Nerve pain (neuralgia) is a particular type of pain that often feels like a shooting, stabbing or burning sensation. It is caused by damage or injury either to the nerves that send messages to your brain to signal pain, or to the brain itself. Nerve pain can be difficult to treat.
A nerve injury can affect the brain's ability to communicate with muscles and organs. Damage to the peripheral nerves is called peripheral neuropathy. It's important to get medical care for a peripheral nerve injury as soon as possible. Early diagnosis and treatment may prevent complications and permanent damage.
Occipital Neuralgia is a condition in which the occipital nerves, the nerves that run through the scalp, are injured or inflamed. This causes headaches that feel like severe piercing, throbbing or shock-like pain in the upper neck, back of the head or behind the ears.
Injured nerve cells in the central nervous system typically do not regenerate. However, this part of the nervous system can reorganize in response to an injury. This is called "plasticity." Luckily, the brain has a lot of built-in redundancy.
An MRI may be able help identify structural lesions that may be pressing against the nerve so the problem can be corrected before permanent nerve damage occurs. Nerve damage can usually be diagnosed based on a neurological examination and can be correlated by MRI scan findings.
The signs of nerve damage
Numbness or tingling in the hands and feet. Feeling like you're wearing a tight glove or sock. Muscle weakness, especially in your arms or legs. Regularly dropping objects that you're holding.
A nerve conduction velocity (NCV) test — also called a nerve conduction study (NCS) — measures how fast an electrical impulse moves through your nerve. NCV can identify nerve damage. During the test, your nerve is stimulated, usually with electrode patches attached to your skin.
The test involves lightly and briefly (1-2 seconds) touching the tips of the first, third and fifth toes of both feet with the index finger to detect a loss in sensation, and can be performed by patients and relatives alike in the comfort of their own home.
If your nerve is bruised or traumatized but is not cut, it should recover over 6-12 weeks. A nerve that is cut will grow at 1mm per day, after about a 4 week period of 'rest' following your injury.
An MRI scan can depict enhancement of multiple cranial nerves, with or without signal changes in the white matter (Figure 1).
Recommended treatment options by neurologists
In many cases, acute pain is due to strains, muscle damage, or nerve damage. This means the neurologist can then use non-surgical options to treat the condition. The doctor will often recommend physical therapy, lifestyle changes, and rest.
If a patient does see a neurologist after head trauma, the neurologist will perform a neurological exam — checking mental status, speech, balance, reflexes, and vision for indications of a mild TBI or a more severe brain injury.
Multimodal therapy (including medicines, physical therapy, psychological counseling and sometimes surgery) is usually required to treat neuropathic pain. Medicines commonly prescribed for neuropathic pain include anti-seizure drugs such as: Gabapentin (Neurontin®).
Answer: Damaged nerves cannot be seen on a regular X-ray. They can be seen on CAT scan or MRI, and in fact, MRI is recommended for examining details of the spinal cord. For example, MRI can demonstrate tumors of the spinal cord and nerves that extend from the spinal cord called nerve roots.
Chemical and metabolic testing of the blood can indicate some muscle disorders, protein or fat-related disorders that affect the brain and inborn errors of metabolism. Blood tests can monitor levels of therapeutic drugs used to treat epilepsy and other neurological disorders.
If your nerve is only injured, you may recover over time without surgery. Nerves heal slowly, sometimes over many months. For these mild nerve injuries, nonsurgical treatment options include medication, physical therapy or massage therapy. Peripheral nerve surgery can reconstruct or repair damaged nerves.
Nerve damage can become permanent
At first, neuropathy may cause occasional numbness and pain, but as it progresses, your symptoms may become more persistent. The pain may reach a high point before reaching a state of constant numbness. Once your nerves become too damaged, they can't send signals to your brain.
You feel numbness, tingling, or burning.
This sensation is an early sign of nerve damage, and may radiate from your hands or feet into your arms or legs, per the U.S. National Library of Medicine.
One of the most common causes of neuropathy is diabetes. People with peripheral neuropathy usually describe the pain as stabbing, burning or tingling. Sometimes symptoms get better, especially if caused by a condition that can be treated. Medicines can reduce the pain of peripheral neuropathy.
An EMG test helps find out if muscles are responding the right way to nerve signals. Nerve conduction studies help diagnose nerve damage or disease.
While the general benefits of aerobic and flexibility exercises are well-known, increasing movement and heart-rate are particularly important for people suffering with peripheral neuropathy. Physical activity can improve blood circulation, which strengthens nerve tissues by increasing the flow of oxygen.
Patients who are allergic to or sensitive to medications, contrast dye, iodine, or shellfish should notify the radiologist or technologist. MRI contrast may also have an effect on other conditions such as allergies, asthma, anemia, hypotension (low blood pressure), and sickle cell disease.
The vitamins B1, B6 and B12 are essential for nerve health. These vitamins can help with the healing of nerve damage and relieve nerve damage symptoms like pamamanhid (numbness) and tusok-tusok (tingling)—this is why they are called 'neurotropic' vitamins.