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Neuropathy (neuropathic) pain is a common symptom that can be caused by a variety of different damaging conditions against the nerves in the brain, spinal cord or peripheral nerves. Whilst many non-specialists treat neuropathy (neuropathic) pain in exactly the same way despite a different cause, it is important to consider the cause as pain treatments and results will vary widely. This is where the advice of a pain specialist is important, and some of the specific treatments will be outlined below.

Diabetic Neuropathy:

Neuropathy (neuropathic pain) secondary to diabetes is a common symptom and can be very difficult to treat. It commonly presents as nerve pain in the feet and legs symmetrically, but can affect the hands as well.  The National Institute for Health and Clinical Excellence which governs NHS treatments, recommends Duloxetine (Cymbalta) as the first line treatment for this condition.

Post Herpetic Neuralgia:

This is a nerve pain condition common in the elderly and is a result of nerve damage after shingles.  It  presents with pain and extreme skin sensitivity (allodynia) in a well defined area. The use of medicated plaster called Versatis which has been impregnated with local anaesthetic has revolutionised the treatment of this condition and is well tolerated with minimal side effects.

A new capsaicin plaster (quetenza) also shows promising long term benefit but is not widely available as yet.

Percutaneous Electrical Nerve Stimulation:

This is the latest in technique used to alleviate neuropathy pain, and has just been approved for the management of neuropathic pain by the National Institute for Health and Clinical Excellence which governs NHS treatments. This technique involves insertions of a small needle under the skin layer adjacent to the nerve and stimulating it with a tiny electrical current.  This can be used in a variety of neuropathic pain conditions from diabetic neuropathy to focal pain syndromes like post herpetic neuralgia.

Spinal Cord Stimulations:

This advanced technique similar to the technology used in heart pacemaker systems, it involves stimulating the pain nerves in the spinal cord to alleviate nerve pain associated with chronic back and leg pain after spinal surgery.  It is currently available in only specialised centres in the NHS.  It holds the exciting promise of being able to treat chronic back pain and avoiding spinal surgery in the future with the use of the new NEVRO system.