Neuropathic Pain
Neuropathic pain is pain generated by damaged or diseased sensory nerves rather than ordinary tissue inflammation alone.
Key points
- Burning, electric shocks, tingling and pain from light touch support a neuropathic mechanism but do not identify its cause.
- Diabetes, shingles, nerve compression, chemotherapy and nutritional or alcohol-related neuropathy require different evaluation.
- Gabapentinoids, certain antidepressants and topical agents have different sedation, kidney, cardiovascular and interaction risks.
The listings below do not confirm neuropathic pain or its cause; neurological assessment should guide treatment.
Defining the nerve pattern
Location, sensory change, reflexes and weakness help identify a single nerve, nerve root, spinal cord or length-dependent neuropathy. Blood tests or imaging are targeted to diabetes, vitamin deficiency, thyroid disease, compression or another suspected cause. Sudden motor loss needs urgent evaluation.
Treatment goals
Medicine is titrated toward meaningful sleep and function improvement rather than complete numbness. Duloxetine, amitriptyline, gabapentin and pregabalin have condition-specific evidence and adverse effects; combination therapy increases burden. Physiotherapy, foot protection and treatment of the underlying disease remain important.
When to seek urgent care
Seek urgent care for new weakness, loss of bladder or bowel control, saddle numbness, rapidly ascending symptoms, a cold pale limb or severe pain with fever and spreading redness.