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Rehabilitation

Neuralgia

08/16/2006

Question:

My mother, 74, has had neuralgia for 27 months now. she has tried several different otc and prescribtion meds with no relief. The pain is around her waist and seems to be worse at night keeping her up and exhausted. Would cortisone shots be of any help to her? From everything I have researched for her there seems to be no cure and very little help. They live in a very rural area and have to travel over a hundred miles to the closest big town. I have suggested acupunture but there is a problem with local availability. Do you have an opinion about TENS or comparable systems?

Answer:

Neuralgia, as the name suggests, occurs in the nerves, often because of compression. The first step is to assure that this is indeed neuralgia. It can be diagnosed with electromyography, or "EMG" for short, in which a physician (usually a physiatrist, which is a doctor who specializes in rehabilitation) examines the conduction of the nerves. Although I know that it is quite a distance for them to get this important test, proper diagnosis is key to proper treatment.

There are indeed non pharmacologic treatments to neuralgia as well as some medicines, such as neurontin. Unfortunately, these approaches treat the symptoms (pain) rather than the root cause at the nerve, for which there is no known cure. I would suggest that you see a physiatrist to discuss both non pharmacologic as well as pharmacologic options.

TENS is probably not as strong an option; it contracts the muscle but does not necessarily address the core nerve pain that she is experiencing.

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Response by:

Stephen J Page, PhD Stephen J Page, PhD
Director of Research, Associate Professor
Drake Center
University of Cincinnati