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 Neuropathic Pain: Signs, Causes, Treatment, and More Everyday Health MenuNewslettersSearch Neuropathy <h1>What Neuropathic Pain Feels Like and the Main Causes of This Neuropathy Symptom</h1> By Sheryl Huggins SalomonMedically Reviewed by Samuel Mackenzie, MD, PhDReviewed: May 10, 2018Medically ReviewedNeuropathic pain is caused by damage to nerves that share information between the brain and the body. AlamyNeuropathic pain can develop when the nerves of the somatic (voluntary) nervous system become damaged and transmit sensory signals to the central nervous system in an altered and disordered fashion. This kind of pain is estimated to affect 7 to 10 percent of the general population worldwide.
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 Neuropathic Pain: Signs, Causes, Treatment, and More Everyday Health MenuNewslettersSearch Neuropathy

What Neuropathic Pain Feels Like and the Main Causes of This Neuropathy Symptom

By Sheryl Huggins SalomonMedically Reviewed by Samuel Mackenzie, MD, PhDReviewed: May 10, 2018Medically ReviewedNeuropathic pain is caused by damage to nerves that share information between the brain and the body. AlamyNeuropathic pain can develop when the nerves of the somatic (voluntary) nervous system become damaged and transmit sensory signals to the central nervous system in an altered and disordered fashion. This kind of pain is estimated to affect 7 to 10 percent of the general population worldwide.
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(1,2) <h2>What Are the Symptoms of Neuropathic Pain Exactly </h2> Often when we think of pain it is the nociceptive kind, the acute pain that comes with injury or tissue damage caused by a specific event. Neuropathic pain, on the other hand, tends to be chronic and less sharp. “The character and quality of neuropathic pain tends to be pain that’s burning or electric in character,” says Vernon Williams, MD, a sports neurologist and the director of the Center for Sports Neurology and Pain Medicine at Cedars-Sini Kerlan-Jobe Institute in Los Angeles.
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What Are the Symptoms of Neuropathic Pain Exactly

Often when we think of pain it is the nociceptive kind, the acute pain that comes with injury or tissue damage caused by a specific event. Neuropathic pain, on the other hand, tends to be chronic and less sharp. “The character and quality of neuropathic pain tends to be pain that’s burning or electric in character,” says Vernon Williams, MD, a sports neurologist and the director of the Center for Sports Neurology and Pain Medicine at Cedars-Sini Kerlan-Jobe Institute in Los Angeles.
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Liam Wilson 4 minutes ago
Additionally, he says, the pain will often be associated with other symptoms, such as: (3)Paresthesi...
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So if you touch someone very lightly with the tip of a pen, the individual has dramatic or severe pa...
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Additionally, he says, the pain will often be associated with other symptoms, such as: (3)Paresthesia “There may be numbness or tingling, or lack of normal sensation associated with the pain.”Allodynia “This is a painful response to a stimulus that wouldn’t normally be considered painful at all, such as a light touch or a cold wind. Those stimulus types don’t normally trigger pain signals.”Hyperalgesia “This is where there’s a dramatic increase in the severity of the response to a signal one might not ordinarily consider to be very painful.
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Additionally, he says, the pain will often be associated with other symptoms, such as: (3)Paresthesia “There may be numbness or tingling, or lack of normal sensation associated with the pain.”Allodynia “This is a painful response to a stimulus that wouldn’t normally be considered painful at all, such as a light touch or a cold wind. Those stimulus types don’t normally trigger pain signals.”Hyperalgesia “This is where there’s a dramatic increase in the severity of the response to a signal one might not ordinarily consider to be very painful.
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So if you touch someone very lightly with the tip of a pen, the individual has dramatic or severe pain in response.” <h2>Most Recent in Neurology</h2> <h3>Real-Life Examples of Cognitive Dissonance</h3> <h3>How to Craft a Life s Mission Statement</h3> <h3>Migraine Diet Modifications What Really Works </h3> <h3>Dysarthria When MS Makes It Hard to Speak</h3> <h2>What Are the Most Common Causes of Neuropathic Pain </h2>Neuropathic pain can develop from: <h3>Diabetic Neuropathic Pain </h3> Diabetic peripheral neuropathy affects between 12 percent and 50 percent of people with diabetes. Within that group, distal symmetric polyneuropathy (DSP) is most prevalent. With this form of neuropathy, the first nerve fibers to malfunction are those that are most distant from the central nervous system, with symptoms such as pain, burning, and tingling felt symmetrically in the feet and then traveling up the legs as the condition progresses.
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So if you touch someone very lightly with the tip of a pen, the individual has dramatic or severe pain in response.”

