Introduction
Neuralgia is the technical term for nerve pain and refers to a pain that occurs in the supply area of a nerve. It is caused by an injury to the nerve itself and not by damage to the surrounding tissue. Nerve damage can be caused by mechanical influences such as pressure, inflammation, metabolic disorders, chemical influences such as burns and radiation damage.
What are the underlying causes of neuralgia?
Neuralgia is caused by damage to a nerve. The nerve fibers are irritated in various ways, which then cause pain. The mechanisms that trigger the pain can have different causes.
For example, the insulating layer of the nerve may have been damaged, which is why ongoing excitation also passes to the pain fibers and activates them. Furthermore, the nerve can be blocked by an injury, which leads to a lack of information in the brain and consequently to pain. It is also possible that the nerve is no longer supplied with sufficient blood by the damage, which leads to an undersupply, accumulation of metabolic products in the nerve cells and pain as a result. The causes of damage to the nerves and associated pain are many and varied, including
- Mechanical influences e.g. by crushing in an accident come.
- Inflammation of nerves such as shingles
- Metabolic diseases like diabetes.
- Chemical influences, e.g. in the context of severe burns or radiation damage, can cause nerve pain.
Neuralgia in the face
If a neuralgia occurs in the face, it is extremely unpleasant for the person concerned. Even small touches of the skin or movements, such as when speaking or chewing, cause pain. If this sensitivity to pain increases to its highest level, a gust of wind blowing over the face can cause pain.
The strength with which the pain occurs in the case of neuralgia in the face is enormous. When patients are asked to rate the intensity of pain on a scale from 1 to 10, the value 9 or 10 is almost always given. A particularly frequent nerve pain in the face is trigeminal neuralgia.
The damage or irritation is caused by the trigeminal nerve, a cranial nerve which is responsible for the sensitivity of the face. The pain sensations are also conducted via this nerve. The nerve pain is described by patients as attack-like and extremely intense.
The treatment of trigeminal neuralgia is difficult because conventional pain medication has little or no effect. For this reason, the anticonvulsant carbamazepine is often used, which is also used in the drug therapy of epilepsy. The drug lowers the threshold for pain sensations and thus has a preventive effect.
In the surgical treatment of facial neuralgia, in which parts of the nerves causing the pain are severed, there is a high risk of secondary damage. Often lifelong sensory disturbances remain in the face. However, surgery is the very last resort and is only considered in cases of extreme suffering.
A neuralgia of the ear is in most cases a post-zosterneuralgia. In this case, after a zoster oticus, i.e. a herpes disease of the ear, there is persistent pain. The type of pain and duration of the attacks is similar to that of other forms of neuralgia: Recurring periods of intense, shooting pain lasting seconds to minutes.
In addition, trigeminal neuralgia can also manifest itself predominantly in the ear if the branches of the trigeminal nerve leading to the ear are affected. Finally, neuralgic pain in the ear can also occur in the context of occipital neuralgia. Here, the occipital nerve, i.e. the nerve for the back of the head, is the culprit.
The ear can then also be affected, as some branches of the nerve pull into the ear and conduct pain information from the ear to the brain. Here, too, there are always violent attacks of pain lasting from a few seconds to several minutes. A neuralgia of the jaw is based on damage to the nerve tracts in the jaw that run to the teeth.
This can be caused by caries, inflammation or other dental diseases, but can also be the result of dental treatment.Neuralgia manifests itself in the form of shooting pains that radiate from the tooth into the palate and jaw. The pain attacks are usually triggered by chewing, cold or heat. If you have such complaints, a dental examination as soon as possible is strongly recommended.
If you hesitate too long, the process may progress, which should be prevented at all costs. Even the permanent intake of painkillers cannot replace a visit to the dentist. Firstly, this does not eliminate the cause, but only suppresses the symptoms, and secondly, a long-term intake of painkillers can cause considerable side effects, such as stomach ulcers.
Trigeminal neuralgia also sometimes manifests itself in the form of neuralgic pain in the jaw. This is the case when branches of the trigeminal nerve are affected which run in the skin above the jaw. The surface of the teeth is not equipped with nerves and therefore not sensitive to pain.
However, to the chagrin of many affected people, this does not apply to the pulp and neck of the tooth. So if an inflammation develops in these inner parts of the tooth or a caries disease penetrates to the pulp, the nerves running there are directly irritated. This is how the typical, extremely unpleasant neuralgia pain develops, which is described by most of those affected as “shooting up” and very severe.
If you feel such pain in your teeth, you should not wait and see a dentist as soon as possible. For the reasons described above, the pain is a sign that the disease has already reached the inside of the tooth and requires immediate treatment. Trigeminal neuralgia is one of the most common forms of neuralgia.
In this clinical picture, the trigeminal nerve is affected, whose numerous branches “sensitively supply” the skin of the face, as the expert says. This means that all sensory information from the skin of the face, i.e. information about touch, temperature, but also pain, is conducted via this nerve to the brain. The cause of trigeminal neuralgia can be too close contact between nerve and blood vessels: Over time, the rhythmically repeated expansion of the blood vessel generated by the heart causes the nerve sheath surrounding the nerve to break down.
As a result, the nerve becomes inappropriately sensitive and sends strong pain signals to the brain, even though there is actually no reason for this. Typical is therefore the triggering of the pain attacks by facial movements such as chewing. Since the face is constantly in motion, such as when talking or smiling, trigeminal neuralgia with its shooting, violent pain attacks often represents a high psychosocial burden for those affected, which can lead to secondary diseases such as high blood pressure or depression. Therapy options include conservative (drugs such as carbamazepine) and surgical (insertion of a Teflon layer between the vessel and nerve) options.
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