One
of the most comprehensive treatments
of neuropathic pain was given
at the Washington DC Neuropathy
Summit in December 2010 by Dr.
Sudhir Diwan, MD Neurologist
titled Understanding Neuropathic
Pain is Key to Managing It.
To request a copy of this document
send an email to gene@neuropathysupportnetwork.org
and request document #PM 35.
Understand that some neuropathies involve symptoms, but not pain. Multifocal Motor Neuropathies and there variants are motor neuropathies and not sensory or autonomic neuropathies. Thus these neuropathies involve the inability to move muscles rather than messing with your sensations of touch or the internal systems of the body. If the motor nerves are damaged, this often does not present with pain, but with the inability to control the muscles affecting the feet and hands, so although this is understood in MS, few are aware that this is a fact of life for patients with a motor type Peripheral Neuropathy. Dr. Latov’s book talks about the idea of neuropathic pain and symptoms.
Only recently have we begun to understand neuropathic symptoms and pain and for some doctors even accepted them as a reality. To add to the nightmare, I remember the boss who played doctor and assumed that all of this pain and the symptoms were due to my inability to handle stress and my working too hard! His punishment was to take away salary and force me to work part time!
Neuropathic pain is not like other types of pain and will not respond to the normal pain medications. The reason for this is that in normal pain, if you put a burning match to your foot you feel normal pain and that pain signal is sent to your brain allowing you to protect the foot by removing the lit match. However, in neuropathic pain or symptoms there is no match or flame touching the foot, but the peripheral nerves have been damaged and so these damaged nerves are sending a message of pain back to the brain. If you say your foot is burning and there is nothing touching your foot, they of course will look at you like you are crazy. But you are not crazy; you have neuropathic pain or symptoms from damaged peripheral nerves. This really gets difficult when you tell someone your foot feels numb (this is damaged nerves no longer working) and there is burning (damaged nerves sending this single to the brain) at the same time. How on earth can your foot be numb and yet feel pain? We are a strange bunch!
The answer is: Neuropathic pain is caused by damaged peripheral nerves and may include sensations of numbness (no feeling) or extreme painful sensitivity to touch, electric shocks, burning, tingling, overflow incontinence, digestive problems of bloating or alternating constipation and diarrhea, problems with sweating, absence of tearing, difficulty breathing or swallowing, bone pain, muscle cramps, strange feelings like balloon feet or socks and gloves on when they are absent. The most important thing to realize is that you are not crazy, but you probably have damaged peripheral nerves and deserve to be treated medically and with respect. Now realize that many diseases may cause some of the above symptoms, but peripheral neuropathy, given your medical history and total symptoms, must be considered by the doctor as he evaluates your illness.
Understand that some neuropathies involve symptoms, but not pain. Multifocal Motor Neuropathies and there variants are motor neuropathies and not sensory or autonomic neuropathies. Thus these neuropathies involve the inability to move muscles rather than messing with your sensations of touch or the internal systems of the body. If the motor nerves are damaged, this often does not present with pain, but with the inability to control the muscles affecting the feet and hands, so although this is understood in MS, few are aware that this is a fact of life for patients with a motor type Peripheral Neuropathy. Dr. Latov’s book talks about the idea of neuropathic pain and symptoms.
Only recently have we begun to understand neuropathic symptoms and pain and for some doctors even accepted them as a reality. To add to the nightmare, I remember the boss who played doctor and assumed that all of this pain and the symptoms were due to my inability to handle stress and my working too hard! His punishment was to take away salary and force me to work part time!
Neuropathic pain is not like other types of pain and will not respond to the normal pain medications. The reason for this is that in normal pain, if you put a burning match to your foot you feel normal pain and that pain signal is sent to your brain allowing you to protect the foot by removing the lit match. However, in neuropathic pain or symptoms there is no match or flame touching the foot, but the peripheral nerves have been damaged and so these damaged nerves are sending a message of pain back to the brain. If you say your foot is burning and there is nothing touching your foot, they of course will look at you like you are crazy. But you are not crazy; you have neuropathic pain or symptoms from damaged peripheral nerves. This really gets difficult when you tell someone your foot feels numb (this is damaged nerves no longer working) and there is burning (damaged nerves sending this single to the brain) at the same time. How on earth can your foot be numb and yet feel pain? We are a strange bunch!
The answer is: Neuropathic pain is caused by damaged peripheral nerves and may include sensations of numbness (no feeling) or extreme painful sensitivity to touch, electric shocks, burning, tingling, overflow incontinence, digestive problems of bloating or alternating constipation and diarrhea, problems with sweating, absence of tearing, difficulty breathing or swallowing, bone pain, muscle cramps, strange feelings like balloon feet or socks and gloves on when they are absent. The most important thing to realize is that you are not crazy, but you probably have damaged peripheral nerves and deserve to be treated medically and with respect. Now realize that many diseases may cause some of the above symptoms, but peripheral neuropathy, given your medical history and total symptoms, must be considered by the doctor as he evaluates your illness.
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