June 24, 2014 by Dr. Steve Grinstead
Many people I work with really struggle with neuropathic pain — they are not alone as millions of others also experience this type of pain. I can empathize as I’ve had to deal with neuropathic pain flare ups periodically over the past 32 years and more frequently this past year. This type of pain doesn’t respond to the normal acute or chronic pain medications. It is usually the result of damage to the pain system itself. Please watch my Video Blog below and then read the remainder of my post.
Neuropathic pain is a complex chronic pain state that is usually accompanied by tissue injury. With this type of pain, the nerve fibers themselves may be damaged, dysfunctional or injured. These damaged nerve fibers send erroneous signals to other pain centers in the brain. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and other areas around the injury.
According to the Neuropathic Pain Network, anywhere between five to twenty-three million people (that’s between 2 to 8 percent of our population) are living with neuropathic pain in the United States. Unfortunately, it is a syndrome that is often under-diagnosed and under-treated.
Neuropathic pain symptoms include shooting pain, burning pain, tingling, and numbness. An example of Allodynia—a non-harmful stimulus perceived as painful—is rough clothing rubbing on your skin which you feel as if it were sandpaper; another example would be someone shaking your hand in what is really a gentle grasp, but you feel it as crushing or excruciating.
Another striking example of neuropathic pain is called phantom limb syndrome. This occurs when a limb like an arm or a leg has been removed because of illness or injury. The brain still receives (or perceives) pain messages from the nerves that originally carried impulses from the missing limb. These nerves now misfire and cause pain.
As anyone living with neuropathic pain knows, the treatment can be frustrating and often ineffective. While acute short-term pain is usually easy to manage and most chronic pain conditions can be treated effectively, neuropathic pain can be a major treatment challenge for both patients and their healthcare providers. Unfortunately, neuropathic pain often responds poorly to standard pain treatments and occasionally may get worse instead of better over time. For some people, it can lead to serious disability.
The capsaicin patch could be a much needed tool for many people experiencing neuropathic pain symptoms who find that other pain management medications (e.g., opiates or SSRI’s and SNRI’s) are not helping or have too many side effects. Of course medication management is only one component of an effective pain management treatment plan.
I believe that people also need to be develop nonpharmacological interventions, as well as learning to better manage the psychological/emotional components of their pain. For those symptoms cognitive behavioral and rational emotive therapeutic interventions give the best outcomes. To learn more please check out my book Managing Pain and Coexisting Disorders: Using the Addiction-Free Pain Management® System.