Neuralgia, which affects a nerve, is manifested by pain that can be permanent or start suddenly. There are different types of neuralgia depending on the location of the affected nerve. What are the causes ? And the treatments?
Neuralgia is a peripheral neuropathy (which reaches a peripheral nerve). Different types of neuralgia are distinguished depending on the location of the affected nerve. Neuralgia can be chronic or brutal. From symptoms evoked, neuralgia causes burning or a feeling of electric shock. What are the causes of neuralgia? How theto diagnose? And what treatments set up ?
Definition: what is neuralgia?
Neuralgia East peripheral neuropathy (which reaches a peripheral nerve). “It is the irritation of a nerve, often sensory, associated with pain similar to electric shocks“, summarizes Dr. Alexandre Morin, neurologist at Pitié-Salpêtrière (Paris). Neuralgia can affect different nerves for varying periods of time – days, weeks, sometimes years. She can manifest permanently or occur suddenlyeither spontaneously or due to movement or prolonged pressure on the area.
What causes neuralgia?
The causes of nerve damage are diverse:
- nerve compression,
- neurological pathologies,
- viral infections,
- strong shocks…
These causes may differ depending on the location of the neuralgia. Cervical trauma, after a fall for example, can cause Arnold’s neuralgia. Other causes include blockage of a cervical vertebra, lesions at the base of the skull, rheumatism or spinal cord disease (rarely) known as Syringomyelia. Dental neuralgia, on the other hand, is due to damage to a nerve located in the deep part of the tooth. The first sources of dental neuralgia are caries.
What are the types of neuralgia?
► Cervico brachial neuralgia. One of the most common neuralgias is cervico-brachial neuralgia, commonly called “neck sciatica” or “arm sciatica”, because it is a compression or irritation of a nerve in the neck that extends along the arm. The pain concerns the neck, collarbone, upper back, shoulder and arm, sometimes on one or both sides.
► Facial neuralgia that affects the trigeminal nerve causes severe pain in the face. “This nerve starts from the brainstem and innervates the face..” The pain is felt in the face and can radiate to the ear.
► Third type of common neuralgia: Arnold’s neuralgia. It affects the nerve formed by the “nerve of Arnold” which innervates the deep muscles of the neck. “The pain will then be localized at the level of the skull and neck“, says Dr. Morin.
► The dental neuralgia refers to a very sharp pain felt inside the mouth and due to damage to a nerve that innervates all the oral elements. The primary sources of dental neuralgia are cavities. While initially these cavities that form in the tooth are not painful, they eat away at the enamel of the teeth before spreading to the underlying tissues where they can cause, in advanced stages, inflammation of the nerve (tooth pulp). Other causes of dental neuralgia are abscesses, consequences of a bacterial infection of a tooth or gum.
► pudendal neuralgia, meanwhile, is more rare but very painful. It consists of damage to the nerves located in the deep region of the pelvis and causes pubic pain.
What are the symptoms of neuralgia?
Pain is frequently described as burning or electric shock sensationsometimes paresthesias pain, sensations of tingling or numbness, and more rarely, dizziness. The pain can radiate intensely and reach more or less large areas.
Neuralgia can be difficult to diagnose, due to extensive symptomatology. “It is a somewhat catch-all disease, causing many indirect signs“, explains the neurologist. An interrogation and a clinical examination allow you to put on the track. THE CT scan or MRI of the cervical spine is prescribed in case of persistent pain, in order to seek the origin of the compression of the nerve. “A electromyogram may also be ordered to assess nerve conduction, but this test cannot be performed on all nerves“, adds Dr. Morin.
► The taking standard analgesics such as paracetamol may be prescribed to relieve painful episodes. Locally, surgery may be considered to limit nerve compression. “Sometimes surgery is done around the trigeminal nerve to give him space“, adds the specialist.
► Non-drug therapies, such as sophrology, meditation or self-hypnosisare a useful remedy. “These approaches allow you to learn to live with your pain by working on it“, concludes Dr. Alexandre Morin.
► physiotherapy exercises allow you to suffer less and to avoid amyotrophy with a decrease in volume and tone of the muscle concerned, linked to the lack of physical activity. “But these exercises are not effective in all neuralgia – in case of damage to the trigeminal nerve, for example”underlines the neurologist.
Thanks to Dr Alexandre Morin, neurologist at Pitié-Salpêtrière (Paris).