral receptors and physical pain caused by pathological changes in the sensory pathway of the central nervous system are generally not in the category of neuralgia.

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Clinical symptoms of neuralgia

Neuralgia symptoms

Neuralgia and neuropathy after extremity injury, pain, hyperalgesia, and hypersensitivity after extremity injury; initial pain is limited to the trauma site or the distribution area of injured nerve, and then it can be extended to the entire limb; in addition to pain, there may be Vasomotor dysfunction (beginning with vasodilation, the skin becomes warm and dry, and later it becomes vasoconstricted. Skin edema, cyanosis, and coldness) and excessive or insufficient sweating, nutritional changes in the skin, subcutaneous tissues, and muscles, and bone quality Looseness should go to the hospital for treatment, which may be radiation sympathetic malnutrition.

Nervous pain

Neuralgia in the face, throat, and occipital area

Neuralgia in the shoulder or upper limbs

Neuralgia in the chest

Neuralgia in lower legs or lower limbs

Common causes of neuralgia

They are described in two major aspects:

Peripheral neuralgia

1. Trigeminal neuralgia: It is common in inflammatory infiltration, atherosclerotic compression, and cerebellopontine angle tumors, nasopharyngeal carcinoma, trigeminal ganglion tumors, chordoma, and multiple sclerosis.

2, sphenopalatine ganglion pain, pterygoid neuralgia, knee ganglion pain: seen in parasinusitis, sphenoid sinusitis, ethmoid sinusitis, structural deformation of the nasal cavity, bending of the nasal septum due to mechanical compression of the turbinate, skull base fracture, metastasis Cancer, shingles diagnosis of viral infections.

3. Occipital neuralgia: common in neuritis, upper respiratory tract infection, influenza, malaria, rheumatism, diabetes, thyroid disease, alcohol, lead poisoning, occipital, neck trauma, cervical spondylosis, rheumatoid spondylitis Or metastatic cancer, cranial base indentation, occipital foramen stenosis, atlantooccipital fusion, atlantoaxial dislocation, upper cervical vertebral insufficiency, subcranial tonsil hernia, spinal tumor, occipital foramen tumor, adhesive spinal cobweb Meningitis, syringomyelia, suboccipital joint ligament damage, atlanto-anteroposterior arch fracture, atlantoaxial subluxation, cervical muscle damage, etc.

4. Intercostal neuralgia: common in infectious and toxic radiculitis, pleurisy, chronic pneumonia, aortic aneurysm, mitral valve stenosis, thoracic organ disease, thoracic spinal tuberculosis, tumor, ankylosing spondylitis, myeloma, spinal cord Spinal diseases such as inflammation, rib tumors, rib fractures, epiphysis, shingles.

5. Neck, shoulder and arm neuralgia, brachial plexus neuritis: common in cervical osteoarthropathy, neck mass, tumor, shingles, influenza, typhoid fever and malaria infection, cold, vaccination with xenogeneic serum vaccine.

6. Ulnar neuralgia, median neuralgia, and lateral femoral cutaneous neuralgia are found in neuritis, trauma, local inflammation and compression lesions.

7, femoral neuralgia and sciatica: found in nerve root diseases such as tumor compression, lumbar disc herniation, tumors, inflammation and other diseases.

8. Coccygeal pain: seen in trauma and fracture.

9, burning neuralgia: seen in trauma such as knife cuts, crush injuries, severe injuries, especially firearm injuries, chemical injuries, infections and so on.

10. Shingles: The cause is caused by the chickenpox-zoster virus. .

Central pain

1. Spinal pain:

(1) Posterior horn pain is more common in trauma, tumors, and syringomyelia.

(2) Posterior spinal cord pain is seen in multiple sclerosis and spinal cord ridges.

(3) Spinal thalamus is more common in syringomyelia.

2. Thalamic pain: Thalamic pain is more common in cerebrovascular diseases and tumors.

3, pontine, bulbar pain: seen in cerebrovascular disease, tumors, multiple sclerosis and so on.

4. Cerebral cortical pain: Cerebral cortical pain is rare, usually tumors, vascular diseases and so on.

Differential diagnosis of neuralgia

It should be differentiated from the following symptoms:

1. Occipital great neuralgia refers to paroxysmal or persistent pain in the area of the greater occipital nerve (postoccipital). It can also be exacerbated on the basis of persistent pain. The clinical manifestations are acupuncture, knife-cutting, or burning-like pain in one or both of the posterior occipital regions or the nape. The patient is afraid to turn his head when the pain occurs, and the head and neck are sometimes in a straight state. On examination, tenderness was found at the exit of the great nerve, and the area of the greater occipital nerve (C2-3), which was below the ear tip line to the hairline, was hyperalgesic or diminished.

2. Postherpetic neuralgia is a neuropathic pain syndrome that appears after infection with acute shingles. Most patients with shingles can recover after treatment, but some patients experience pain in the damaged skin area after the herpes heals for more than 3 months, which is called postherpetic neuralgia.

