Diagnosis: Nerve Pain
- Rin Spine & Aesthetics
- Nov 16, 2022
- 4 min read
Updated: May 27
Home > Pain Center > Diagnosis: Nerve Pain
What is nerve pain?
Our nerves are bundles of whitish fibre that help transfer signals between your sensory organs and your spinal column and brain. Nerve pain, also known as ‘neuralgia’ or ‘neuropathic pain’, occurs when something disrupts this natural relay of information.
What are the symptoms of nerve pain?
Nerve pain can produce a range of symptoms which may include qualities such as:
a ‘burning’, ‘shooting’, ‘stabbing’ or ‘pins and needles’ sensation
mild to severe in degree
occurring sporadically, without any apparent trigger
occurring during everyday activities such as sleeping, exercising and working
loss of positional awareness
loss of feeling (numbness) and decreased touch sensitivity.
What are the different types of nerve pain?
There are many conditions that relate to nerve pain or reduced sensation in and around particular parts of the body.
Radiculopathy (‘pinched nerve’)
Radiculopathy involves pain or weakness caused by compression or ‘pinching’ of a nerve root on the spine. It typically affects a range of muscles connected to the area of dysfunction. For example:
Cervical Radiculopathy - involves an impinged nerve in the neck, which can cause numbness, tingling and pain in the shoulder that may travel down towards the arm, hands or fingers.
Sciatica or Lumbar Radiculopathy - involves nerve compression or irritation in the lower back that causes pain or weakness in the foot or leg (usually on one side). It is usually caused by a herniated disc (‘slipped’ or ‘ruptured’ disc) in the lower back or spinal stenosis.
“In about 90% of cases, [sciatica] is caused by a herniated disc with nerve root compression” [1] - Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007 Jun 23; 334(7607):1313-7
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome relates to a compressed nerve in the wrist that causes pain or numbness in the fingers, with pain potentially extending up the arm.
How common is nerve pain?
Nerve pain (neuropathic pain) affects around 7-10% of the general population [2], while 5% of cases can be severe [3]. Such pain can affect either the central nervous system (the brain and spinal cord) or the peripheral nervous system (all nerves branching out from the brain and spinal cord).
“Neuropathic pain is caused by a lesion or disease of the somatosensory system, including peripheral fibres (Aβ, Aδ and C fibres) and central neurons, and affects 7–10% of the general population.” - Nat Rev Dis Primers. 2017 Feb 16; 3: 17002.
What causes nerve pain?
There are a range of causes for nerve pain, including:
diseases and medical conditions - such as cancer, diabetes and multiple sclerosis
infection - such as shingles and syphilis
injuries - particularly involving the back, legs or hips.
What are the risks associated with nerve pain?
Nerve pain typically begins at the extremities (such as the hands and feet) and progresses backwards towards the arms or legs. Left untreated, possible risks [4][5] include:
a herniated disc (‘slipped disc’ / ‘ruptured disc’)
increased pain
weakness or loss of feeling in the legs or hands
loss of bowel or bladder function
permanent nerve damage.
Appropriate treatment can stop the pain progressing any further and even reverse the progression or remove it entirely.
What are the treatment options for nerve pain?
Medication
A wide range of over-the-counter or prescription medications can be taken to address nerve pain, with varying efficacy. There are potential downsides to taking medication, which include:
only providing temporary pain relief
risk of dependence on medication
risk of side effects, such as headaches.
Surgical implants
Invasive treatment procedures exist that involve placing a device in either the brain or spine that helps control electrical impulses to the brain, spinal cord or nerves. These are usually employed when other treatments haven’t worked.
Chiropractic treatment
Chiropractic treatment is a means of relieving nerve pain without medication or surgical intervention. Part of chiropractic treatment includes spinal manipulation, which has been shown to be effective for the treatment of lower back pain with or without sciatica [6] and carpal tunnel syndrome [7]. Other studies support the use of manual therapies for treating cases of cervical radiculopathy [8][9].
“Consider manual therapy (spinal manipulation, mobilisation or soft tissue techniques such as massage) for managing low back pain with or without sciatica, but only as part of a treatment package including exercise, with or without psychological therapy.” - National Institute for Health and Care Excellence
During an initial consultation, chiropractors are able to assess, diagnose and subsequently treat nerve pain through a range of treatment methods including:
soft tissue therapy
physical modalities, including dry needling, electrical stimulation and ultrasound
providing lifestyle advice - with regard to muscle stretches, relaxation exercises and posture.
1. Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007 Jun 23; 334(7607):1313-7
2. Colloca, L., Ludman, T., Bouhassira, D. et al. Neuropathic pain. Nat Rev Dis Primers 3, 17002 (2017)
3. Didier Bouhassira, Michel Lantéri-Minet, Nadine Attal, Bernard Laurent, Chantal Touboul. Prevalence of chronic pain with neuropathic characteristics in the general population. PAIN, Elsevier, 2008, 136 (3), pp.380-7. 10.1016
4. University of Rochester Medical Center. Sciatica, Health Encyclopedia
5. Spine Health. Cervical Radiculopathy Symptoms, Cervical Radiculpathy,
6. National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management 2016 Nov 30.
7. Valente R1, Gibson H. Chiropractic manipulation in carpal tunnel syndrome. J Manipulative Physiol Ther. 1994 May;17(4):246-9.
8. Boyles R, Toy P, Mellon Jr J, Hayes M, Hammer B. Effectiveness of manual physical therapy in the treatment of cervical radiculopathy: a systematic review. J Man Manip Ther. 2011;19(3):135–42.
9. Brouillette DL, Gurske DT. Chiropractic treatment of cervical radiculopathy caused by a herniated cervical disc. J Manipulative Physiol Ther. 1994 Feb;17(2):119-23.
Comments