Neuropathic Pain
Neuropathic Pain is caused by damage to or dysfunction of either the central or peripheral nervous systems. It is a very chronic (long term) and ultimately complex pain that is different from typical injury pain which is simply the result of direct activation of pain receptors in the body. In Neuropathic Pain, the injured nerve fibers can send incorrect signals to pain centers resulting in pain at the site of injury and also areas surrounding the injury. Although its cause may not be specifically known, some disease states commonly result in Neuropathic Pain. Alcoholism, amputation, diabetes, HIV infection or AIDS, multiple sclerosis and direct spine injury may cause it.
Neuropathic pain is very difficult to diagnosis and very often hard to treat. This is due to the fact that the pain reported is often not evident by physical examination findings. To some patients the pain is caused by the slightest touch or movement, which is termed hyperexcitability. The type of pain patients may present with can differ widely. It may show as numbness, hot burning sensation, pins and needles, muscle weakness, or like an electrical shock. It is important to try and recognize what makes the pain better or worse, where it is located, how it compares to past pain experiences and does the pain change with time? All of these factors are essential in helping your physician properly diagnose the pain.
Even after the difficult diagnosis is properly made, treatment can be very complex and at times seem like trial and error. Due to the wide range of causes and symptoms of Neuropathic Pain, treatments often vary from patient to patients. Some of the easier cases are treated with over the counter non-steroidal anti-inflammatory drugs (NSAIDs) like Motrin or with Tylenol. Unfortunately, this is not very common in many Neuropathic Pain patients. Usually prescription strength medications are needed to relieve the pain. Opioids are commonly used medications (morphine or fentanyl) that have variable success rates, although tolerance and dependence are possible barriers to treatment with these drugs. Anti-seizure drugs like Neurontin and other specifically designed drugs like Lyrica have also been successfully used.
Even with all of these commercially available prescription medications, sometimes relief is still not found. In these cases it is important that medications be specifically made for each individual. Unlike many other community pharmacies, we here at Lee Davis Pharmacy have the ability to compound unique formulations of medications to fit each person’s specific need. We can work with your physician as a team to find a combination that works. It is possible with Neuropathic Pain that oral medications do not reach the site of pain in high enough concentrations to work, so we can compound topical formulations that can be applied directly to the area. Understanding your options and finding an appropriate treatment are essential elements in the treatment of Neuropathic Pain.
