The underlying cause of any type of neuralgia is damage to a nerve. Each nerve in your body is protected by a coating called the myelin sheath. When the myelin is damaged or wears away from the nerve, the stabbing, severe, shock-like pain of neuralgia results. There are many different factors, including old age, which can cause damage to the myelin. Unfortunately, in many cases of neuralgia, a cause can never be found.
Infection
The cause of postherpetic neuralgia is shingles, an infection caused by the chickenpox virus. The likelihood of having this infection increases with age. Lyme disease, HIV, and syphilis can also cause neuralgia.
Multiple Sclerosis
Multiple sclerosis (MS) is a disease that is caused by the degradation of myelin. Among the many symptoms that result from MS is neuralgia, often in the face.
Pressure on Nerves
The myelin on nerves can be worn away by pressure. The pressure may come from a bone, ligament, blood vessel, or a tumor that is pressing on the nerve. The pressure of a swollen blood vessel is a common cause in trigeminal neuralgia.
Diabetes (Diabetic Neuropathy)
Many people with diabetes will suffer from some type of neuralgia because excess glucose in the bloodstream can lead to myelin damage.
Less Common Causes
If the cause of neuralgia cannot be blamed on an infection, MS, diabetes, or pressure on the nerves, it may be from one of many less common factors. These include:
- chronic kidney disease
- porphyria (a rare blood disease)
- medications like cisplatin, paclitaxel, or vincristine (prescribed to cancer patients)
- trauma, such as that caused by surgery
- chemical irritation
Better control of blood sugar levels in those with diabetes-caused neuralgia (Diabetic neuropathy)
Medications
Medicines can be used to relieve neuropathic pain. Medications prescribed may include:
- Antidepressants
- anti-seizure medications
- topical creams with capsaicin
- over-the-counter pain relievers like aspirin or ibuprofen
Nerve Blocks
Nerve blocks are injections directed at a particular nerve or nerve group that is intended to reduce inflammation and relieve pain.
- Stellate ganglion block is given for any pain in head, neck & upper limb.
- Intercostal nerve block is given for post herpetic neuralgia of chest wall
- Lumber sympathetic block is given for burning pain in both lower limb due to diabetic neuropathy.