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What Are the Most Common Causes of Neuropathic Pain

Neuropathic pain can develop from:

Diabetic Neuropathic Pain

Diabetic peripheral neuropathy affects between 12 percent and 50 percent of people with diabetes. Within that group, distal symmetric polyneuropathy (DSP) is most prevalent. With this form of neuropathy, the first nerve fibers to malfunction are those that are most distant from the central nervous system, with symptoms such as pain, burning, and tingling felt symmetrically in the feet and then traveling up the legs as the condition progresses.
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Eventually, the upper extremities may also become involved. The main symptoms are painful tingling and burning. Over time, numbness and then profound loss of sensation can set in.
Liam Wilson Member
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Eventually, the upper extremities may also become involved. The main symptoms are painful tingling and burning. Over time, numbness and then profound loss of sensation can set in.
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Liam Wilson 11 minutes ago
Patients may think they are getting better when the pain subsides, but actually this is the worst-ca...
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Patients may think they are getting better when the pain subsides, but actually this is the worst-case scenario. (4,5)More on Managing Diabetic Neuropathy <h3>4 Great Exercises for People Managing Diabetes-Related Neuropathy</h3>“All of us hate pain, but pain is a protective mechanism,” explains Peter Highlander, a doctor of podiatric medicine in private practice in Sandusky, Ohio. “It tells us to take our hand from the hot stove.
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Patients may think they are getting better when the pain subsides, but actually this is the worst-case scenario. (4,5)More on Managing Diabetic Neuropathy

4 Great Exercises for People Managing Diabetes-Related Neuropathy

“All of us hate pain, but pain is a protective mechanism,” explains Peter Highlander, a doctor of podiatric medicine in private practice in Sandusky, Ohio. “It tells us to take our hand from the hot stove.
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If you don’t have that protective mechanism — if you put your hand on the hot stove and don’t ...
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If you don’t have that protective mechanism — if you put your hand on the hot stove and don’t pull it off — you’ll go all the way from first-degree burns right down to wounds with bone exposed,” without feeling the pain and acting to avoid situations that require amputation. <h3>Chemotherapy-Related Neuropathic Pain </h3> People with cancer can suffer from neuropathy induced by chemotherapy and other drugs used to treat the disease they’re battling, and the pain can be severe.
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If you don’t have that protective mechanism — if you put your hand on the hot stove and don’t pull it off — you’ll go all the way from first-degree burns right down to wounds with bone exposed,” without feeling the pain and acting to avoid situations that require amputation.

Chemotherapy-Related Neuropathic Pain

People with cancer can suffer from neuropathy induced by chemotherapy and other drugs used to treat the disease they’re battling, and the pain can be severe.
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After chemotherapy is done, the symptoms often abate quickly. But sometimes they last longer or don�...
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After chemotherapy is done, the symptoms often abate quickly. But sometimes they last longer or don’t go away at all.
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After chemotherapy is done, the symptoms often abate quickly. But sometimes they last longer or don’t go away at all.
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HIV AIDS-Related Neuropathic Pain

