Overview

Neuralgia is a nerve pain typically caused by irritated or damaged nerve(s) that can occur anywhere in the body. While the cause of some nerve pain is not yet fully understood, common causes include aging, infections, and diseases such as diabetes or multiple sclerosis. Your pain from this condition can last for months or years and is usually severe. 

If you suspect you have shingles, which is one of the common causes of neuralgia, you should see your doctor. Shingles should be treated as soon as possible in order to prevent complications, such as postherpetic neuralgia. 

Currently, there is no cure for neuralgia, but it is treatable. Some types of neuralgia improve over time. Living with neuralgia can be difficult, so you may benefit from finding a support group to connect with others living with this condition. 

Treatment options 

The exact treatment for your pain depends on what type of neuralgia you have. Some common treatment options are:

• Blood sugar monitoring for diabetes-related neuralgia
• Medications: antidepressants, anticonvulsants, antispasmodic agents, short-term narcotic painkillers, topical creams containing capsaicin, botox injections
• Nerve block
• Physical therapy
• Surgery to help alleviate pressure on the affected nerve

If you’re over 50 years old, the Centers for Disease Control and Prevention (CDC) recommends getting a Shingrix vaccine to prevent shingles. This vaccine can also help prevent postherpetic neuralgia. 

Symptoms

Some common symptoms of all types of neuralgia include aching, muscular atrophy, involuntary muscle weakness and twitching, numbness, and tingling sensations. 

Trigeminal neuralgia

• Pain when touching your face, chewing, speaking, or brushing your teeth
• Constant aching or burning feeling that evolves into spasm-like pain in your face
• Pain in areas such as the cheek, jaw, teeth, gums, lips, eyes, or forehead
• Pain on one side of the face that can be localized to one spot or

Postherpetic Neuralgia

The symptoms of this type of neuralgia are generally relegated to the area where your shingles outbreak first occurred. The symptoms include:

• Pain lasting three months or longer after your shingles rash healed
• Burning, sharp, jabbing, deep, aching pain where your shingles rash was
• Sensitivity to light touch
• Itchiness and numbness

Glossopharyngeal Neuralgia

• Sharp, stabbing pain in the back of the throat, tongue, tonsils, and middle ear
• Pain while swallowing, drinking cold liquids, sneezing, coughing, talking, or clearing your throat

Occipital neuralgia

• Headache or dull, throbbing pain localized to the back of the head

Diagnostic tests

Before you visit your doctor, try to keep a journal of your symptoms, their frequency, and severity because your doctor will ask about these. If you noticed any triggers for pain, write those down too, but your doctor can help you further identify triggers. Make sure you bring a list of any medications, vitamins, or other supplements with their dosages and how often you take them to the appointment. 

Your medical professional will perform a physical exam and may send you to a variety of specialists to help further identify the cause of your pain and rule out other conditions. If your doctor suspects you have trigeminal neuralgia, they may send you to a dentist to make sure your facial pain is not a dental issue. Your doctor may order the following tests:

• Neurological examination
• Blood work
• MRI
• Nerve conduction velocity test

Types

• Postherpetic Neuralgia: occurs as a complication of shingles and can happen anywhere on the body and is usually isolated to one side of the body 
• Trigeminal: pain associated with the trigeminal nerve, which is the nerve responsible for facial sensations and motor functions, such as biting and chewing
• Glossopharyngeal: pain in the glossopharyngeal nerve, which is located in the neck and throat area
• Occipital: irritation of an occipital nerve at the back of your head which causes headaches

Causes

Some types of neuralgia, such as postherpetic neuralgia, have known causes while others, such as glossopharyngeal neuralgia, don’t. 

• Aging
• Infection: shingles, Lyme disease, HIB
• Diseases:
  • Multiple Sclerosis: This condition causes the myelin, or the covering of nerves, to deteriorate which may cause nerve pain
  • Diabetes: This condition increases your glucose levels which may damage nerves. Those experiencing neuralgia caused by diabetes will likely have nerve pain in their hands, arms, feet, and legs.
  • Chronic Kidney disease
• Nerve pressure: Pressure stemming from your bones, ligaments, blood vessels, and tumors may cause a type of neuralgia. A common cause of trigeminal neuralgia is the pressure caused by a swollen blood vessel. 
• Less common causes: Cancer medications, some antibiotics, chemical irritation, and trauma or injury to a specific area can cause neuralgia. 

Facts 

Trigeminal neuralgia is most common in people who are 50 years or older and affects women more than men.