Neuralgia is a stabbing burning and often severe pain due to an irritated or damaged nerve. The damage maybe anywhere in the body . The damage may be caused by several things, including ageing, some disease or an infection.
Healthcare professionals divide neuralgia into categories depending on the areas of the body it affects. The following are some common types of neuralgia-
• Trigeminal neuralgia –
It involves the trigeminal nerve in the head. It is twice more common in women then men. It is common in people of age more than 50 yrs. The areas of pain will depend on the three branches of trigeminal nerve-
1) Maxillary – Affects lower eyelid ,side of nose, check, gun, lip and upperteeth.
2) Mandibullar – Affects the jaw, lower teeth, gum and lower lip.
3) Opthalmic – Affects the forehead, nose and eyes.
Trigeminal nerve has two Subdivisions –
It causes a painful burning or Electric shock like sensation in parts of the face. People with type -1 trigeminal neuralgia experience irregular episodes that come on Suddenly. The duration of these episodes varies from person toperson but usually it can last upto 2minutes.
b) Type- 2
It produces a constant dull aching sensation in the face.
The exact cause of trigeminal neuralgia is still unclear. Still the cause that can be understood for trigeminal neuralgia is blood vessels pressing on the root of the trigeminal heave.This makes the nerve transmits pain signals thatfull as stabbing pain.
Multiple sclerosis (MS) Can give rise to trigeminal neuralgia. MS is a neurological disorder that causes inflammation that damages the mylein sheath surrounding nerve fibres in the Central Nervous System.
• Postherpetic neuralgia –
It is a painful condition that affects the nerves in the skin. Postherpetic neuralgia is the most common complication of shingles. Shingles is a viral infection that causes blisters and a painful skin rash. The varicella-zoaster virus which causes chickenpox, remains dormant in the nervous system and reactivates later in the life, causing shingles. When the virus reactivates it can caus einflammation in the nerve fibres. This inflammation can lead to permanent nerve damage that causes pain, even after the infection subsides.
• Occipital neuralgia –
This form of neuralgia affects the occipital nerves Which originate in the neck and send signals to the back of the head.
It causes a throbbing or shooting pain that starts near the base of the skull and radiates along the scalp. Occipital neuralgia pain can flow to the back of the eyes. It may be Caused due to sudden head movements, tense neck muscles, lesions or tumors in the neck,Inflamed blood vessels,infections ,gout, diabetes,neck injuries.
• Peripheral neuralgia –
It refers to pain that occurs due to nerve damage in the peripheral nervous damage. It includes all nerve fibres Outside of the brain and Spinal cord. It affects a single nerve or entire nerve groups. Sustaining damage to the peripheral nervous system can affect nerves that control muscle movements, transmit sensory information and regulate internal organs. It can cause pain or numbness in the hands, feet, arms and legs. Its other symptoms are –
• Involuntary muscle cramping
• loss of coordination
• Difficulty in speaking
• Difficulty eating or swallowing
• Excess sweating
• Gastrointestinal problems
• Hypersensitivity to touch or temperature
• Difficulty in performing complex motor tasks such a buttoning a shirt or tying shoelaces.
• Intercoastal neuralgia –
It affects the nerves that sit just below the ribs. It causes a sharp burning pain that affects the chestwall, upper abdomen and cupper back. Certain physical movements like breathing, coughing or laughing can worsen the pain.Itmay be caused due to chest injuries or chest surgical procedures,pressure on the nerves, some viral infections like Shingles.
Some additional Symptoms are-
• Tightness or pressure around the chest
• Numbness or tingling in the upper chest or upper back
• Muscle twitching
• Loss of appetite
• Diabetic neuropathy –
It is the most common complication of Diabetes. Its symptoms includes loss of balance,numbress, tingling and pain.
• Sudden episodes of extreme shooting or stabbing pain that follows the path of a damaged or irritated nerve.
• Tingling or numbness
• Muscle weakness
• Loss of muscle mass or Atrophy
• Involuntary muscle twitching or cramping
• Persistent aching or burning pain
• Difficulty in sleeping
• Emotional problems due to chronic pain and difficulty in expressing how you are feeling
The cause of neuralgia is not completely understood. Still some known causes of neuralgia are –
• An infection like Shingles, chickenpox, Syphilis, tooth infection.
• Pressure on the nerves that may comes from a bone, ligament, blood vessels or tumour
Some less common causes-
• Medications prescribed for cancer
• fluoroquinolone antibiotics
• Chemical irritation
• Trauma Such as from surgery
• Vitamin B deficiency
There are no specific tests for neuralgia. Diagnosis relies more on ruling out other possible causes for the pain. Tests may include-
1) Neurological Examination- To determine specific areas for pain.
2) Dental Examination – To check for the abscesses that may be irritating near by nerves.
3) Blood Tests – To check for the infection.
4) X-rays or MRIs – To see if the affected nerves are being compressed.
If your doctor can pinpoint the cause of your neuralgia, your treatment will focus on treating the underlying cause.
Potential treatments may include –
1) Surgery to relieve the pressure on the nerve.
2) Nerve block, which is an injection directed at a particular nerve or name group and that is intended to turn off pain signals and reduce inflammation.
3) Better control of sugar levels in people with diabetes caused neuralgia.
4) Physical therapy
5) Medication to relieve the pain
Medication that can treat neuralgia are-
1) Anticonvulsants such as carbamazepine, topiramate
2) Antidepressants like amitryptylline
3) Muscle relaxants such as baclofen
4) Membrane-stabilizing medications such as gabapentin
5) Short term narcotic pain medication such as Codeine
6) Topical creams such as capsaicin
Neuralgia is caused by an imbalance in Vata dosha. Vater dosha must be in a state of balance for the proper functioning of the nerves and signal conduction, but when vata gets aggravated due to various causes like diabetes, injury, improper diet, chemotherapy etc. it affects the structure and function of nerves resulting in neurological deficits and problems.
Effective Panchakarma therapies–
Shiro dhara –
Beneficial Herbs –
Medications for prescription-
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