Neuropathy is a common type of pain that affects the nerves in our body. Some common causes of neuropathic pain include:

• Diabetes

  • One of the most common causes of neuropathy

• Medications

  • Common causes are chemotherapy and HIV medications

• Toxins

  • Lead and mercury​

• Excessive alcohol consumption/abuse​

• Vitamin Deficiency 

  • Vitamin B12, B6 and folate​

• Infections​

  • Shingles, AIDS/HIV​

• Hypothyroidism (low thyroid levels)​

• Autoimmune (body's immune system attacks itself)

  • Guillain-Barre syndrome, Lupus, Rheumatoid Arthritis​

• Strokes​

• Amputations

  • Phantom Limb Pain​

• Spinal Cord Injuries​

• Trauma

  • Neuropathy can occur from nerves being crushed and compressed for a long period of time​

• Cancer​

  • Tumors, Lymphoma, Myeloma​

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What type of pain can you experience with neuropathy?

Neuropathy can affect nerves that control sensation (sensory nerves), nerves that control muscles (motor nerves) or a mixture of both. Symptoms can present as:

• Sharp stabbing pain

• Electric pain

• Numbness and tingling

• Pins and needles

• Burning pain

• Muscle weakness

  • Even foot drop and wrist drop depending on the nerves involved and severity of the injury​

• Balance issues or stumbling when walking​

• Decreased feeling when touching affected areas

• Increased sensitivity or discomfort when touching affected areas

• Muscle wasting if nerves that control muscles are affected

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How can our St. Louis pain doctors help diagnose your neuropathy?

• Every good diagnosis is made by first taking a good history and performing a thorough physical exam.

• A neurological exam is also important in figuring out what nerves and muscles are affected

• A Nerve conduction study and EMG is done to help distinguish between different types of neuropathies and even locate the specific region that the nerve is injured at.

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What are your treatment options?

At St. Louis Spine and Joint Pain Specialists, our pain management doctors work extensively with our patients to find a treatment plan that provides maximum pain relief and one that our patients are comfortable with. Many neuropathy treatment includes combination of therapeutic pain management and medical pain management such as:

• Non-steroidal anti-inflammatory medications (NSAIDS)

• Gabapentin (Neurontin) and Pregabalin (Lyrica)

  • Previously used to treat seizures but have been found to help significantly with decreasing nerve pain​

• Opioid medications​

  • In severe neuropathy pain, opioid management can be very beneficial when used together with other medications listed here.

  • When used appropriately, studies have shown that the risk of addiction is extremely low

• Skin creams and patches​

  • Lidocaine cream, lidocaine patches, capsaicin cream​

• Anti-depressants​

  • Many of these medications have been shown to block pain signals in the spinal cord and brain. If the pain signal is blocked, pain can decrease in affected areas​

• TENS​

  • Also blocks pain signals from affected areas​

• Physical therapy

  • Strengthen affected muscles and provide desensitization therapy

• Injections

  • Have been shown to help with shingles pain and neuropathies from pinched nerves

 

What can you do to avoid or decrease neuropathic pain?

• Control your blood sugars

  • Follow with your primary care doctor and monitor your A1c​

• Exercise​

• Stop smoking

  • Smoking decreases blood flow to the nerves and muscles. This can make your neuropathy worse​

• Good nutrition and diet​

  • Make sure to eat foods that are rich in vitamins which can help avoid neuropathy caused by vitamin deficiencies. ​

  • Healthy foods can also help you lose weight which has been shown to decrease complications from diabetes and even reverse diabetes altogether

• Avoid drinking large amounts of alcohol, especially for prolonged periods of time​

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For more information or to discuss an appropriate treatment plan for your neuropathic pain with one of our specialized pain management physicians, call Saint Louis Spine and Joint Pain Specialists today.

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