For most people, pain is an automatic reflex that protects them from damaging stimulus like a hot stove or candle. For example, heat exposure activates pain receptors in the skin, which pass a signal along a sensory neuron to the spinal cord. This activates a motor neuron, which sends a signal to the muscles in the arm, causing it to contract. But nerve damage can send false signals that cause real pain, or prevent individuals from feeling pain when they are injured.
Left untreated, nerve damage may worsen over time. Pain usually starts in the nerves farthest from the brain and spinal cord – like those in the feet and hands – and then moves up into the legs and arms.
One of the first symptoms of nerve damage is loss of sensation or numbness in the fingertips, which makes it harder for patients to do activities that involve the hands, such as knitting, typing, or tying shoes. Patients with nerve damage often report a dulled sense of touch.
Nerve pain is often worse at night, causing difficulty sleeping. Patients may be hypersensitive, reporting discomfort from the touch of sheets or the pressure of lying down.
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Patients with nerve damage often experience muscle weakness that may make it harder to maintain balance. Physical therapy and assistive devices, such as braces, canes and walkers, can be helpful for preventing falls.
Although some people develop nerve pain for no identifiable reason, identifying and treating underlying conditions such as diabetes, shingles, and cancer may help relieve pain and halt the progression of nerve damage.
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Medications for nerve pain relief include OTC painkillers such as nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, creams, ointments and gel, and prescription opioids.
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Complementary and alternative approaches to alleviating nerve pain include acupuncture, biofeedback, hypnosis, and meditation.