Neuropathic Pain Conditions We Treat
-
Post-Herpetic Neuralgia
-
Diabetic Peripheral Neuropathy
-
Carpal Tunnel Syndrome
-
Complex Regional Pain Syndrome (CRPS)
-
Polyneuropathy
-
Trigeminal Neuralgia
-
Peripheral Nerve Injury Pain
Post-Herpetic Neuralgia (PHN)
Overview
Post-herpetic neuralgia is a chronic nerve pain that follows a shingles (herpes zoster) infection. It occurs when the varicella-zoster virus damages sensory nerves, leading to lingering pain long after the skin lesions heal. PHN is more common in older adults and can be severe enough to affect sleep and emotional well-being.
Symptoms
- Burning, stabbing, or electric-shock pain along the healed rash area
- Extreme sensitivity to light touch or temperature
- Itching, numbness, or tingling
- Pain that worsens at night, disrupting rest
Diagnosis
- Clinical assessment based on history of shingles and residual pain
- Sensory mapping to determine affected dermatomes
- Exclusion of infection or neural inflammation through imaging, if necessary
Treatment
- Medications: Neuropathic agents (gabapentin, pregabalin), tricyclic antidepressants, and topical lidocaine or capsaicin patches.
- Interventional Procedures: Paravertebral, epidural, or peripheral nerve blocks for resistant cases; radiofrequency ablation in chronic refractory pain.
- Adjunct Care: Moisturising and desensitising creams, physical therapy, and counselling for anxiety or depression related to pain persistence.
Diabetic Peripheral Neuropathy
Overview
Diabetic neuropathy is nerve damage caused by prolonged high blood sugar levels, commonly affecting the feet and legs. It results in pain, tingling, numbness, and loss of balance. Proper management prevents complications like ulcers and infections.
Symptoms
- Burning or tingling pain in the feet, worse at night
- Loss of sensation or balance
- Numbness, weakness, or cramps
- Foot ulcers or slow-healing wounds
Diagnosis
- Physical and neurological examination
- Monofilament testing and vibration sensitivity tests
- Nerve conduction studies
- Glycaemic control assessment and blood work
Treatment
- Medical Management: Blood-sugar regulation, neuropathic medications, and vitamin B-complex supplementation.
- Interventions: Peripheral nerve blocks or sympathetic blocks in severe pain.
- Supportive Care: Foot care education, physiotherapy for balance, and footwear modification.
- Preventive Strategy: Regular screening and glucose optimisation.
Carpal Tunnel Syndrome (CTS)
Overview
Carpal Tunnel Syndrome occurs when the median nerve is compressed at the wrist, leading to pain and numbness in the hand. Repetitive movements, diabetes, and thyroid disorders increase risk. Early intervention prevents long-term nerve damage and loss of grip strength.
Symptoms
- Tingling or numbness in the thumb, index, and middle fingers
- Weak grip or difficulty holding small objects
- Pain radiating up the arm
- Night-time hand discomfort
Diagnosis
- Physical examination (Phalenʼs and Tinelʼs tests)
- Nerve conduction and EMG studies
- Ultrasound for nerve swelling assessment
Treatment
- Non-Surgical: Wrist splinting, anti-inflammatory medication, and activity modification.
- Interventional: Ultrasound-guided median nerve block or corticosteroid injection.
- Physiotherapy: Nerve-gliding exercises and ergonomic advice.
- Surgical Referral: Carpal tunnel release for severe or persistent cases.
Complex Regional Pain Syndrome (CRPS)
Overview
CRPS is a chronic pain condition following injury, surgery, or nerve trauma. It involves abnormal nerve responses and affects skin, muscles, and circulation in the affected limb. Early diagnosis and multidisciplinary care improve outcomes.
