How is neuralgia treated?

Written by Zhang Hui
Neurology
Updated on September 18, 2024
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Neuralgia can cause severe pain and significantly impact a patient's life. Treatment for neuralgia primarily focuses on the following aspects: First, treatment should be based on the cause of the pain. For instance, if the patient suffers from trigeminal neuralgia, antiepileptic drugs may be prescribed. Surgery may be necessary in some cases. If the neuralgia is caused by a viral infection, active antiviral treatment is required. If tumor cells invade and cause the neuralgia, tumor treatment should be administered. The second type of treatment involves symptomatic management. This mainly includes medications to relieve neuralgia, commonly comprising tricyclic antidepressants and antiepileptic drugs, which can be effective in alleviating the pain and should be taken under the guidance of a doctor.

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Written by Liu Shi Xiang
Neurology
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How to relieve neuralgia

Neuropathic pain can be relieved through treatments such as medication, physical therapy, and surgery. Medications used primarily include antiepileptic drugs and non-steroidal anti-inflammatory analgesics, such as carbamazepine, oxcarbazepine, gabapentin, pregabalin, sodium diclofenac, ibuprofen, and celecoxib. Physical therapy mainly involves localized heat application, massage, manipulation, and acupuncture. Surgical treatment is mainly suitable for patients who do not respond well to medication and physical therapy. Currently, the surgical approach mainly involves minimally invasive surgery to relieve nerve compression, thereby alleviating the symptoms of neuropathic pain. Beyond symptomatic treatment, it is important to identify and treat the underlying cause of the neuropathic pain, such as tumors, trauma, diabetes, etc. These causes can lead to neuropathic symptoms, so it is crucial to actively control these underlying diseases to potentially relieve neuropathic pain at its root. (Medications should be used under the guidance of a doctor.)

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Written by Zhang Hui
Neurology
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How to diagnose occipital neuralgia?

Occipital neuralgia is a very common condition, generally characterized by pain in the back of the head. The nature of the pain is usually dull, but it can radiate to the top of the head. To diagnose occipital neuralgia, the main examination is to see if there are any significant tender points along the course of the greater occipital nerve. If there are obvious tender points, it is likely that occipital neuralgia is a possibility. Additionally, there are some underlying causes of occipital neuralgia, such as cervical spondylosis, osteoarthritis, or inflammation of muscles in the head and neck area, and even some tumors. Therefore, it is necessary to perform comprehensive auxiliary examinations to rule out these related diseases, including MRI of the cervical spine and X-rays. Treatment is relatively simple and may include the administration of nerve-nourishing medications and pain relievers. (The use of medications should be under the guidance of a doctor.)

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Written by Li Bao Hua
Dentistry
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What to do with tooth nerve pain?

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 Li Bao Hua
Dentistry
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Symptoms of tooth nerve pain

Symptoms of tooth nerve pain include pain triggered by cold, hot, sour, sweet stimuli, spontaneous pain, secondary pain, and nighttime pain, as well as unlocalized pain. These are also the main symptoms of pulpitis. Among them, pain triggered by cold, hot, sour, and sweet stimuli is more obvious. Sometimes the pain may intensify with temperature changes, such as cold and hot stimuli. If the pulpitis reaches the acute suppurative stage, there may also be pain that worsens with heat and is relieved by cold. It is common to see patients coming to the clinic holding cold water, indicating that cold water may provide temporary pain relief. In addition, severe nighttime pain might occur, where there is no pain during the day, but intense pain at night, sometimes making it difficult to sleep or waking from sleep due to the pain. Sometimes tooth nerve pain can also be unlocalized, potentially causing pain in the temporal area or affecting both upper and lower jaw teeth.

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Written by Zhang Hui
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.