Neuralgia is an intense, intermittent pain that follows the path of a nerve, and is caused by damage, inflammation, or irritation to that nerve. Neuralgia is usually a symptom of an injury, like a broken bone or sciatica, or an infection, like shingles.
There are a few different types of neuralgia. Trigeminal neuralgia, or tic douloureux, affects the trigeminal nerve (the main sensory nerve of the face), which causes an intense, shock-like pain to one side of the face. Trigeminal neuralgia most commonly affects women and people over the age of 50.
Occipital neuralgia occurs when the occipital nerve is damaged or inflamed. The symptoms include painful headaches in the upper neck, back of the head, or behind the ears.
Postherpetic neuralgia is a long-lasting, and sometimes permanent symptom of shingles. The nerve pain may be intermittent or continuous, and usually remains around the affected area of skin.
Pudendal neuralgia is a common pain condition and occurs when the pudendal nerve is irritated or compressed. Patients experience pain in their genitals, anus, or pelvis.
Each type of neuralgia may be debilitating and long-lasting, and may drastically reduce the quality of life. Luckily, there are treatment options for those who suffer from neuralgia.
There are both surgical and non-surgical options available to treat pain associated with trigeminal neuralgia. Though medication is available and a viable option, longer-lasting pain may require surgery.
Anticonvulsants were originally designed to treat epilepsy, however doctors have found them to be effective in treating nerve pain, including pain associated with trigeminal neuralgia. To be effective, anticonvulsants need to be taken on an ongoing basis, and not only during episodes of pain. Some of the side effects include dizziness, drowsiness, and nausea.
Surgical treatments for trigeminal neuralgia are usually reserved for patients who continue to experience intense pain, even after ongoing treatment with medication.
Microvascular decompression, or the Jannetta procedure, is the most common surgical procedure to treat trigeminal neuralgia. A small hole is drilled into the skull to expose the trigeminal nerve. Doctors then move the blood vessel away from the nerve. Though this procedure is the most invasive, it is also the most successful in fixing the underlying problem and relieving pain.
Percutaneous procedures are minimally invasive procedures that use a small needle to pierce the trigeminal nerve inside the skull. Percutaneous procedures relieve pain by injuring or destroying the part of the nerve fibers responsible for causing pain. The procedure also helps to suppress pain signals to the brain.
Stereotactic radiosurgery is a non-invasive surgery that uses photon beams to deliver highly concentrated doses of radiation to the trigeminal nerve root. Over the course of multiple treatments, the damage to the nerve interrupts the pain signals to the brain.
As with all surgery, the risks should be taken in account alongside the benefits. Though many trigeminal neuralgia patients experience relief after surgery, there is no guarantee.
Oral medications like anti-inflammatory medication, muscle relaxants, and anticonvulsants have been proven to reduce the pain of occipital neuralgia. Over-the-counter heating pads also offer relief when applied to the affected area. Many patients also include physical or massage therapy in their occipital neuralgia treatment.
Surgical treatments include occipital nerve stimulation, spinal cord stimulation, and a Ganglionectomy.
Wearing loose, comfortable clothing composed of breathable fabric will cause less irritation to the skin. A cold pack pressed to the area can also provide relief. Though medicine won’t stop the pain altogether, painkillers and ibuprofen can ameliorate symptoms and provide some pain relief. Patients may also speak to their doctor about the benefits of antidepressants and anticonvulsants to treat postherpetic neuralgia.
Pain medications can help relieve some of the pain associated with pudendal neuralgia. More movement and daily activity can help with nerve pain, but certain exercises, like squats or cycling, may make the pain worse. Physical therapy to relax pelvic muscles may also aid in pain relief.
We are here to help. Schedule an appointment with one of our physicians today to find relief.