Neuropathic pain is chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord).
Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Neuropathy is a dysfunction of nerves leading to loss of sensation. Although many people develop neuropathy, a limited number of those people go on to experience pain associated with their symptoms. This condition is known as painful neuropathy, and the pain is described as neuropathic pain.
The specific reason that pain develops with neuropathy isn't known. Several theories have been proposed; one theory suggests that when nerve cells are unable to conduct sensory impulses or messages, spontaneous activity begins within the nerve cells that the brain interprets as pain.
Unlike pain that occurs in response to an injury, neuropathic pain occurs without any associated stimulation. At times, neuropathic pain may be associated with an exaggerated or heightened sensitivity to normal stimulation (such as a light touch or the sensation of clothing) and these sensations may be misinterpreted as pain.
Pain is unique to everyone. As such, the words used to describe neuropathic pain may vary. Frequent descriptions include pricking, tingling, burning, stabbing, or aching. The pain may be present on a constant basis, or it can wax and wane in intensity. As described, the pain is most often present without associated stimulation, but actions such as bearing weight may dramatically exacerbate or worsen the pain.
What are the causes of and risks for neuropathy and neuropathic pain?
There are multiple causes of neuropathy, ranging from diabetes mellitus (the most common cause of neuropathy in the U.S.) to exposure to toxins. Many illnesses -- not just diabetes -- may be associated with development of neuropathy, including HIV and kidney failure. Injury to a peripheral nerve can lead to neuropathy. Alcohol and tobacco can lead to neuropathy and some prescription drugs have been shown to cause neuropathy. Shingles (herpes zoster) can lead to pain in the nerve fibers which were affected by the rash. Once neuropathy has developed, pain may begin at any point. At this time, doctors aren't able to predict who will develop neuropathic pain; in fact, many people are unaware of the presence of neuropathy until pain begins.
What are treatment options for a patient with diabetic neuropathy?
There are newer medications on the market that may be of benefit called duloxetine (Cymbalta) and Lyrica. You should speak with your doctor about the possibility of trying these agents either alone or in combination with other medication.