Pathological changes within the nerve are the ultimate answer to what is chronic nerve pain according to this article. Nerve fibers are totally damaged due to partial nerve injury, which causes chronic inflammation and tenderness. Diabetes and HIV can also be attributed towards death of the nerve fibers. A chronic nerve injury may be evoked by a stimulus causing intense burning and spontaneous soreness, which is unbearable and may sometimes be fatal. Non-steroidal anti-inflammatory drugs can provide adequate relief for chronic inflammatory soreness.

What Is Chronic Nerve Pain?

Chronic nerve soreness results from pathological changes within a nerve that appear to be self-sustaining and thus continues for a long time.

Chronic nerve soreness results from pathological changes within a nerve that appear to be self-sustaining and thus the continues for a long time. The pathological changes can result from partial damage to a nerve and/or inflammation within the nerve. It is this we have studied. They can also result from diseases involving the nerve.
What can cause partial nerve injury that leads to chronic nerve pain?

 

Partial nerve damage leads to death of some nerve fibres within a nerve, and survival of other fibres. Partial damage can result from crush or stretch of a nerve during an accident, or during surgery sometimes leading to long term postoperative pain. Some lower back pain results from a nerve being compressed or partially crushed, or from a prolapsed disc causing pressure on the nerve and also local inflammation.

 

Death of some nerve fibres within a nerve also occurs in some diseases, including diabetic neuropathy in patients with advanced diabetes, and also in HIV. Other autoimmune diseases have immune responses within the nerve that cause nerve damage and neuroinflammation. Several chemotherapeutic drugs for cancer cause toxic damage to peripheral nerves. All the above can result in chronic nerve pain.

Do the damaged or surviving nerve fibres cause the pain?

 

There is growing evidence that degeneration of damaged nerve fibres and particularly of their myelin sheaths, cause neuroinflammation and/or immune system activity, and that this causes greater excitability and firing of the surviving fibres, which contributes to, or results in, chronic pain. Simply, the degeneration of damaged fibres may cause an environment that triggers activity in the surviving fibres.

 

By showing changes in subgroups of these surviving neurons that could lead to the different qualities of chronic nerve pain, our study adds support to the view that the surviving fibres are very important in causing chronic nerve pain.

What are the different qualities or types of chronic nerve pain?

 

Patients experiencing chronic nerve pain describe a combination of different types of pain. The pain may be evoked pain (a stimulus is needed to cause the pain) as in allodynia: intense pain from gentle stimulation such as skin touch (e.g. moving cotton wool across the skin) or hyperalgesia: more pain caused by a normally painful stimulus.

 

Patients also report spontaneous pain unrelated to any stimulus: either ongoing burning pain or sharp, shooting, stabbing pain. This spontaneous pain is hard to live with as it is unrelenting, sometimes called “unbearable” and makes people feel very unwell and very miserable. People with this type of pain may find they are unable to be comfortable even in bed, which can cause insomnia. Some patients report strange sensations, called paresthesias.

 

What methods of pain relief do patients with chronic pain currently use?

 

Many people find pain relief with drugs available over the counter, including the non-steroidal anti-inflammatory drugs (NSAIDS) such as paracetamol/acetaminophen, aspirin, and ibuprofen. If these do not provide adequate relief, it is important to consult a physician who prescribe a variety of drugs including: the NSAID diclofenac/volterol, gabapentin or pregabalin, lidocaine patches, opioids, tramadol or tricyclic antidepressants.

 

These have all been shown to be effective but their efficacy varies between patient and the use of some is limited by adverse side effects. There are other treatment options, but treatment is often not fully effective, leaving an urgent need for development of more effective neuropathic pain therapeutics.

 

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Unending research work is in progress to find out the exact causes of chronic injury, but adequate information is gathered which explains what is chronic nerve pain. When the nerve fibers are totally damaged because of the pathological changes within the nerves it may be due to many factors, both external and internal, to cause long term problems. Many diseases have also been found to damage the nerve fibers causing intense pain in the back area. Various methods of treatment for chronic soreness include NSAIDs, but their efficacy depends upon the body constitution. More and more extensive studies may find a permanent solution for all those people suffering from chronic nerve problems.

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