Nerve pain in the back

introduction

Nerve pain, also as neuropathic pain referred to, arise through a direct Damage to nerves. This means that they differ fundamentally in their origin from other types of pain, such as headaches, pain after injuries or tumor pain.

Nerve pain is very different and individual. Mostly they are called suddenly occurring, severe burning pain described. However, they can also be saved as more permanent, sharp pain exist. Nerve pain in general, but also nerve pain in the back, can be included Loss of sensitivity and with motor failure symptomssuch as paralysis or weakness in the legs. Furthermore, those affected often feel a Numbness, as well as a reduced feeling of cold or warmth.
The sensory disturbances or symptoms of paralysis usually only occur within a certain skin area - im Coverage area of the damaged nerve.

Nerve pain in the back can have many different causes. The most common causes are Herniated discs or the Shingleswhich occurs preferentially on the trunk.

For more information, please also read our pages Recognize herniated disc and Shingles pain.

causes

A relatively common cause of back nerve pain is that disc prolapse. Herniated discs occur mainly between the ages of 30 and 50. Year of life and mostly concern the Lumbar spine. With age, the intervertebral disc loses its resilience, so that it is subject to high stress on the back, for example when heavy lifting, to a Tear in the intervertebral disc and to the emergence of the gelatinous, inner intervertebral disc nucleus (Nucleus pulposus) comes, which then presses on the emerging nerve roots.
The compression of the nerves by the herniated disc can lead to failure symptoms. This is how those affected feel strongest painthat can radiate down to the legs (Lumboischialgia), such as Loss of sensitivity (Sensory disturbances). In severe cases it can too Signs of paralysis come.
Every herniated disc should be urgent medically clarified and be treated. In severe cases, for example when paralysis occurs, or when the incontinence that occurs suddenly occurs, is often a surgery indexed.

Another cause of back nerve pain is that Shingles (Herpes zoster). Shingles is a disease that, after a had chickenpoxYears later, the virus reactivates, which then turns out to be more painful, blistered rash manifested.
The rash often occurs on the back or in the face on and leads to severe nerve pain, With Sensory disturbances and one Allodynia. Allodynia describes the symptom that normal contact in the affected area of ​​the skin can cause extreme pain.
Triggers for reactivation of the virus can be a weakened immune system, the Use of immunosuppressive drugs (for example cortisone) or a lot of stress be.
If the condition is not treated properly, it can lead to a Post-zoster neuralgia come. The strong nerve pain and pain when touched (Allodynia), although the rash is already healed is. Often times the pain boring and step as short attacks of pain on.

But also neurological diseases as a epilepsy, one multiple sclerosis, one Paraplegia or a stroke can be accompanied by nerve pain in the back or arms and legs. Often they are from painful cramps accompanied. Also Operations or Injuries to the back can damage the nerves and cause nerve pain in the back.

Symptoms

Nerve pain in general, but also nerve pain in the back, are very different. You can burning, stabbing or boring could be paroxysmal occur or as Persistent pain exist. Mostly there is no direct trigger for the pain. Furthermore they are Sensibility, the Cold and heat perception, as well as the Pressure perception significantly reduced.
Often also kick Tingling paresthesia ("Ant running"), itching or Muscle spasms on. In general, there is a Skin hypersensitivityso that they feel the greatest pain even on harmless touches or stimuli, which normally would not cause pain. This is also known as "Allodynia“.

Diagnosis

For the diagnostic clarification of nerve pain in the back, a thorough anamnesis is very important. The more precisely the patient can describe his pain, the easier it is for the doctor to make a correct diagnosis. In the anamnesis information about the exact Localization of the pain, the Pain quality, about the Frequency of pain attacks and the trigger raised. Usually there are special ones for this Pain questionnaires which the patient can fill out at home and bring to the first session.
Furthermore, a full neurological examwhere the sensitivity, temperature and pressure perception, as well as the motor skills are examined. By means of a Neurography the nerve conduction velocity can be determined. The QST (Quantitative sensory testing) is a new process that consists of a variety of various sensitivity tests exists and on the basis of the measurement results and the comparison with healthy test persons decides whether there is neuropathic pain or not.

To determine the pain intensity of a nerve pain, there is Pain scaleson which the patient can enter his subjectively perceived pain. This is particularly important for therapy and the use of painkillers. Also imaging examination methods, as the MRI of the spine or the Skeletal scintigraphy, can with certain forms of neuropathic pain (e.g. disc prolapse) are used.

therapy

At the beginning of any therapy for nerve pain in the back you must first organic diseases excluded or treated. With certain clinical pictures, such as a herniated disc, there is sometimes one surgery necessary. In the case of shingles, one should above all antiviral therapy be initiated.
Generally, however, nerve pain should as early as possible treated to achieve a good prognosis and to avoid chronic pain.

To treat nerve pain in the back, multimodal therapy is usually carried out - a combination of Painkillers, physical therapy and psychological treatment. In addition to classic painkillers, basic drugs for combating pain are such as Ibuprofen, Diclofenac and Novalgin, also Opioids.
Co-pain relievers are often drugs from the group of Anticonvulsants (Antispasmodic drugs) or Antidepressants used. These drugs have the advantage that they act on certain channels in the nervous system and the Passing on the pain can block directly. The drugs only achieve a full effect after about two to four weeks, therefore, it is important to be concerned Be patient and the drugs do not stop independently beforehand. Also the use of Capsaicin or lidocaine patches can help. Capsaicin patches can cause the nerve endings to become inexcitable by generating heat, and so on quick help bring with nerve pain.
Lidocaine is a Local anestheticthat enters the skin locally and numbs the overexcited nerves and thus counteracts pain.

