How is neuralgia treated?

Written by Zhang Hui
Neurology
Updated on September 18, 2024
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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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What is brachial plexus neuropathy?

Brachial plexus neuropathy occurs when certain pathological changes affect the brachial plexus, causing clinical symptoms such as pain, numbness, and weakness. The brachial plexus is composed of four nerves from cervical vertebrae 6 to 7, 8, and thoracic vertebra 1. The brachial plexus gives rise to the median nerve, ulnar nerve, and radial nerve, making it a central hub. If the brachial plexus is injured, for instance, through trauma such as stretching, tearing, tumor compression, or bone impingement, this can lead to clinical manifestations including pain, numbness, and weakness in the arms and hands, a condition known as brachial plexus neuropathy. If such symptoms occur, it is crucial to promptly complete the necessary examinations to clarify the changes in the condition.

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How to diagnose occipital neuralgia?

Occipital neuralgia is a very common condition, generally characterized by pain in the back of the head. The nature of the pain is usually dull, but it can radiate to the top of the head. To diagnose occipital neuralgia, the main examination is to see if there are any significant tender points along the course of the greater occipital nerve. If there are obvious tender points, it is likely that occipital neuralgia is a possibility. Additionally, there are some underlying causes of occipital neuralgia, such as cervical spondylosis, osteoarthritis, or inflammation of muscles in the head and neck area, and even some tumors. Therefore, it is necessary to perform comprehensive auxiliary examinations to rule out these related diseases, including MRI of the cervical spine and X-rays. Treatment is relatively simple and may include the administration of nerve-nourishing medications and pain relievers. (The use of medications should be under the guidance of a doctor.)

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How is intercostal neuralgia treated?

In our clinical practice, for intercostal neuralgia, we generally have the following treatment methods: The first type is oral medication, specifically non-steroidal anti-inflammatory drugs, which can alleviate pain. The second type is traditional Chinese medicine, such as drugs that invigorate blood circulation and remove blood stasis, which can also increase local blood circulation to relieve pain. The third method is to use acupuncture, which has comparatively good therapeutic effects on this type of intercostal neuralgia. Generally speaking, most cases of intercostal neuralgia do not last very long. Regardless of which method you choose, you can achieve relatively good results, so the above methods are the most common treatments for intercostal neuralgia. (Medication should be used under the guidance of a doctor based on specific circumstances.)

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How to relieve neuralgia

Neuropathic pain can be relieved through treatments such as medication, physical therapy, and surgery. Medications used primarily include antiepileptic drugs and non-steroidal anti-inflammatory analgesics, such as carbamazepine, oxcarbazepine, gabapentin, pregabalin, sodium diclofenac, ibuprofen, and celecoxib. Physical therapy mainly involves localized heat application, massage, manipulation, and acupuncture. Surgical treatment is mainly suitable for patients who do not respond well to medication and physical therapy. Currently, the surgical approach mainly involves minimally invasive surgery to relieve nerve compression, thereby alleviating the symptoms of neuropathic pain. Beyond symptomatic treatment, it is important to identify and treat the underlying cause of the neuropathic pain, such as tumors, trauma, diabetes, etc. These causes can lead to neuropathic symptoms, so it is crucial to actively control these underlying diseases to potentially relieve neuropathic pain at its root. (Medications should be used under the guidance of a doctor.)

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Symptoms of neuralgia

Neuralgia comes in many types and is generally quite severe. Patients may experience episodes of intense, short-lasting pain. The common symptoms include: Firstly, a classic type is trigeminal neuralgia, where patients primarily suffer from episodic severe pain in the areas innervated by the trigeminal nerve. This can feel like burning or electric shocks, and is often unbearable. Treatment usually requires antiepileptic drugs. The second major type of neuralgia commonly seen is postherpetic neuralgia, where pain is intense and follows the nerve distribution. Tricyclic antidepressants and antiepileptic drugs can be used for treatment. Additionally, peripheral neuropathy caused by diabetes can also lead to neuralgia. (Please use medication under the guidance of a doctor.)