The Role of Your Pain Doctor in Treating Neuropathy
If you have been suffering with nerve pain, chances are you either already have received a diagnosis of neuropathy or you will receive such a diagnosis once you head to the pain clinic. The role of your pain doctor is to get your neuropathy pain under control so that you can get back to living a normal life.
Your pain doctor will work on getting the right balance for you that include using medications to reduce your nerve pain or even eliminate but at the same time making sure that the side effects you experience are minimal. Your pain doctor and your pain management team will also teach you ways that you can deal with your pain such as deep breathing.
Neuropathy is tricky to treat. Nerve pain does not respond to pain medications the same way that other types of pain do. That means your pain doctor will turn to different types of medications to help you such as nerve blocks that can be implanted, physical therapy that uses the TENS, and psychological therapy that helps you learn techniques for coping with your pain. It also means that usually multi disciplinary treatments are needed in order to get the best results.
Nerve pain is one of the most intense types of pain and so your pain doctor likely won’t mess around, instead getting you started on medication as fast as possible, and then working on secondary treatments once the first line of defense is working properly. You will need to be patient because it can take a while to find the medications that work for you. There is no cut and dry solution as everyone responds differently to these medications.
Pain medications that include opioids, analgesics, and NSAIDs are prescribed but you should know that these are the least effective treatment available. However, when pain medications are combined with anticonvulsants their effectiveness increases and the combination of medications seems to offer the highest level of relief for neuropathy. Also opioids tend to bring relief when the doses are high enough. Family doctors make the mistake of not prescribing high enough dosages. Your pain doctor will not make this mistake and will ensure that you receive adequate dosages. Opioid injections are the most effective.
Anticonvulsants are thought to be one of the most effective ways to bring relief to those suffering from neuropathy. These drugs are not FDA approved but rather this is a secondary use for them. Older drugs include felbamate, carbamazepine and clonazepam have been shown to be effective. However, gabapentin, which is a newer anticonvulsant is highly effective and it is well tolerated with very few side effects, making it a preferred choice.
Tricyclic Antidepressants like Amitriptyline help to reduce nerve pain and help neuropathy patients to sleep. The dosages used are small compared to what would be used when treating depression. The newer SSRI antidepressants don’t work the same.
Nerve blocks work by interrupting the pain signal to the brain and that brings the sufferer relief from the neuropathy. This is not as common a treatment as the ones we already discussed with your pain doctor may decide it’s right for you.