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Unexplained Nerve Pain: The Mystery of Neuropathic Pain

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If you have nerve pain, you know that it can take many forms: burning, tingling, electricity, and pins-and-needles are a few of the ways people describe the sensation. But if you have no idea what's causing the pain, you're not alone. Millions of people have unexplained nerve pain. While traditional medicine can offer some relief, there are a number of other ways to lessen the pain.

Known Causes of Nerve Pain

Nerve pain is caused by damage to the nerve. More than 50 medical conditions, drugs, and toxins are known to cause nerve damage, including:

  • Diabetes mellitus
  • Human immunodeficiency virus (HIV) infection
  • Celiac disease
  • Trauma
  • Amyloidosis
  • Fabry's disease
  • Medications, including B6 (pyridoxine), isoniazid, HIV medicines, or chemotherapy
  • Toxins, such as heavy alcohol drinking
  • Autoimmune conditions, such as lupus and vasculitis

Once a nerve is damaged, it is more likely to start behaving abnormally. It may become quiet and send no information, which causes numbness. Or it may send excessive and inappropriate pain messages.

Unexplained Nerve Pain: Searching for Causes

For many people, the cause of nerve pain cannot be identified even after extensive testing. This is called unexplained (idiopathic) nerve pain, or idiopathic neuropathy. Unexplained nerve pain may still be due to nerve damage that occurred at some point, but current medical knowledge and testing can't say how, when, or why.

Between 15 million to 20 million Americans are believed to have unexplained nerve pain -- about one in 10 people over the age of 40. It's most likely to occur in people over 60 years old.

In some studies, almost half of the participants with unexplained nerve pain also had prediabetes. Some experts believe that the elevated blood sugars of prediabetes may be the main cause of this.

Other studies have found that metabolic syndrome -- the combination of high blood pressure, abnormal cholesterol levels, obesity, and prediabetes -- is also common in people with unexplained nerve pain. These factors may contribute to the pain.

Symptoms of Unexplained Nerve Pain

Idiopathic peripheral neuropathy, like diabetic neuropathy, usually causes numbness in the hands and feet. The numbness may go unnoticed if it causes no pain.

Nerve pain in idiopathic peripheral neuropathy is usually in the feet and legs but can also be in the hands and arms. People describe their unexplained nerve pain in different ways:

  • Burning
  • Tingling
  • Pins-and-needles
  • Crawling
  • Electrical shocks

Simple touching can cause nerve pain, and pain may be constant even when there's no stimulation. Often, unexplained nerve pain is worst at night, interfering with sleep. This can compound the problem because people need adequate sleep in order to cope with pain.

Seeking Medical Care for Unexplained Nerve Pain

Anyone who has nerve pain should get a full physical examination done by a doctor. Get checked for diabetes, high cholesterol, and blood pressure. Get evaluated for recent viral illnesses and toxins to which you may have been exposed. Discuss your full family medical history with the doctor.

Medical therapies are available to treat unexplained nerve pain, and it's worthwhile to discuss them with your doctor. But while medications can help, they usually can't reduce more than half of the pain.

Self-Care and Home Treatment

Several self-care strategies can help you cope and live better with unexplained nerve pain.

  • Get moving. Regular exercise may expand blood vessels in the feet over time, nourishing damaged nerves back to health. Start with a daily walk and gradually build up your pace and distance.
  • Step up foot care. If you have nerve pain in your feet, examine them daily, wear comfortable shoes, and see a podiatrist regularly.
  • Get some sleep. Getting a good night's sleep can be tricky if you have nerve pain. Increase your odds by limiting caffeine intake in the afternoon, keeping a consistent bedtime, and reserving the bedroom for sleep.
  • Explore the mind-body connection. Ask your doctor or a trusted friend for a referral to a reputable professional who provides guided imagery, meditation, biofeedback, or hypnosis.

If your nerve pain isn't responding to medicines and your best self-care, it may be time to talk to a neuropathic pain specialist. Your primary care doctor will provide a referral, most likely to a neurologist. A neuropathic pain specialist may be familiar with the multiple "off-label" uses of medicines for nerve pain and be able to provide you with additional help.

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