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(6) <h3>HIV AIDS-Related Neuropathic Pain </h3> People being treated for HIV/AIDS may develop neuropathy from effects of the virus and the drugs used to treat it. Common painful symptoms include burning, stiffness, prickling, and tingling in the toes and soles of the feet. Sometimes the nerves in the fingers, hands, and wrists are also affected.
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HIV AIDS-Related Neuropathic Pain

People being treated for HIV/AIDS may develop neuropathy from effects of the virus and the drugs used to treat it. Common painful symptoms include burning, stiffness, prickling, and tingling in the toes and soles of the feet. Sometimes the nerves in the fingers, hands, and wrists are also affected.
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The drugs Videx (didanosine), Hivid (zidovudine), and Zerit (stavudine) are most frequently associat...
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The drugs Videx (didanosine), Hivid (zidovudine), and Zerit (stavudine) are most frequently associated with neuropathic symptoms. (7)More on Living With HIV/AIDS <h3>10 Ways to Stay Healthy if You Have HIV</h3> <h3>Inflammation-Related Neuropathic Pain</h3>Inflammation caused by infections such as herpes zoster (also known as shingles), Lyme disease, or hepatitis B and hepatitis C can lead to neuropathy. In the case of shingles, the risk of developing postherpetic neuralgia, or lasting nerve pain, increases with age.
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The drugs Videx (didanosine), Hivid (zidovudine), and Zerit (stavudine) are most frequently associated with neuropathic symptoms. (7)More on Living With HIV/AIDS

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Inflammation-Related Neuropathic Pain

Inflammation caused by infections such as herpes zoster (also known as shingles), Lyme disease, or hepatitis B and hepatitis C can lead to neuropathy. In the case of shingles, the risk of developing postherpetic neuralgia, or lasting nerve pain, increases with age.
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Inflammation resulting from autoimmune disorders such as vasculitis, sarcoidosis, or celiac disease can also result in nerve pain, especially burning and tingling. (8,9,10) <h3>Other Potential Causes of Neuropathic Pain</h3> Neuropathic pain can also result from the following conditions: metabolic disorders such as hypoglycemia or kidney failure; autoimmune disorders such as rheumatoid arthritis, lupus, Sjögren’s syndrome and Guillain-Barré syndrome; toxicity; hereditary disorders such as Charcot-Marie-Tooth disease; hormonal disorders; alcoholism; and vitamin deficiencies; trigeminal neuralgia (pain from a nerve carrying signals from the face to the brain); physical trauma; compression; and repetitive stress. Additionally, many people have idiopathic neuropathy, meaning doctors don’t know the cause.
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Inflammation resulting from autoimmune disorders such as vasculitis, sarcoidosis, or celiac disease can also result in nerve pain, especially burning and tingling. (8,9,10)

Other Potential Causes of Neuropathic Pain

Neuropathic pain can also result from the following conditions: metabolic disorders such as hypoglycemia or kidney failure; autoimmune disorders such as rheumatoid arthritis, lupus, Sjögren’s syndrome and Guillain-Barré syndrome; toxicity; hereditary disorders such as Charcot-Marie-Tooth disease; hormonal disorders; alcoholism; and vitamin deficiencies; trigeminal neuralgia (pain from a nerve carrying signals from the face to the brain); physical trauma; compression; and repetitive stress. Additionally, many people have idiopathic neuropathy, meaning doctors don’t know the cause.
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Prescription Medication

Popular prescription medications for neuropathic pain include COX-2...
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(9,10,11,12,13) <h2>More on Your Nerves and Neuropathy</h2> <h3>What Are the Common Signs and Symptoms of Neuropathy </h3> <h3>Optic Neuritis How a Swollen Optic Nerve May Signal Multiple Sclerosis</h3> <h3>Polyneuropathy 101 What to Know About the Most Common Type of Neuropathy</h3> <h3>Nerve Zap Unlikely to Ease Low Back Pain</h3> <h2>How Is Neuropathic Pain Typically Treated </h2>Pain medication can help with pain symptoms and improve sleep and quality life, but it won’t “reverse or cure neuropathy,” Dr. Williams says. <h3>Over-the-Counter OTC Medications</h3> Common over-the-counter medications that people reach for to address mild to moderate neuropathic pain include Tylenol (acetaminophen); nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) and Aleve (naproxen); and topical treatments such as capsaicin and lidocaine creams.
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How Is Neuropathic Pain Typically Treated

Pain medication can help with pain symptoms and improve sleep and quality life, but it won’t “reverse or cure neuropathy,” Dr. Williams says.

