I have been having pain in my foot and leg for some time now. The pain is intermittent. It is sometimes tingling and burning, and sometimes mild.

It has been driving me crazy. I went to see a doctor, and he said that I had neuralgia. What is neuralgia?

Neuralgia means pain in the distribution (or skin and tissue coverage) of a nerve or nerves.

It is an explanation of what you have, rather than a description of what causes it.

What causes it then?

Before going into that, let us first understand what causes the nerve to experience pain.

Neuralgia is often described as a stabbing or burning pain. It is often very painful.

It actually happens when the nerve concerned is irritated or damaged. This can occur to any nerve in the body.

How do nerves get irritated or damaged?

There are many causes. All of them either damage the nerve, put pressure on the nerve, or change the way the nerve functions.

They are:

• Infection: A virus such as the herpes zoster virus, which causes shingles, can damage the nerves in a certain area of your skin.

Additionally, if you have an infection in a certain part of your body, this can also affect a nerve nearby. For example, if you have a tooth or gum infection, this can affect a nearby nerve and give you pain.

• Pressure on the nerves: Compression of a particular nerve can cause pain. The pressure may come from a bone (such as in a fracture), blood vessel, ligament or tumour.

A very well known example of neuralgia is trigeminal neuralgia, where the pressure comes from a blood vessel.

• Diabetes: Uncontrolled high blood sugar can damage nerves, especially what we call peripheral nerves – nerves in your hands and feet, arms and legs.

• Multiple sclerosis: This is not common in Malaysia, but is quite common in Western countries. Here, the myelin sheath which covers your nerves is damaged.

Other less common causes may include damage to the nerves after surgery, certain types of medications for cancer, certain antibiotics and some chemicals.

What is trigeminal neuralgia?

Trigeminal neuralgia is neuralgia that affects the trigeminal or fifth cranial nerve in your head.

The trigeminal nerve’s function is to carry sensation from your face to your brain, where it is interpreted. The trigeminal nerve is a “huge” nerve with three large branches that supply the different parts of your face.

Naturally, there is a left and right trigeminal nerve.

Trigeminal neuralgia causes chronic pain, which can be severe. Even something as minor as brushing your teeth, chewing food, speaking, or putting on make-up may trigger an electric shock-like jolt of excruciating pain.

It affects women more than men, especially those over the age of 50.

It initially starts off as mild, short attacks. Then those attacks get longer and more painful.

That sounds painful and terrible!

It is painful. But nowadays, you can get treated and you are not doomed to a lifetime of pain.

Trigeminal neuralgia usually affects one side of the face at a time. Rarely, it can affect both sides. It can focus on one spot, or spread over a wider area.

It is believed to be caused mostly by a blood vessel putting pressure on the base of your trigeminal nerve in your brain stem. The nerve then “malfunctions”.

However, anything else that damages the trigeminal nerve can cause this disorder. Ageing, multiple sclerosis damaging the myelin sheath of your trigeminal nerve, or a tumour compressing the nerve at its origins may also trigger off this disorder.

How can neuralgia be treated?

If we can find the cause of the neuralgia, then we can treat it. If we cannot find the cause, then we will treat the pain.

Treatments may include:

• Surgery to relieve the pressure on the nerve.

• Better control of blood sugar levels in patients with diabetes.

• Physiotherapy to relieve the pressure on the nerve and to strengthen the muscles around the nerve.

• Nerve block, an injection directed at a particular nerve or nerve group to turn off pain signals and reduce inflammation.

Medications may include antidepressants, which are effective in treating nerve pain, anti-seizure medications and pain medications.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.