About chronic neuropathic pain
Neuropathic pain comes from the nerves themselves rather than from a joint, tendon, or muscle. After an illness, injury, surgery, or certain medications, nerves can keep firing pain signals even when there is no ongoing damage. People often describe it as burning, electric, shooting, or tingling pain.
Because this pain is driven by the nervous system, it often responds poorly to standard pain relievers. It can also affect sleep, mood, and activity, which can make the pain feel worse. Effective care looks at the whole person and uses targeted procedures when they fit.
Common symptoms
- Burning, stabbing, or electric shock sensations
- Pain from light touch, clothing, or bed sheets
- Tingling, pins and needles, or numbness in the painful area
- Pain that persists for months after the original cause has healed
- Disrupted sleep and reduced activity because of pain
Common causes and risk factors
- Diabetes and other causes of peripheral neuropathy
- Shingles, which can leave lasting nerve pain
- Nerve injury from trauma or surgery
- Chemotherapy and certain other medications
- Nerve root irritation from the spine
How we diagnose it
Dr. Chen takes a careful history of where the pain is, how it feels, and what triggers it, then examines sensation and strength to identify the nerves involved. EMG, nerve conduction testing, and nerve ultrasound can confirm nerve damage and locate the source, and imaging may be ordered when the spine is a suspected contributor. A diagnostic nerve block can help confirm which nerve is driving the pain before a longer-lasting procedure is considered.
How Propel treats chronic neuropathic pain
The foundation is a plan that keeps you moving: a graded exercise program, attention to sleep and stress, and careful use of medications designed for nerve pain. We coordinate with your other physicians and therapists so the plan fits your overall health and goals.
When pain stays high, Dr. Chen may recommend targeted procedures. Peripheral nerve stimulation places a thin lead near the nerve to deliver mild electrical pulses, cryoneurolysis uses targeted cold to quiet a nerve for a time, and chemoneurolysis uses medication placed at the nerve to calm it. For widespread or severe pain, spinal cord stimulation may be an option. It is an outpatient procedure that starts with a short trial, and a permanent device is considered only if the trial helps.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about chronic neuropathic pain
- What is a spinal cord stimulator trial?
- During a trial, temporary leads are placed near the spinal cord and connected to an external device for several days so you can see how the stimulation affects your pain and activity. If the trial helps, a permanent system may be implanted in a separate outpatient procedure.
- Are these procedures permanent?
- Cryoneurolysis and chemoneurolysis typically provide relief that lasts for a period of time and can often be repeated. Nerve and spinal cord stimulators are designed to remain in place long term and can be adjusted or removed if needed.
- Can exercise really help nerve pain?
- Yes. Regular activity helps calm an overactive nervous system, improves sleep and mood, and supports overall health. We build the program gradually so that it helps rather than flares your symptoms.