If you are suffering from burning pain or tingling sensation in hands or feet; sharp shooting pain in legs; numbness in hands or feet, then you might be suffering from Neuropathic pain.

Watch this video about it on youtube: https://www.youtube.com/watch?v=n-YzIBR-3SQ&t=54s

What is a neuropathic pain? 

Neuropathic pain is a special type of pain which occurs when there is damage to nerve fibres, which produces tingling or burning type of pain. It is of two types:

1. Peripheral Neuropathic pain: It occurs when there is an injury to peripheral nerve fibres (A-delta or C-fibers) which carries pain sensation to the brain (Thalamus) for interpretation. 


2. Central Neuropathic pain: It occurs due to sensitization of central pain interpreting mechanisms (Thalamus) to falsely feel pain when peripheral nerve fibres are no longer sending pain impulses to them.

Worldwide-estimates of the prevalence of neuropathic pain is 7% i.e. 7 persons out of 100 people are suffering from different types of neuropathic pain.

Symptoms:

  • Tingling sensation or feeling of ants crawling under skin
  • Burning sensation
  • Sharp shooting pain or electric current-like sensation 
  • Stabbing pain
  • Dull pain with numbness or heaviness

Reasons for neuropathic pain:

  • Diabetes mellitus: Most common cause worldwide due to uncontrolled blood sugar levels, causing damage to nerve fibres.
  • Alcohol consumption/Cigarette smoking: Damage to nerve fibres or damage to blood vessels supplying nerve fibres.
Burning pain in feet
  • Neck pain/Low Back pain/Glutei pain
  • Vit. B12 deficiency
  • Chemotherapy for cancer patients
  • Post-Herpes virus infection
  • Post-Spine surgery
  • Post-Amputation
  • Diseases like Spinal cord injury, multiple sclerosis, HIV, Lead toxicity, etc.

Special Neuropathies:

1. Carpal tunnel syndrome: Tingling, burning sensation in hand which occurs due to compression of median nerve in the wrist area. It occurs in women especially due to pregnancy, hypothyroidism, diabetes, etc. and in men due to improper position of the wrist during working on computers.

2. Cervical Radiculopathy: Pain in neck and shoulder region (which increases with neck movements), along with sharpshooting pain radiating from neck to hand occurs in cases of cervical radiculopathy. This is due to compression of the cervical nerve root by disc prolapse, facet subluxation, muscle spasm, trauma, etc.

3. Lumbar Radiculopathy: Pain in lower back or glutei region with sharp shooting pain radiating from hip to leg/foot region, occurs in cases of Lumbar radiculopathy or Sciatica. This is due to compression of lumbar nerve root or sciatic nerve by disc prolapse, facet joint, trauma, hypertrophied ligamentum flavum, piriformis syndrome, etc.

4. Meralgia paresthetica: Tingling or burning sensation in front of the thigh, occurs due to compression of lateral cutaneous nerve of thigh, near waist region. Usual causes are tight or constrictive clothing at waist region, prolonged sitting, protuberant abdomen, etc.

Prevention of Neuropathy:

1. Avoid Alcohol consumption and cigarette smoking.

2. Maintain ideal body weight/BMI (Body mass index)

3. Lifestyle changes: Daily exercises (>30 minutes per day) or brisk walking or swimming; Avoid prolonged sitting or standing (>30 minutes).

4. Food/Diet should have following components:

  • Green vegetables e.g. spinach, fenugreek leaves (methi), radish, etc
  • Coloured vegetables e.g. Tomato, carrot, Capsicum (green/red), ladies-finger (bhindi)
  • Milk products e.g. Milk, buttermilk, curd, cheese (paneer)
  • Protein-rich foods e.g. Fish, egg, chicken, pulses (daal)
  • Fibre-rich foods e.g. Bran, oats, Brown-rice
  • Fruits e.g. Apple, orange, guava, papaya, pomegranate, Berries

5. Blood sugar control (in diabetics)

6. Care of feet:

  • Regular inspection of feet (with mirror)
  • Comfortable,well-fitted shoes
  • Regular consultation with a podiatrist
  • Treatment of wounds, foot deformities

7.  Adequate sleep

8.  Warm water bath (increases blood flow to the affected area)

Treatment:       

  • Consult Pain medicine specialist.
  • Neuropathic painkillers e.g. Amitriptyline, Pregabalin, Gabapentin, Capsaicin, Duloxetine, etc.
  • Vit. B12 supplements, Anti-oxidants, multi-vitamins.
  • Transcutaneous electrical nerve stimulation (TENS)
  • Acupuncture
  • Relaxation and Yoga
  • Neural Prolotherapy