Over-the-Counter OTC Medications

Common over-the-counter medications that people reach for to address mild to moderate neuropathic pain include Tylenol (acetaminophen); nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen) and Aleve (naproxen); and topical treatments such as capsaicin and lidocaine creams.
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Prescription Medication

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<h3>Prescription Medication</h3> Popular prescription medications for neuropathic pain include COX-2 inhibitors, like Celebrex (celecoxib), which reduce pain and inflammation by blocking a specific enzyme (COX-2) in the body; and Ultram (tramadol), a nonopioid medication that interferes with pain signals to the brain and affects neurotransmitters. When other medicines don’t work to relieve severe nerve pain, sometimes opioid medication such as hydrocodone, OxyContin (oxycodone), and morphine (Roxanol, Kadian) are prescribed.
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Prescription Medication

Popular prescription medications for neuropathic pain include COX-2 inhibitors, like Celebrex (celecoxib), which reduce pain and inflammation by blocking a specific enzyme (COX-2) in the body; and Ultram (tramadol), a nonopioid medication that interferes with pain signals to the brain and affects neurotransmitters. When other medicines don’t work to relieve severe nerve pain, sometimes opioid medication such as hydrocodone, OxyContin (oxycodone), and morphine (Roxanol, Kadian) are prescribed.
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Of course, there is a risk of addiction with these medications. (12)More on Using Opioids for Pain Management <h3>Why Less May Be More When It Comes to Preventing Opioid Addiction</h3> <h3>Antidepressants</h3>Williams cites antidepressant and anticonvulsant medications as “the types of categories we’re likely to turn to and that can be most helpful,” because they have a specific effect on the pain pathways and act on pain from abnormal nerve firing or nerve signals.
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Of course, there is a risk of addiction with these medications. (12)More on Using Opioids for Pain Management

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Antidepressants

Williams cites antidepressant and anticonvulsant medications as “the types of categories we’re likely to turn to and that can be most helpful,” because they have a specific effect on the pain pathways and act on pain from abnormal nerve firing or nerve signals.
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“Antidepressants have an effect on some of the neurotransmitters, like norepinephrine and serotonin, which can have an effect on pain,” explains Williams. Among the options in this category of treatment are selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), and Zoloft (sertraline), which restore the chemical balance in the nerve cells of the brain; serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta (duloxetine) and Effexor (venlafaxine), which inhibit the production and release of specific neurotransmitters, including serotonin and norepinephrine; norepinephrine reuptake inhibitors (NRIs), which inhibit the reuse of the neurotransmitters dopamine, serotonin, and norepinephrine; and serotonin receptor modulators such as Dutonin (nefazodone) and Oleptro (trazodone) that increase the levels of serotonin and norepinephrine in the brain available to transmit signals to other nerves.
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“Antidepressants have an effect on some of the neurotransmitters, like norepinephrine and serotonin, which can have an effect on pain,” explains Williams. Among the options in this category of treatment are selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine), and Zoloft (sertraline), which restore the chemical balance in the nerve cells of the brain; serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta (duloxetine) and Effexor (venlafaxine), which inhibit the production and release of specific neurotransmitters, including serotonin and norepinephrine; norepinephrine reuptake inhibitors (NRIs), which inhibit the reuse of the neurotransmitters dopamine, serotonin, and norepinephrine; and serotonin receptor modulators such as Dutonin (nefazodone) and Oleptro (trazodone) that increase the levels of serotonin and norepinephrine in the brain available to transmit signals to other nerves.
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10 Unexpected Uses of Antidepressants

