Nerve pain is a condition that affects 7%-10% of the population in the country. It is also known as neuropathic pain and it is a highly subjective experience for each individual. There are several nerve pain relief treatments available, based on the diagnosis.

What is Nerve Pain?
The nerves in our body help us feel sensations like touch, heat, cold, pressure, pleasure, and pain. When they suffer damage due to disease or injuries, they may send random, inaccurate, or false signals to the pain centers in the brain and spinal cord.

Specific Neuropathy Types
There are different, specific forms of nerve pain:

• Trigeminal Neuralgia
  It is a type where patients experience intense and sudden facial pain due to damage to the trigeminal nerve that controls chewing and sensation in the face.
• Phantom-limb Pain
  The person experiences false pain in a missing or amputated limb.
• Herpes
  Herpes pain follows an attack of herpes zoster or shingles and can last for months, sometimes even years.

Symptoms
People with this condition feel stabbing, shooting, burning or crawling sensations, along with other sensations like tingling, numbness, or a feeling of being pricked by pins and needles. Some people experience an electric-shock kind of sensation. People who suffer from this condition are over-sensitive to different sensations like cold, heat, and touch.

Even a casual brushing of the skin can cause enormous discomfort and pain. It is usually worse at night. Sleep disturbances, anxiety and depression are commonly experienced by those with nerve pain. Nerve pain is more commonly reported in women especially for patients aged above 50.

In other cases, there may be a complete lack of the response to pain even when injuries are suffered. This is commonly seen in conditions like diabetic neuropathy or vitamin B12 deficiency when the person does not feel any sensation of pain although injuries have occurred.

Diagnosis
General practitioners can diagnose nerve pain after a physical exam, consider your medical history, and perform certain tests. These include palpating the affected area with fingers, toothpicks, cold or hot objects, cotton-wool etc to gauge the severity.

Other tests like blood tests, MRI scan, skin biopsy, nerve-conduction, tissue and nerve biopsy can also help doctors to locate and identify the type of neuropathy that the patient suffers from.

Causes
When a part of the somatosensory nervous system that interprets and conveys the conscious perception of touch, pressure, pain, temperature, vibration, movement, pressure etc get damaged, the result is neuropathic pain. In rare cases, neuropathy can be inherited.

Typical causes include:

• Nerve injury
• Damage to the spinal cord
• Nerve compression
• Diabetes
• A tumor pressing against a nerve
• HIV/AIDS infection
• Stroke
• Multiple sclerosis and other motor neuron diseases like Lou Gehrig’s disease
• Chemotherapy
• Drug reactions
• Ingestion of toxic substances
• Vitamin B12 or thiamine deficiency
• Infectious diseases like herpes

Modulation Mechanism

Pain is a highly subjective, individual response. Some patients experience intense and debilitating pain, while others may show a more moderate response. The response to medications may also be similarly modified and personalized in people. Pain expectancy is also something that is modified by individuals and those around them.

Experiments have been carried out using techniques like suggestion and placebo trials to create a pain-profile for all the affected people. This concept holds much potential for pain-management. Pain-profiles can help doctors to manage pain in postoperative conditions.

Treatment
Treatment for nerve pain for those seeking nerve pain relief is based on the accurate identification of the root cause of the pain. This is done by consulting a pain specialist. General practitioners can also treat pain with different pain relief medications. Other professionals who may be involved are psychologists, occupational therapists, nurses, physiotherapists etc.

Multidisciplinary Approach
Nerve pain treatments are available on various levels to provide nerve pain relief.

• Medications
  OTC medications are usually the first line of treatment. These include non-steroidal anti-inflammatory drugs, acetaminophen etc. which may be ingested or applied topically in gel, cream, spray, oil or ointment forms. Local anesthetics like paracetamol may provide temporary relief. Opioids show limited effectiveness. Capsaicin cream provides relief but they have to be used in consultation with your doctor.  Research shows that antidepressants and anticonvulsant medications show good results. However, it’s important to monitor their use since many of them are addictive.
• Root Cause Treatment
  Doctors can locate and pinpoint the exact cause of pain in most cases. In the case of diabetic neuropathy, control of blood glucose levels provides relief. In the case of diabetic neuropathy, the peculiar phenomenon of “glove and stocking” type of pain distribution is seen, where the hands, forearms, legs, and feet are involved.  Conditions like vitamin B12 or thiamine deficiency can be addressed with the intake of adequate dietary supplements.
• Mental/Emotional Therapy
  Psychotherapy, counseling and cognitive behavior therapy provide respite from pain. Relaxation techniques, yoga, meditation, and massage can help in certain cases. Biofeedback, hypnosis, etc may give comfort and relief.
• TENS
  Transcutaneous Electrical Nerve Stimulation uses low-level electric currents to block pain sensations to the brain.
• Acupuncture
  Traditional Chinese systems and modern acupuncture techniques may provide relief.
• Complementary, Traditional, and Natural Treatments
  Dietary intervention, herbs, roots and natural products used in traditional medicine all around the world can yield good results.
• Exercise, Diet, and Sleep
  Weight-loss, regular exercise that triggers the release of endorphins, proper rest and relaxation with adequate sleep provides relief from pain.
• Invasive Treatments
  In severe cases, surgery, injections, or nerve blocks may be needed to block pain transmission.