Causes of Neuralgia

Written by Zhang Hui
Neurology
Updated on September 24, 2024
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Neuralgia is extremely painful, with patients often experiencing severe, unbearable pain. The causes of neuralgia mainly include the following types. The first type to note is viral infection, such as herpes zoster virus infection, which can leave postherpetic neuralgia. In such cases, it is crucial to actively use antivirals and employ neuropathic pain medications for treatment. The second scenario may relate to nerve compression, such as trigeminal neuralgia, which may be associated with local vascular compression causing abnormal nerve discharges. Surgical treatment might be necessary to relieve the compression. Sciatica is also caused by compression of the sciatic nerve. The third case might be due to nonspecific inflammatory responses. For example, Guillain-Barre syndrome can also cause neuralgia, and treatment should be directed at the underlying cause.

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Dentistry
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Symptoms of tooth nerve pain

Symptoms of tooth nerve pain include pain triggered by cold, hot, sour, sweet stimuli, spontaneous pain, secondary pain, and nighttime pain, as well as unlocalized pain. These are also the main symptoms of pulpitis. Among them, pain triggered by cold, hot, sour, and sweet stimuli is more obvious. Sometimes the pain may intensify with temperature changes, such as cold and hot stimuli. If the pulpitis reaches the acute suppurative stage, there may also be pain that worsens with heat and is relieved by cold. It is common to see patients coming to the clinic holding cold water, indicating that cold water may provide temporary pain relief. In addition, severe nighttime pain might occur, where there is no pain during the day, but intense pain at night, sometimes making it difficult to sleep or waking from sleep due to the pain. Sometimes tooth nerve pain can also be unlocalized, potentially causing pain in the temporal area or affecting both upper and lower jaw teeth.

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Written by Zhang Hui
Neurology
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How is neuralgia treated?

Neuralgia can cause severe pain and significantly impact a patient's life. Treatment for neuralgia primarily focuses on the following aspects: First, treatment should be based on the cause of the pain. For instance, if the patient suffers from trigeminal neuralgia, antiepileptic drugs may be prescribed. Surgery may be necessary in some cases. If the neuralgia is caused by a viral infection, active antiviral treatment is required. If tumor cells invade and cause the neuralgia, tumor treatment should be administered. The second type of treatment involves symptomatic management. This mainly includes medications to relieve neuralgia, commonly comprising tricyclic antidepressants and antiepileptic drugs, which can be effective in alleviating the pain and should be taken under the guidance of a doctor.

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Written by Zhang Hui
Neurology
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How to deal with occipital neuralgia?

Occipital neuralgia is a relatively common type of neuralgia, and the following recommendations are suggested for its management: Firstly, it is important to identify the cause of the occipital neuralgia. There are many potential causes, such as cervical spondylosis, viral infections, or metastasis of tumors, among others. Actively searching for the cause and addressing it effectively, especially if it stems from cervical spine issues, is crucial. Secondly, medication can be used to alleviate symptoms. This typically includes painkillers, such as non-steroidal anti-inflammatory drugs. If the pain is more pronounced, medications used to treat neuralgia, such as antiepileptic drugs, can also be considered. Thirdly, local physical therapy, acupuncture, and, if necessary, local block treatment in the area most affected by occipital neuralgia, can also be effective.

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Written by Na Hong Wei
Orthopedics
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How to diagnose intercostal neuralgia

The examination for intercostal neuralgia includes two parts. The first part is to confirm whether it is indeed intercostal neuralgia, often based on three reasons. The first is pain that follows a semicircular path along the ribs. Second, there are usually fixed tender points or percussion points, also called trigger points, where pressing will cause pain and lead to a type of pain that radiates along the path of the intercostal nerves. The third is that it is more commonly seen between the fifth and ninth ribs, often causing pain or triggering increased pain during activities like sneezing or deep breathing. With this, it is basically possible to diagnose intercostal neuralgia. However, identifying the cause of intercostal neuralgia is very complex. The usual causes of intercostal neuralgia include five aspects: The first is congenital anomalies, the second is trauma, the third is tumors, the fourth is inflammation, and the fifth is other causes. Therefore, a complete diagnosis of intercostal neuralgia should not only confirm the presence of intercostal neuralgia but also identify the underlying cause. Only by treating the cause of the intercostal neuralgia can there be a very good treatment outcome.

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Written by Zhang Hui
Neurology
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How to relieve neuralgia

Firstly, symptomatic treatment can be administered to patients. Medications for treating neuralgia mainly include tricyclic antidepressants and anticonvulsants, and serotonin reuptake inhibitors may also be effective. These medications should be taken under the advice of a doctor when necessary to help alleviate pain. Secondly, localized block treatment can also achieve certain clinical effects. Thirdly, it is crucial to identify the cause of the neuralgia and treat it accordingly. For example, if a patient’s neuralgia is caused by optic neuromyelitis, corticosteroids should be used; if it is due to herpes zoster virus infection, antiviral medications are required.