Neuralgia is a type of pain caused by a nerve that’s irritated or damaged. Causes include shingles and underlying medical conditions such as multiple sclerosis. Treatment will vary depending on the cause.
Neuralgia is a stabbing, burning, and often severe pain due to a nerve that’s irritated or damaged.
The nerve may be located anywhere in the body. The damage may result from one of several causes, including:
- an infection such as shingles
- a chronic condition such as multiple sclerosis (MS) or diabetic neuropathy
Treatment for the pain depends on the cause.
What’s the difference between neuralgia and neuropathy?A Healthline reader
Neuralgia is a type of pain that’s caused by a nerve problem, and neuropathy is a type of nerve damage.
There are many causes of neuralgia, including nerve injury, pressure on the nerve, and neuropathy.
Neuralgia causes pain because of disruption of a nerve’s structure or function. This can happen for many reasons.
You may feel nerve pain from:
- damage or injury to a nerve
- pressure on a nerve
- changes in the way a nerve functions
The cause of your pain may also be unknown.
Shingles is caused by the same virus as chickenpox. Your likelihood of having shingles increases with age.
An infection in a specific part of the body may also affect a nearby nerve. For example, if you have an infection in a tooth, it may affect the nerve and cause pain.
Pressure on nerves
Pressure or compression of nerves may cause neuralgia. The pressure may come from:
MS sometimes affects the sensory areas of the spinal cord or brain, which can make these regions hypersensitive.
Many people with diabetes have issues with their nerves, including neuralgia and neuropathy (nerve damage).
Diabetic neuropathy causes symptoms such as tingling or a “pins and needles” feeling.
Less common causes
Less common causes of neuralgia include:
There are multiple types of neuralgia. Neuralgia may be categorized by its cause or by the nerves it affects.
Common causes include dental work, a severe dental condition, and the pressure of a swollen blood vessel.
Other causes include:
- a blood vessel pressing down on the nerve where it meets with the brain stem
- nerve injury
Postherpetic neuralgia occurs as a complication of shingles and may affect any part of the body.
Neuralgia can occur wherever the outbreak of shingles occurred.
The pain can be mild or severe and intermittent or persistent. It can also last for months or years.
Because the pain always occurs along the path of a nerve, it’s usually isolated to one side of the body.
Pain from the glossopharyngeal nerve, which is located in the throat, isn’t very common. This type of neuralgia produces pain in the neck and throat.
Occipital neuralgia is another rare type of neuralgia. The occipital nerves are located in the scalp. As a result, occipital neuralgia causes a type of headache pain.
Intercostal neuralgia affects the intercostal nerves, which run through the chest, rib cage, and abdomen.
Neuralgia pain is usually severe and sometimes debilitating. If you have it, see a doctor or healthcare professional as soon as possible. If you don’t already have a healthcare professional, our Healthline FindCare tool can help you connect with physicians in your area.
Also, see a doctor if you suspect you have shingles. Shingles should be treated as soon as possible to prevent complications. Postherpetic neuralgia can cause debilitating and lifelong pain.
When you see a doctor about neuralgia, you can expect to be asked a series of questions about your symptoms.
The doctor will want you to describe the pain and tell them how long the pain has been a problem. You’ll also need to tell them about any medications you take and any other medical issues you have. This is because neuralgia may be a symptom of another illness such as MS, diabetes, or lupus.
The doctor will also perform a physical exam to pinpoint the location of the pain and the nerve that’s causing it, if possible.
You may also need to have a dental exam. For example, if the pain is in your face, the doctor may want to rule out other possible dental causes such as an abscess.
In addition, to help find an underlying cause of your pain, the doctor may order certain tests such as:
- Blood tests: A healthcare professional may perform a blood draw to check your blood sugar levels and kidney function.
- MRI: An MRI can help a doctor determine if you have MS.
- Nerve conduction velocity test: The nerve conduction velocity test can help a doctor determine the extent of your nerve damage. It shows how fast signals are moving through your nerves.
If the doctor can pinpoint the cause of your neuralgia, your treatment will focus on treating that underlying cause. If they can’t identify the cause, treatment will instead focus on relieving your pain.
Potential treatments may include:
- better blood sugar management, which might help slow the progression of diabetic neuropathy
- physical therapy
- a nerve block, which is an injection directed at a particular nerve or nerve group that’s intended to “turn off” pain signals and reduce inflammation
- medications to relieve the pain
- surgery to relieve pressure on the nerve
Medications that they may prescribe include:
- capsaicin, which is available as a cream or patch
- antidepressants such as amitriptyline or nortriptyline (Pamelor), which are effective in treating nerve pain
- antiseizure medications such as carbamazepine (Epitol, Tegretol), which are effective against trigeminal neuralgia
The Food and Drug Administration (FDA) has approved the use of Epitol and Tegretol for people with trigeminal neuralgia. However, most antidepressants and antiseizure medications are used off label for neuralgia.
Off-label drug use
Off-label drug use means a drug that’s approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that hasn’t yet been approved.
However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs but not how doctors use drugs to treat people.
So, a doctor can prescribe a drug however they think is best for your care.
Neuralgia can be uncomfortable and even debilitating, but it’s not life threatening.
There’s no cure for it at the moment, but various treatments are available to help improve your pain. More research is being performed to identify even more treatments, with a recent literature review touting botulinum toxin as a promising remedy.