Pain protects us from damage to the body – for example when we come close to a source of heat such as a fire, we withdraw our hands to prevent damaging our skin. Nerve pain or neuropathic pain has no function, but is a consequence of damage to the nervous system. That damage can generate in the brain, the spinal cord or the nerve tracts.
Nerve pain can suddenly appear without reason, but can also be the consequence of a viral infection (shingles), an operation or a trapped nerve after an accident. Diabetics can also suffer from nerve pain as a result of their condition. The pain generated can also be experienced in different ways: for some, nerve pain comes and goes, for others the pain is continuous. Nerve pain can feel like a severe, burning, shooting or stinging pain. Besides pain, a damaged nerve can also affect the blood flow to parts of the body.
Carbamazepine belongs to the anti-epileptic drugs and is the preferred choice for many types of nerve pain. As such, carbamazepine will usually be prescribed by the doctor as a first choice.
For diabetics, it is essential to have the treatment of the condition under control, and doctors will prescribe amitriptyline for severe nerve pain as a consequence of diabetes or shingles infection. Amitriptyline belongs to a group called tricyclic anti- depressants, but the drug works a lot faster for nerve pains than to treat depression as a much lower dose is needed to be effective for nerve pains than to treat depression.
Normal painkillers (paracetamol) are preferred for pressure pain (as a consequence of a hernia for example). If normal painkillers do not work, doctors can prescribe tramadol – a painkiller which (partially) blocks pain signals to the brain. The pain is then experienced as less heavy.