Pain And Your Nerves
Colleen Shannon, our Health Writer, explains how to find help.
WHEN you’re hurting day in and day out, it really wears you down physically and emotionally. Depression, anxiety and fatigue are common in people who have chronic (long-lasting) pain, which affects one in five people.
While there is not always a cure, fortunately the right care can make a big difference, and help you get your life back.
There are two main kinds of pain: the type that comes from damage to the body’s tissues (known as nociceptive pain) and pain that is caused by nerves that are damaged or working incorrectly (neuropathic pain).
This second type is often more severe and harder to treat, so I asked pain specialist Dr Jonathan Mcghie to tell us more about it. Dr Mcghie is a Consultant in Anaesthesia and Pain Medicine, and a Member of the Board for the Faculty of Pain Medicine of the Royal College of Anaesthetists.
He explained that neuropathic pain affects up to eight in 100 people. Some common causes of neuropathic pain are diabetes, chemotherapy, cancer, strokes and shingles. Having an injury, or the after effects of surgery, can also cause longlasting neuropathic pain. It happens when the body’s natural rewiring process, which can repair damaged nerves and their connections, goes wrong.
In some people, a pain pathway through the nerves becomes permanently switched on. You can think of it like a frayed electrical wire that keeps on sparking. The system can also wind itself up more and more, so that even a light touch becomes painful.
People describe it as shooting pain, like a bad sunburn, or being scalded. Sometimes it is numb and tingling.
If you have this type of pain – or indeed any kind of lasting pain – please do see your GP. They can refer you to the local pain management clinic if needed.
Once you have a diagnosis, a specialist pain service can offer a range of drug and non-drug treatments. Some people take a low dose of anti-depressant medication, which helps dampen the pain signals.
Certain drugs that were designed for epilepsy may also help to stop that winding-up process. They don’t work for everyone, and sometimes different drugs are combined.
Very strong painkillers may help in some cases, but they have risks that must be balanced with the benefits.
Depending on the cause and location of the nerve damage, some people have implants or injections.
Helping your mind and body adapt is also important. Physiotherapy can allow you to manage better on the physical side. You may be offered counselling to deal with the negative thoughts and mood changes that can develop as a result of persistent pain.
To learn more online, visit chronicpainscotland.org or paindata.org. The Faculty’s website at www.rcoa.ac.uk/faculty-of-pain-medicine/for-patients-andrelatives also has information. Or go to www.nice.org.uk/guidance/cg173 to read new NHS guidelines on this condition, including information for the public.
The Brain and Spine Foundation has information at www.brainandspine.org.uk/ neuropathic-pain, and you can call 0808 808 1000 to talk to a helpline nurse. n