With the help of physical therapy you can painful muscle tension and the functionality of the muscles can be preserved. Further physical measures that can lead to a relief of the discomfort are acupuncture, TENS or sports like yoga.

With the help of psychological therapy, the affected person becomes the Fear of pain taken and that Sparing behavior fights. Training courses like this are often helpful here Autogenic training or the Progressive Muscle Relaxation.

forecast

In general, the prognosis for chronic nerve pain in terms of complete healing is rather poor. However, using multimodal therapy concepts, a significant reduction in pain can be reached, helps those affected to actively participate in everyday life again and to sleep well at night. Generally, one is recommended in the treatment of nerve pain early pain reliefto prevent the pain from becoming chronic.

Medication

Medicines that are used in the treatment of nerve pain in the back are on the one hand classic pain relieverssuch as diclofenac, novalgin or opioids. These painkillers are often not effective on their own, which is why so-called "Co-analgesics“Can be used.
These are drugs from the class of antidepressants or anticonvulsants. Via a direct inhibition of ion channels in the nerve cells, the transmission of pain is blocked, resulting in a Freedom from pain leads. However, these drugs only achieve their full effect after about 2-4 weeks. Representatives of these groups are for example Amitriptyline, or also Pregabalin (Lyrica®).

Also Cortisone has an analgesic effect through its anti-inflammatory and decongestant components, and is often used in the Therapy for herniated discs used. Muscle relaxant drugs like Baclofen often help against painful spasticity and are also used in the treatment of nerve pain.

Nerve pain in the abdomen

Nerve pain in the abdomen can have various causes. A common cause is that Shingleswhich occurs preferentially on the trunk and face. But diseases of internal organs can also express themselves as nerve pain. Medical professionals speak of the Head zones, Skin areas that are assigned to specific internal organs.
So can stomach pain or Liver and gallbladder disorders in the Upper abdomen project. Pain around the navel around, can for Diseases of the small intestine speak. Diseases of Colon, of the Urinary tract or Genital organs project mainly into the Lower abdomen. Kidney disease can be called nerve pain in the Afford occur.
Organs that are not in the abdomen can also lead to nerve pain in the abdomen - for example, a Heart attack in some cases as diffuse epigastric pain With nausea manifest.

Nerve pain in the hip

Nerve pain in the hip is often associated Herniated discs in the lumbar spine together. Damage to the nerve root can lead to a stabbing nerve pain that radiates from the back, over the hips, to the leg. Depending on which side the herniated disc is on, the nerve pain in the hip occurs on the same side.

Of the "Lumbago“, An acute neuropathic pain in the lower back, often occurs in people between the ages of 30-50 and goes with it severe pain in the lower back and sometimes even in the Legs hand in hand. Often those affected can hardly stand up in the pain.
Causes of lumbago can be muscular tension or Blockages be in the sacroiliac joints, but also Herniated discs. If the symptoms do not go away within a few hours, or if they worsen, a doctor should be consulted.

Other causes of nerve pain in the hip may have taken place Operations or operations such as punctures on the hip. All invasive interventions can lead to injury and damage to the nerves, which then manifests itself as nerve pain. Depending on which side the operation took place, the pain occurs on the left or right.

Nerve pain in the leg

Nerve pain in the leg is common Herniated discs conditionally. When a nerve root is compressed by the intervertebral disc, sensory disorders occur in the skin area supplied by the nerve and, in severe herniated discs, even symptoms of paralysis. A herniated disc at the level of the fifth lumbar vertebrain which it becomes a Numbness that comes over the Inside of the leg, about the knee to Big toe leads.

Another cause of nerve pain in the leg can be poorly controlled blood sugar Diabetes mellitus (Diabetes) be. Constantly high blood sugar leads to a Damage to the nerve endings and thus to the destruction of the nerves that take the form of Numbness and burning pain noticeable in the legs. Most are in the case both legs at the same time affected. The pain starts at the soles and can go higher and higher. A well-adjusted blood sugar has a preventive effect.

Another cause of nerve pain is in the legs chronic alcohol consumption. Alcohol abuse leads to a reduced absorption of vitamin B12, which has a protective effect on the nerves. Through a Vitamin B12 deficiency there is damage to the nerves that emerge as Burn and as Numbness in the feet expresses.
But also after Operations or Injuries in the legs, nerve pain may occur in the affected leg.

homeopathy

Nerve pain should be for now medically clarified and treated become. However, homeopathic remedies can also be used to support and after consultation with the doctor. Against tingling paresthesia ("Ant running") helps for example zincoften helps against sharp pain or cramps magnesium. Also Johannis herbs Can be taken as an oral capsule or as an oil to help relieve nerve pain.
Other preparations that are used in homeopathy against neuralgia are Cantharis, Cyclamen (the cyclamen) or Verbascum (the Mullein). The latter two are mainly used in the Trigeminal neuralgia used.

The combined preparation "Apozema - Nerve Pain Drop No. 24“Can also be used for nerve pain to activate your own self-healing powers. As components it contains among other things Blue monkshood, Belladonna, Mullein and magnesiumall of which have good efficacy against chronic nerve pain. Before using homeopathic remedies, however, a doctor should be consulted in order to rule out a possible interaction with other drugs that one takes and thus avoid serious side effects.

Please also read our page Homeopathy for nerve pain.