What is it?

What is Neuropathic pain? Well, I don't know exactly, but as I understand it Neuropathic pain occurs when your nervous system becomes hyper-sensitive. Feelings of pain and discomfort are generated without there actually being any pain receptors stimulated in the area pain is felt. From what Bill Turner has written it appears that the nerves that relay pain messages to the brain begin to misfire. Eventually your body can begin misinterpreting any senses (eg. touch, cold, hot, movement) as pain. This state can be very unpleasant, as any activity, massage, or change in environment causes discomfort and pain.

At first I could not recognise this type of pain. It felt like all my TPs had been reactivated at once, my skin crawled, I would become depressed, avoid social interaction, and have headaches. I would feel as if I did not want to move, or touch any part of my body, it was impossible to become comfortable. My muscles would all feel tight, although no amount of stretching would make me feel better.

Eventually I could recognise this as neuropathic pain. I would feel pain in the referred pain areas, but the TP itself was not necessarily painful. The whole thing would gradually subside over a period of perhaps a week.

Neuropathic pain was usually brought on by stress, or sometimes strong physical activity. I was particularly sensitive to any stress, so a visit to the doctor, a visitor or phone call could be enough to cause problems.

An example from my experience was a several hour trip by car with my parents to see my grandfather in another city. To begin with the car vibration was very uncomfortable, then arriving at the rest home for Alzheimer's patients things got worse. For a start place did not smell very good. I, as I always do, found it disturbing seeing elderly people I respect having lost their faculties, tied into chairs, talking nonsense. Especially being unable to speak sensibly with my grandfather, who also did not recognise us. Anyway, this was all stressful and I could not wait to leave. We were meant to be visiting others in the city, but I could not fact it, feeling extremely miserable and distracted. In the end I asked to be dropped off at the park gardens for the afternoon. I felt like I was in a cocoon of pain and discomfort. No position I would sit / stand / lie in would be comfortable.

Eventually, after many hours the worst had subsided, and several days later I was feeling much better.

TENS (Trans-cutaneous Electrical Nerve Stimulation)

To begin with I found TENS very helpful in alleviating neuropathic pain. The first thing was to recognise it. Looking back I think many TP reactivations were actually neuropathic pain. Using a TENS unit I set it at continuous, 1-2 pulses per second, wide pulse width. This was applied between the neck and arm. One electrode placed on shoulder at base of neck, the other on inside of elbow, or inside of wrist. 30 mins - 1 hr was enough to notice considerable difference. I had the strength quite high, in fact, as high as I could take. Often this would cause some muscles to jump with the pulses. For a while I did this every evening whilst watching television.

Although I experimented a bit I did not find high frequencies to be useful, the slow tense release cycle was best.

How TENS works successfully I don't know. Perhaps it anaesthetises the nerves that are generating the pain messages, or perhaps it somehow acts to turn of the nerves that are misfiring, and incorrectly interpreting messages as pain.

Relaxation

When I finally began to learn relaxation techniques I found that this could replace TENS, and was actually more effective. Measuring my muscle tension levels with an EMG unit I found that neuropathic pain was accompanied by high resting levels of muscle tension. After a successful relaxation session the EMG levels had decreased to more normal. This would usually take around 30 mins - 1hr. Leaving the EMG unit attached was useful, showing (with colour led level readout) the activity level slowly reducing with time. However, the EMG unit was not needed to tell me I had been successful, as the difference was easy to feel. Skin crawling, discomfort, etc would all subside.

Needless to say I needed much practice to do this effectively (see section on relaxation). But in the end, instead of neuropathic pain taking many days to subside I could get it under control in a few hours.

Nerve Stretches

These haven't really anything to do with neuropathic pain, but I had to mention them somewhere. I found these, done for the median, radial and ulnar nerves good for reducing a lot of discomfort in my arms / shoulders / neck. The trick is to do them a lot (several times a day), and gently (if pins and needles are felt you're doing it too strongly). A really good one is placing your palm against the wall at shoulder height, fore arm at right angles, hold shoulders as low as possible, turn head away from wall and try and move as far away from wall as you can without taking palm off wall, ie try and place as much distance between the wall and your head.

Exact stretches to do for each nerve can probably be found by asking your local physio, osteopath,

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