Neuropathic pain is pain felt when nerves that start from the brain and reach the end points of the body are damaged for various reasons or when their function is impaired.
Neuropathic Pain and Neuralgias
Neuropathic pain is pain felt when nerves that start from the brain and reach the end points of the body are damaged or function is impaired for various reasons. The resulting pain occurs without an external stimulus. The problem is due to the abnormal processing of the information carried in the nerves.
Neuralgia literally means nerve pain. The sensation that occurs in neuropathic pain and neuralgia may occur spontaneously without any stimulus or in the form of pain caused by a normally non-painful stimulus.
What are the Characteristics of Neuropathic Pain?
Neuropathic pain manifests itself in various forms. can show. It can be in the form of sharp pain, pounding pain, electric shock pain, constant pain, burning pain, blunt pain or throbbing pain, or it can occur as an uncomfortable condition such as tingling and numbness.
What are the Causes of Neuropathic Pain?
Neuropathic pain usually does not occur as a result of a single disease. It is a result of various health problems. A sign of multiple sclerosis may occur after a stroke or due to injury to the spinal cord in a traffic accident. After the blockage in the vessels feeding the nerve, the oxygen-deprived nerve cell can cause pain. Although peripheral nerve diseases are the most common cause of neuropathic pain; causes of pain can be classified as metabolic disorders, various infections, nutritional disorders, toxins, cancers, hereditary, inflammatory and idiopathic causes.
- Metabolic disorders: Diabetes (diabetes), hypothyroidism, uremia, amyloidosis , fabry syndrome
- Infectious agents: HIV, Postherpetic neuralgia
- Nutrition disorders: Alcoholism, Thiamine deficiency
- Toxins: Pyridoxine deficiency due to isoniazid use, vincristine, nitrofurantoin, arsenic, thallium
- Cancers: Small cell lung cancer, lymphomas, multiple myeloma
- Hereditary: Charcot-Marie-Tooth Disease
- Inflammation There are causes: Guillain - Barre syndrome called acute inflammatory demyelinating polyneuropathy
- Idiopathic causes: Fibromyalgia, idiopathic trigeminal neuralgia
What is Diabetic Polyneuropathy?
Diabetic polyneuropathy occurs when high blood sugar levels damage nerve cells. The word polyneuropathy means that more than one nerve is affected. This effect most commonly occurs in the legs and feet. Diabetic polyneuropathy is a process that can be slowed down by keeping blood sugar within safe limits and a healthy lifestyle. When a person with diabetes realizes that the healing of a wound on his foot is delayed, when he has symptoms such as burning, tingling and weakness in the hands and feet that limit his daily activities; When he notices changes in digestion, urination and sexual functions, he should apply to the nearest health institution when he begins to experience dizziness or lightheadedness during the day.
How to Treat Diabetic Polyneuropathy?
For neuropathic pain The treatment to be applied is not related to the duration of the existing disease causing it. As in diabetic neuropathy, although the disease continues, when neuropathy is controlled by various methods, neuropathy treatment is discontinued after a certain period of time, while the treatment of diabetes lasts for life. Applicable conditions for the treatment of neuropathic pain can be classified into 4 groups: These are; physical medicine and rehabilitation, cognitive-behavioral therapy, interventional therapy and pharmacological, that is, drug therapy.
Acupuncture as an Alternative Treatment Method in Neuropathy
In addition to medical treatments, there are various alternative treatments to relieve the complaints of patients and improve their quality of life. Especially acupuncture is an effective method for pain control. In the philosophy of acupuncture, which was practiced 2500 years ago, the energy called qi circulates through the body in certain ways. These pathways are called meridians. Pain is believed to be caused by the interruption of this energy flow over the meridians. In order to restore the energy flow, needles are applied to certain points of the body for treatment purposes. In the light of current scientific developments, various information has been obtained about how acupuncture works in the body. As a result of needle application to acupuncture points, free nerve endings responsible for pain perception are stimulated. Following this stimulation, molecules known as endogenous opioids responsible for pain control are released in the body. These molecules show pain relief when they are secreted in the body.
Nerve Compressions (Trap Neuropathies) What is it?
By transmitting the commands from the brain to other parts of the body and by transmitting sensory information from the surface of the body to the brain. While the nerve cells in charge move on their own paths, they pass through structures called fibrous tunnels in some regions. Trapped neuropathies occur as a result of the compression of the nerve in this tunnel or compression with the surrounding tissues. After the compression, neuropathic pain occurs in the area where the nerve is responsible for transmission.
The most common entrapment neuropathy is the compression of the median nerve in the wrist, known as carpal tunnel syndrome. Examples of less common but relatively frequent entrapments are cubital tunnel syndrome due to compression of the ulnar nerve at the elbow, tarsal tunnel syndrome in the leg, and marelgia paresthetica, which occurs as a result of compression or damage to the lateral cutaneous femoral nerve, which causes complaints like trouser pockets.
br>The cause of trap neuropathies is usually minor repetitive traumas. Areas where the nerve passes e, narrowing, trauma or space-occupying lesions, various inflammations or amyloid deposits seen in some diseases, edema during pregnancy or hypothyroidism, and diabetes causing nerve damage can be counted among the causes that may lead to entrapment neuropathy. It begins with the determination of what the nerve may be causing. With provocation tests, the diagnosis can be made by revealing pain and other findings. Electroneuromyography (ENMG) is used to examine the neural activity in the distribution region of the nerve, which is later seen as the cause. According to the suspected condition, x-ray, computed tomography and magnetic resonance imaging methods can be used for diagnosis. By using antidepressants and anticonvulsants, symptoms such as pain, burning, tingling and numbness can be relieved. Surgical interventions can be applied in order to eliminate the pressure of the nerve in the entrapment area. Symptoms that occur with entrapment neuropathy can be controlled with non-surgical methods. These methods generally include physical therapy and rehabilitation modalities, especially ultrasound, paraffin baths and ionophoresis. Splints can be used to reduce the effect of the pressure.
At the same time, the control of edema and inflammation in the trap area can be achieved with local corticosteroid injections to be applied to the trap area. Another point that should not be forgotten is that the recommendations of the doctor concerned should be taken into account for the elimination of risk factors related to the occupation and occupation that require the use of the entrapment nerve.
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