Symptoms
- Severe, burning pain disproportionate to injury
- Swelling, colour, or temperature changes in the limb
- Limited mobility and stiffness
- Skin sensitivity and excessive sweating
Diagnosis
- Clinical criteria (Budapest criteria)
- Thermography and autonomic testing
- Exclusion of infection or vascular disorders
- Diagnostic sympathetic block
Treatment
- Medications: Neuropathic agents, bisphosphonates, and vasodilators.
- Interventional: Sympathetic nerve blocks (lumbar or stellate); spinal cord stimulation for advanced cases.
- Physiotherapy: Desensitisation, mirror therapy, and gradual movement.
- Counselling: Education and emotional support for chronic pain management.
Polyneuropathy
Overview
Polyneuropathy refers to widespread damage to multiple peripheral nerves, often due to diabetes, toxins, or autoimmune conditions. It affects both sensory and motor nerves, leading to weakness, numbness, and imbalance.
Symptoms
- Burning, tingling, or “glove and stockingˮ numbness
- Loss of reflexes and coordination
- Muscle cramps or weakness
- Difficulty walking or maintaining balance
Diagnosis
- Neurological examination
- Nerve conduction and EMG tests
- Blood tests for metabolic, vitamin, or immune causes
- Nerve biopsy (if required)
Treatment
- Medical: Neuropathic drugs, vitamins B12, folate), and immune-modulating therapy for autoimmune causes.
- Interventional: Peripheral nerve blocks or electrical neuromodulation for severe pain.
- Rehabilitation: Balance training, orthotic support, and mobility exercises.
- Monitoring: Regular follow-ups to track progression and adjust treatment.
Trigeminal Neuralgia
Overview
Trigeminal Neuralgia causes sudden, severe, stabbing facial pain along one or more branches of the trigeminal nerve. Even light touch, chewing, or speaking may trigger attacks. Though not life-threatening, it greatly affects daily function and quality of life.
Symptoms
- Sudden, electric-shock facial pain lasting seconds to minutes
- Triggered by touch, wind, or facial movement
- Usually affects one side of the face
- Pain-free intervals between attacks
Diagnosis
- Neurological assessment and pain-pattern mapping
- MRI to rule out vascular compression or multiple sclerosis
- Diagnostic nerve block for confirmation
Treatment
- Medication: Anticonvulsants (carbamazepine, oxcarbazepine) are first-line therapy.
- Interventions: Radiofrequency ablation of trigeminal nerve or glycerol injection in refractory cases.
- Surgical Options: Microvascular decompression when nerve compression is evident.
- Counselling: Stress management to reduce triggers.
Peripheral Nerve Injury Pain
Overview
Injury to peripheral nerves due to trauma, surgery, or compression can cause long-term pain, tingling, or hypersensitivity. Early recognition and intervention promote nerve recovery and reduce chronicity.
Symptoms
- Burning, tingling, or shooting pain
- Weakness in affected muscle groups
- Numbness or altered sensation
- Pain aggravated by movement or pressure
Diagnosis
- Detailed injury history and neurological assessment
- Nerve conduction and EMG studies
- Imaging to locate nerve discontinuity or scarring
Treatment
- Medication: Neuropathic drugs and anti-inflammatories.
- Interventional: Peripheral nerve blocks, PRP injections, or nerve hydrodissection to relieve entrapment.
- Physiotherapy: Strengthening and desensitisation exercises.
- Surgical Referral: Nerve repair or grafting if severe structural injury
Your Journey to better Health starts here!
Need to see a doctor? We’re here for you. Send us your details, and we’ll take care of the rest.
We're here to help!
Need more answers? Reach out to us!
FAQs
What is neuropathic (nerve) pain?
Neuropathic pain is caused by nerve damage and is often felt as burning, shooting, or electric-shock–like pain.
Can nerve pain be treated effectively?
Yes. Nerve pain can be managed with specialised medications, nerve blocks, and advanced pain procedures tailored to the cause.
When should I see a specialist for nerve pain?
If pain is persistent, worsening, affects sleep or daily activities, or does not respond to regular painkillers, you should consult a specialist.