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Alternative Names Return to topNerve pain
Definition Return to top
Neuralgia is pain that follows the path of a nerve.
See also: Trigeminal neuralgia
Causes Return to top
Causes of neuralgia include:
In many cases, the cause is unknown.
Trigeminal neuralgia is the most common form of neuralgia. A related but uncommon neuralgia affects the glossopharyngeal nerve, which provides feeling to the throat.
Neuralgia is most common in elderly people, but it may occur at any age.
Symptoms Return to top
Any touch or pressure is felt as pain. Movement may also be painful.
Exams and Tests Return to top
An exam may show:
A dental examination can rule out dental disorders that may cause facial pain (such as a tooth abscess). Other symptoms (such as redness or swelling) may help rule out conditions such as infections, bone fractures, or rheumatoid arthritis.
There are no specific tests for neuralgia, but the following tests may be done to find the cause of the pain:
Treatment Return to top
The goal of treatment is to reverse or control the cause of the nerve problem (if found), and provide pain relief. Treatment varies depending on the cause, location, and severity of the pain, and other factors. Even if the cause of the neuralgia is never identified, the condition may improve on its own or disappear with time.
The cause (if known) should be treated. This may include surgery to remove tumors or separate the nerve from blood vessels or other structures that press on it. This can be done for some cases of carpal tunnel syndrome and trigeminal neuralgia.
Strict control of blood sugar may speed recovery in people with diabetes who develop neuralgia.
Medications to control pain may include:
Other treatments may include:
Unfortunately, these procedures do not guarantee improvement and can cause loss of feeling or abnormal sensations.
When other treatment methods fail, doctors may try motor cortex stimulation (MCS). An electrode is placed over the sensory cortex of the brain and is hooked to a pulse generator under the skin.
Treating shingles with antiviral medication may reduce the likelihood of developing postherpetic neuralgia. Postherpetic neuralgia may also be treated with oral (taken by mouth) prednisone.
Physical therapy may be helpful for some types of neuralgia, especially postherpetic neuralgia.
Outlook (Prognosis) Return to top
Most neuralgias are not life-threatening and are not signs of other life-threatening disorders. However, pain can be severe. For severe pain, be sure to see a pain specialist so that you can explore all treatment options.
Most neuralgias will respond to treatment. Attacks of pain usually come and go. However, attacks may become more frequent in some patients as they get older.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Contact your health care provider if:
Prevention Return to top
Treating related disorders such as diabetes and renal insufficiency may prevent some neuralgias. Strict control of blood sugar may prevent nerve damage in people with diabetes. In the case of shingles, there is some evidence that antiviral drugs can prevent neuralgia.
References Return to top
Shy ME. Peripheral neuropathies. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 446.
Cutrer FM, Moskowitz MA. Headaches and other head pain. In: In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 421.Update Date: 9/22/2008 Updated by: Daniel B Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.