Nerve pain; Painful neuropathy; Neuropathic pain
Neuralgia is a sharp, shocking pain that follows the path of a nerve and is due to irritation or damage to the nerve.
Common neuralgias include:
Causes of neuralgia include:
In many cases, the cause is unknown.
Postherpetic neuralgia and trigeminal neuralgia are the two most common forms of neuralgia. A related but less common neuralgia affects the glossopharyngeal nerve, which provides feeling to the throat.
Neuralgia is more common in older people, but it may occur at any age.
Symptoms may include any of the following:
The health care provider will perform a physical exam, and ask about the symptoms.
The exam may show:
Other symptoms (such as redness or swelling) may help rule out conditions such as infections, bone fractures, or rheumatoid arthritis.
There are no specific tests for neuralgia. But, the following tests may be done to find the cause of the pain:
Treatment depends on the cause, location, and severity of the pain.
Medicines to control pain may include:
Other treatments may include:
Procedures may not improve symptoms and can cause loss of feeling or abnormal sensations.
When other treatments fail, doctors may try nerve or spinal cord stimulation. In rare cases, a procedure called motor cortex stimulation (MCS) is tried. An electrode is placed over part of nerve, spinal cord, or brain and is hooked to a pulse generator under the skin. This changes how your nerves signal and it may reduce pain.
Most neuralgias are not life threatening and are not signs of other life-threatening disorders. For severe pain that does not improve, see a pain specialist so that you can explore all treatment options.
Most neuralgias respond to treatment. Attacks of pain usually come and go. But, attacks may become more frequent in some people as they get older.
Sometimes, the condition may improve on its own or disappear with time, even when the cause is not found.
Complications may include:
Contact your provider if:
Strict control of blood sugar may prevent nerve damage in people with diabetes. In the case of shingles, antiviral drugs and the herpes zoster virus vaccine may prevent neuralgia.
Katirji B. Disorders of peripheral nerves. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 107.
Scadding JW, Koltzenburg M. Painful peripheral neuropathies. In: McMahon SB, Koltzenburg M, Tracey I, Turk DC, eds. Wall and Melzack's Textbook of Pain. 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 65.
Smith G, Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 392.BACK TO TOP
Review Date: 6/23/2020
Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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