3. Sciatica refers to the sciatic neuropathy, which is a group of pain symptoms that occur along the sciatic nerve pathway, that is, waist, hip, posterior thigh, posterolateral calf, and lateral foot. The sciatic nerve is the main neural trunk that innervates the lower limbs. Sciatica refers to the pain in the sciatic nerve pathway and its distribution area (hip, back of thigh, back of calf, and outside of foot).

4. Intercostal neuralgia refers to recurring pain that occurs in one or several intercostal areas, and is exacerbated. Primary intercostal neuralgia is rare, and secondary ones are related to viral infection, toxin stimulation, mechanical damage and foreign body compression. Its pain properties are mostly tingling or burning, and are distributed along the intercostal nerves. When intercostal neuralgia occurs, the pain can be seen from back to front, and the radiation is semicircular along the corresponding intercostal space; the pain is tingling or burning. Increased pain when coughing, breathing deeply, or sneezing. The pain is more common on one nerve on one side.

5. Syncope caused by glossopharyngeal neuralgia or other visceral diseases: This type of syncope is rare. Glossopharyngeal neuralgia, biliary colic, renal colic, transient syncope during bronchial or digestive endoscopy. It is related to severe pain and hyperreflexive reactions of visceral receptors.

Common neuralgia

Some people, when washing their face, brushing their teeth, or eating, suddenly feel a severe flash of pain on one side of their face, which lasts for a few seconds and is unbearable. Some people induce one-sided or bilateral neck pain when swallowing, talking, or turning the neck, which can be relieved for several days or weeks, and the pain can also be radiated backward from the pharynx. Both of the above conditions are pain due to peripheral neuropathy, also called neuralgia. Sciatica, trigeminal neuralgia, and intercostal neuralgia are included in the scope of neuralgia.

Neuralgia is one of the common neurological symptoms. It is pain caused by peripheral neuropathy and radiating to the innervation range. The lesion can be in the nerve root, plexus or nerve trunk. Some neuralgia can provoke or aggravate pain with coughing, sneezing, and exertion. It can even aggravate pain by continuing a certain posture or position. Sometimes, it can cause spinal spinal cord disease caused by spinal structural disease (such as disc herniation). Restricted activity or increased pain during exercise. Common neuralgia is trigeminal neuralgia, sciatica, and intercostal neuralgia.

Sciatica is the largest peripheral nerve in the human body. It starts at the spinal cord of the lumbosacral region, passes through the pelvis, exits through the foramen foramen, reaches the hips, and then runs down the back of the thighs to the feet. Sciatica, the onset of pain can be radioactive pain along the hip, the back of the femur, the outside of the calf, and the back of the foot, and is accompanied by varying degrees of sensory impairment, lower limb muscle strength, reduced or disappeared Achilles tendon reflexes, Reduce the movement of the waist and affected limbs or tap the ring jump (the height of the greater trochanter of the femur to the junction of the outer 1/3 and the inner 2/3 of the coccyx) during the lateral flexion. Sciatica is a common disease. The most common is lumbar disc herniation. Others include spinal tuberculosis, arachnoiditis, and intravertebral metastatic cancer. In addition, sacroiliac arthritis and tumor compression in the pelvic cavity can also cause sciatica. Sciatica is pain that occurs in the areas where the sciatic nerve passes (ie, waist, hips, back of thighs, outside of calf, and feet). Pain intensifies when the sciatic nerve is stretched, so the patient's affected lower limb is often flexed to reduce pain. Sciatica can be treated with B vitamins, traditional Chinese medicines for relaxing muscles and promoting blood circulation, as well as acupuncture and physiotherapy, but the basic approach is to treat the primary disease that causes sciatica.

Trigeminal neuralgia

Trigeminal neuralgia, which is more common in the second branch, is mostly 40 to 50 years old. The patient developed sudden flashes of pain on one side of the face, ranging from a few seconds to a dozen seconds. The self-reporting, burning-like pain was unbearable. Frequent rubbing of the side of the pain at the time of the attack to reduce pain. Because of frequent rubbing, the facial skin becomes rough, and sometimes eyebrows may fall off. The onset time is intermittent, the length of the interval varies, and the milder can occur once every few days or weeks, with a longer interval. Pain can be caused by actions such as washing the face, brushing teeth, eating, etc. Treatment generally uses vitamins to intramuscularly trophic nerves, or surgically cut off nerves and so on.

Intercostal neuralgia

Intercostal neuralgia can be caused by rib fractures, thoracic metastatic cancer, shingles, etc. Caused by shingles, skin damage in this pain area can be seen, there are clusters of cluster rashes, the skin between the rashes is normal, and in severe cases may have exudation or redness. Therefore, in the treatment of intercostal neuralgia, the primary focus should be treated, and then the pain can be treated to reduce local symptoms.

Clinical treatment of neuralgia

There are many treatments for neuralgia, which can be roughly divided into non-invasive and invasive treatments. Non-invasive treatment methods include drug therapy, traditional Chinese medicine, acupuncture, and physical therapy. It is suitable for patients with short course and mild pain. It can also be used as a supplement to invasive treatments. Invasive therapies include surgery, injection therapy, and radiofrequency thermocoagulation.

