What to do with tooth nerve pain?

Written by Li Bao Hua
Dentistry
Updated on August 31, 2024
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Common symptoms of dental nerve pain include severe toothache. If teeth are not brushed and rinsed promptly after eating, food residues linger on the teeth, and bacterial fermentation produces acids, leading to symptoms of dental nerve inflammation. This is also due to the further progression of dental caries. In such cases, dental treatment should be sought as early as possible. If the decayed dental tissues are removed and the dental nerve is not exposed, direct filling treatment can be conducted. If infected dental tissues are removed and the dental nerve is exposed, the treatment depends on the development status of the tooth root. If the tooth root is not fully formed, it is advisable to preserve the living dental nerve as much as possible, and direct pulp capping or vital pulpotomy can be performed. If the root apex foramen has already formed, infected purulent dental tissues or the dental nerve can be removed for root canal treatment.

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Written by Na Hong Wei
Orthopedics
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Symptoms of intercostal neuralgia

Intercostal neuralgia is essentially caused by inherent reasons, or pathological changes in the thoracic vertebrae, ribs, and pleura, leading to an inflammatory symptom involving the intercostal nerves. Therefore, the primary symptom of intercostal neuralgia is pain, but this pain has certain characteristics. First, the pain commonly occurs in the left second rib and the right second, third, and fourth ribs. Second, the range of the pain is usually semicircular; it does not extend beyond the anterior midline at the front or the posterior midline at the back, forming a semicircular pain along the ribs. Third, there are often fixed tender points, which sometimes are located in the costal cartilage or corresponding thoracic vertebrae and paraspinal area; these points, when pressed or tapped, can cause radiating pain. Fourth, many times the examination results are negative, so intercostal neuralgia tends to be a condition where the symptoms are severe, but physical examination often yields very few positive signs.

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Written by Zhang Hui
Neurology
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How to relieve neuralgia

Firstly, symptomatic treatment can be administered to patients. Medications for treating neuralgia mainly include tricyclic antidepressants and anticonvulsants, and serotonin reuptake inhibitors may also be effective. These medications should be taken under the advice of a doctor when necessary to help alleviate pain. Secondly, localized block treatment can also achieve certain clinical effects. Thirdly, it is crucial to identify the cause of the neuralgia and treat it accordingly. For example, if a patient’s neuralgia is caused by optic neuromyelitis, corticosteroids should be used; if it is due to herpes zoster virus infection, antiviral medications are required.

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Neurosurgery
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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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Written by Zhang Hui
Neurology
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How to deal with occipital neuralgia?

Occipital neuralgia is a relatively common type of neuralgia, and the following recommendations are suggested for its management: Firstly, it is important to identify the cause of the occipital neuralgia. There are many potential causes, such as cervical spondylosis, viral infections, or metastasis of tumors, among others. Actively searching for the cause and addressing it effectively, especially if it stems from cervical spine issues, is crucial. Secondly, medication can be used to alleviate symptoms. This typically includes painkillers, such as non-steroidal anti-inflammatory drugs. If the pain is more pronounced, medications used to treat neuralgia, such as antiepileptic drugs, can also be considered. Thirdly, local physical therapy, acupuncture, and, if necessary, local block treatment in the area most affected by occipital neuralgia, can also be effective.

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Neurology
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Causes of Neuralgia

Neuralgia is extremely painful, with patients often experiencing severe, unbearable pain. The causes of neuralgia mainly include the following types. The first type to note is viral infection, such as herpes zoster virus infection, which can leave postherpetic neuralgia. In such cases, it is crucial to actively use antivirals and employ neuropathic pain medications for treatment. The second scenario may relate to nerve compression, such as trigeminal neuralgia, which may be associated with local vascular compression causing abnormal nerve discharges. Surgical treatment might be necessary to relieve the compression. Sciatica is also caused by compression of the sciatic nerve. The third case might be due to nonspecific inflammatory responses. For example, Guillain-Barre syndrome can also cause neuralgia, and treatment should be directed at the underlying cause.