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(15) <h2>10 Unexpected Uses of Antidepressants</h2> Antidepressants can be used for more than just improving mental health. Health problems like urinary incontinence and hot flashes are two other potential benefits, among others, of this class of medications.Medications <h3>Anticonvulsants</h3>Williams says the effectiveness of anticonvulsants is still being investigated, but; “We believe the mechanism of effect is on calcium channels, and that can reduce transmission of those abnormal nerve signals, often within the peripheral nerve or the spinal cord.” Neurontin (gabapentin) is an example of an anticonvulsant used to relieve nerve pain in people who have had shingles or diabetes.
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10 Unexpected Uses of Antidepressants

Antidepressants can be used for more than just improving mental health. Health problems like urinary incontinence and hot flashes are two other potential benefits, among others, of this class of medications.Medications

Anticonvulsants

Williams says the effectiveness of anticonvulsants is still being investigated, but; “We believe the mechanism of effect is on calcium channels, and that can reduce transmission of those abnormal nerve signals, often within the peripheral nerve or the spinal cord.” Neurontin (gabapentin) is an example of an anticonvulsant used to relieve nerve pain in people who have had shingles or diabetes.
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Neuromodulation

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(16,17) <h3>Neuromodulation</h3> There are other treatments that act more directly on nerves, such as neuromodulation or surgery. Neuromodulation can involve placing an electrode along a peripheral nerve, explains Williams.
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Neuromodulation

There are other treatments that act more directly on nerves, such as neuromodulation or surgery. Neuromodulation can involve placing an electrode along a peripheral nerve, explains Williams.
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“These are helpful by essentially turning off pain signals. You can do that very selectively with individual peripheral nerves or you can take a more regional approach with spinal cord stimulation.” (18)More on Carpal Tunnel Syndrome <h3>6 Best Foods for Carpal Tunnel Syndrome</h3> <h3>Surgery</h3>Surgery can be useful to release pressure on a nerve, says Highlander.
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Surgery

Surgery can be useful to release pressure on a nerve, says Highlander.
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Neurolysis is a procedure by which the outer sheath of an affected nerve is opened and scar tissue may be removed. It is a technique more commonly used to treat the pain of carpal tunnel syndrome, but it’s also in use to treat diabetic neuropathy. (19,20,21) Additional reporting by Joseph Bennington-Castro.
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Neurolysis is a procedure by which the outer sheath of an affected nerve is opened and scar tissue may be removed. It is a technique more commonly used to treat the pain of carpal tunnel syndrome, but it’s also in use to treat diabetic neuropathy. (19,20,21) Additional reporting by Joseph Bennington-Castro.
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<h2>Resources We Love</h2>Foundation for Peripheral Neuropathy Mayo ClinicSpine-healthNEWSLETTERS <h3>Sign up for our Diabetes Newsletter </h3>SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. <h2>Editorial Sources and Fact-Checking</h2>Colloca L, Ludman T, Bouhassira D, et al.
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June 29, 2017.Pain Medication. Foundation for Peripheral Neuropathy.Peripheral Neuropathy Pain Manag...
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Anticonvulsants in Neuropathic Pain: Rationale and Clinical Evidence. European Journal of Pain....
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January 2012.Wiffen P, Derry S, Bell R, et al. Gabapentin for Chronic Neuropathic Pain in Adults. Cochrane Database of Systematic Reviews.
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January 2012.Wiffen P, Derry S, Bell R, et al. Gabapentin for Chronic Neuropathic Pain in Adults. Cochrane Database of Systematic Reviews.
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June 9, 2017.Shamji M, De Vos C, Sharan A. The Advancing Role of Neuromodulation for the Management of Chronic Treatment-Refractory Pain.
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Johns Hopkins Medicine Health Library.Barrett S, Nickerson D. Nerve Decompression Surgery Can Reverse Neuropathy of the Foot.
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