Acupuncture therapy is still very effective in treating neuralgia. If the pain is severe, usually 5 to 10 acupuncture treatments may be effective.

Neuralgia family treatment

Active prevention

Learning how to sit, stand, and carry things correctly is the best way to prevent all kinds of neuralgia. A few different physical therapies can know how to act properly to prevent pain, and you can discuss the treatment with a trained therapist.

Massage with ice pack

Massage with ice packs can interrupt the signal transmission along the neural pathway and be replaced by the temperature signal, which can relieve pain.

Beard

For men with trigeminal neuralgia, beards can be used to shield their faces from the cold, and cold can sometimes cause pain.

Shiatsu massage

Pressing the large intestine meridian acupoint located between the thumb and index finger webs can alleviate facial pain. Use the thumb or index finger of the right hand to press the acupoint of the left hand for 1 minute, and then press the right hand again. If you are pregnant, do not use this point.

To alleviate pain in the upper chest and abdomen, you can press the pericardial meridian to acupoint, place your thumb between the middle of the wrist and the upper limbs and bones about 2 fingers wide from the wrist, and press firmly for 3 to 5 times for 1 minute, and then repeat the other side. Pressing the Waiguan acupoint can help alleviate pain in the upper body. Place your thumb at the middle of the upper extremity of the thumb 2 wide from the wrist joint, press for 1 minute, and then repeatedly press the other side, each time 2-3 times.

Neuralgia Nutrition and Diet Therapy

Drink more water and eat more fruits and vegetables

Patients should take more water and avoid irritants such as coffee, soft drinks, cigarettes. Eat more fruits, vegetables, stone fruits, seeds, cereals and other beneficial foods.

Eat more oats

Regular consumption of oatmeal improves the general condition of the nerves. The chopped oat grass is brewed in warm water for 2 minutes and filtered. It is a tonic. Drink 1-4 grams a day. To reduce itching on the skin, wrap oatmeal in a fine cotton cloth under the sprinkler. Water bath.

Preventive measures for neuralgia

Neuralgia mostly occurs when the nerve is stimulated or inflamed. The pain is distributed along the nerve. It can be fleeting or chronic. It manifests in a variety of forms. Symptoms include pain, tingling, tactile allergy, or loss of sensation in the affected area. Redness, swelling, and severe convulsions. The causes of neuritis vary, including lack of nutrients (vitamin B), metabolic disorders, direct impact or fracture by external forces, blood vessels, bones or connective tissues compressing nerves, nerve infections, diabetes, gout, blood cancer, etc., taking methanol, excessive Toxic metals such as lead and mercury can also cause nerve damage. The more common neuralgias are trigeminal neuralgia (mostly in older people over 50 years old), sciatica, and stinging caused by shingles. When the optic nerve in the eye becomes inflamed, it will gradually or suddenly blur the vision. In severe cases, temporary blindness may occur after a few days, and eye pain may also occur. Home treatment can be taken.

Specific manifestations of trigeminal neuralgia

(1) There are often no warning signs before the onset of pain, which is a sudden, lightning-like, short-term and severe pain. Patients are often described as severe bouncing pain like electrocautery, acupuncture, knife-cut, or tear-like. Patients often use the palm or towel to press the affected side or rub the face hard to reduce pain. Sometimes the chewing action is constantly performed during severe episodes. In severe cases, it is often accompanied by reflexive twitching of the facial muscles, and the corner of the mouth is pulled to the side, also known as "painful twitching". Sometimes it is accompanied by facial redness, increased skin temperature, conjunctival hyperemia, Symptoms such as tearing, increased saliva secretion, nasal congestion, and runny nose, and some patients even roll on the bed.

(2) The duration of each episode can suddenly stop after a few seconds to several minutes. A few people may still have a burning sensation during the interval, such as normal people. Generally, the seizures are mild or stopped at night, but in severe cases, frequent seizures can occur overnight. Woke up after pain.

(3) Most of them gradually worsen, and the number of pain episodes becomes more frequent, even once every few minutes so that it persists throughout the day.

(4) The course of the disease can be periodic. Each episode can last for weeks or months, and the remission period can be indefinite for several days or years. The onset cycle seems to be related to the climate, and spring and winter are more susceptible.

Patients with trigeminal neuralgia are very important to self-regulate. Daily attention should be paid to the following issues:

(1) Life and diet should be regular to ensure adequate sleep and rest to avoid overwork.

(2) Keep your mood comfortable, and avoid impulse, anger and depression. Build confidence in treating diseases and actively cooperate with doctors.

(3) Appropriate participation in physical exercise, physical exercise, and physical fitness.

(4) Slowly, avoid all factors that cause pain, such as washing your face and brushing your teeth, and avoid stimulating the trigger point. Keep warm on cold days and avoid cold wind directly irritating your face.

(5) Patients who eat soft foods and those who suffer from chewing should eat liquid foods. Never eat fried foods, irritating foods, seafood products and hot foods.

(6) Insist on treatment, do not stop the medicine at will, in order to cure.