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    You are here : Home » About MS » Symptoms » Neuropathic Pain

    Neuropathic Pain

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    Neuropathic PainWhat is Neuropathic Pain?

    Neuropathic or neurogenic pain differs from other types of pain because it is not caused by physical injury. However, nerves themselves can generate pain and this is a pain which doesn’t disappear very easily, if at all.

    The term ‘Neuropathic Pain’ is derived from the Greek neuro, meaning nerves, and pathy, meaning abnormality. Pain like this without apparent cause also includes, itching, electrical shock sensations, prickling, tingling, or ‘pins and needles’ and patches or larger areas of skin with heightened sensitivity. It can be puzzling and frustrating and is usually chronic rather than acute which means that it’s a constant feature, although it may fluctuate in degrees depending on factors such as viral activity in the body, heat, stress or physical over-exertion. These are called Paresthesias.

    Other neuropathic pains are Dysesthesias; they include a burning feeling, aching or girdling around the body e.g. The MS Hug.

    With demyelination, the last sensation to be lost and the first to recover with healing is a dull, poorly localised burning dysesthesia. It is often described as a pain you’d feel after having just touched a hot stove in which there is a kind of ‘flare’ which has poorly defined boundaries, or again a small patch of bad sunburn. All these are often known to be worse at night thus hindering a good night’s sleep.

    What causes Neuropathic Pain?

    Most pain is felt when nerve endings, called nociceptors get nerve signals confused due to slowing down of nerve impulses caused by demyelination. We have millions of nociceptors throughout our bodies, probably about 1,300 per square inch of skin. Demyelinated axons may cause neural impulses to leak out and spread to other adjacent demyelinated fibres. If the adjacent fibres belong to the sensory pathway, these misdirected neural impulses give rise to pain.

    Treatment and Management of Neuropathic Pain

    Neuropathic Pain does not respond to conventional painkillers because drugs such as aspirin or paracetamol follow the wrong neural pathways to achieve this function successfully.

    It is widely acknowledged that anti-epileptic medications or anti-depressants are more successful at treating this kind of pain therefore these are prescribed for its relief.

    These include anti-epileptics drugs such as:

    Carbamazepine (Tegretol®)
    Phenytoin or Epanutin ( Dilantin®)
    Gabapentin (Neurontin®)
    Pregabalin (Lyrica®) this being the newer, most effective drug on the market with fewer unpleasant side-effects.

    Also included are tricyclic anti-depressants such as:

    Amitriptyline
    Dothiepin (Prothiaden®) also known as Dosulepin

    Other alternatives include medicinal marijuana or cannabis, which can also be obtained as a Sativex spray.

    A drug not licensed for MS but which has been proven to be effective is LDN or Low Dose Naltrexone.

    In extreme cases of Neuropathic Pain, a surgeon may carry out a nerve block procedure but this can be highly dangerous and therefore used as a last resort when all else has failed.

    Personal Experiences

    “I've experienced varying degrees of tingling. I had nine years of constant ‘background’ tingling of my legs, feet and hands. It would get worse if I exerted myself, got hot or had too much alcohol. It then would reach epic proportions, felt like a million ants marching over me in hobnail boots - eeeww! Then I started on 4.5mg of LDN and poof! Within two days I realised that the tingling had gone!!! Now it only resurfaces if I really overdo it, and then it is only very mild and short-lived. Thanks LDN!"

    "It feels like my flesh has been burned off in places. When I go to bed the bedclothes make it feel even more sore.”"

    “I put on cold gel packs for comfort. Also a cool bath to lower my body temperature one degree can help.”

    “I found that none of pain meds. work. I have had the most success with the benzodiazepenes or tranquilisers.”

    “I wake up some mornings with so much tingling and buzzing that the only thing I can do is to get up, even if it’s at the crack of dawn, and go sit by my PC to amuse myself as a distraction.”

    “I eat cannabis chocolate just prior to my going to bed. I keep a supply of this most delicious confectionary by my bed rather than my little pipe because if my legs do get bad during the night smoking in bed is a no-no.”

    More information…

    The British Pain Society
    The largest multidisciplinary professional organisation in the field of pain within the UK.

    The British Pain Society
    Third Floor
    Churchill House
    35 Red Lion Square
    London WC1R 4SG
    Tel: 020 7269 7840
    Fax: 020 7831 0859
    Email: [email protected]
    Website: http://www.britishpainsociety.org

    Pain Concern
    An organisation that offers support and information for pain sufferers. A listening ear helpline giving the chance to talk to others in the same situation.
    Pain Concern
    Unit 1-3
    62-66 Newcraighall Road
    Fort Kinnaird
    Edinburgh
    EH15 3HS
    Telephone: 0300 123 0789
    E-mail: [email protected]
    Website: http://www.painconcern.org.uk/

    Pain Support

    Pain can be a soul-destroying symptom of MS, but the good news is that there is a lot you can do to help yourself manage the pain.

    'Pain Support' is a website set-up by Jan Sadler, Author of the book 'Natural Pain Relief' (Element Books), to help you do just that. It is informative and supportive, and contains details of pain management techniques such as relaxation, exercise, diet, attitude, pacing, how to deal with emotions and much more.

    Jan, who herself suffers from sciatic pain, has been working with people in pain since 1990. Her material for pain control and pain relief is used in many NHS Hospitals, pain clinics, chiropractors, physiotherapists and self-help groups.

    The website is interactive so you can join in discussion forums, leave messages, and make new friends through Pain Support's confidential Contact Club. They also have a good newsletter, which you can subscribe to free, or read online. You can also browse through previous issues.

    Website: http://www.painsupport.co.uk/

    © Multiple Sclerosis Resource Centre (MSRC)

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