International Association for the Study of Pain (IASP) currently define pain as “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
Pain is an unpleasant feeling, which also has an emotional component to it. The way you experience pain could be very different from the way another person experiences it. Pain can be short term which is known as acute or long term (more than 12 weeks), which is known as chronic. Pain itself can be subjective and often difficult to explain the magnitude to others. Rest assured, we understand that neuropathic pain can be very troublesome, and we hope we can help you to manage your pain.
Our bodies contain nerve endings which can send signals via our spinal cord to our brain. This connection of nerves and spinal cord is known as the somatosensory system and it is this system which allows our brain to know if we are cold, hot, in pain or how something feels to touch. We have pain sensors which sit on our nerve endings. When activated they send signals along our somatosensory system, from our nerves to our spinal cord which then amplifies the signal to our brain. The brain then interprets this signal resulting in us experiencing the feeling of pain.
People can experience nociceptive pain this tends to be which tends to be the type of pain we think of when talking about pain. This type of pain is due to a harmful stimulus, think falling and hurting your knee. Nociceptive pain results from actual or threatened tissue damage, inflammation and/or injury.
Another type of pain people can experience is known as neuropathic pain. This type of pain is caused by damage or injury to the nerves that transfer these messages between the spinal cord and our brain. It is due to damage to our somatosensory system. Put simply neuropathic pain occurs when the nerves aren’t working properly and send the wrong signals to the brain.
The type of pain that you are suffering from is called neuropathic. The image below shows the common words people use to describe their pain.
We understand that neuropathic pain can be very debilitating, have a sudden onset and often stop you in your track. However, your prescribing doctor and treating pharmacist should have discussed with you that the medicines might only partly alleviate the symptoms. A pain management plan will look at other things you can do, along with taking your medicine, to help manage your pain.
Your treatment might include drug and non-drug options such as physiotherapy to help strengthen your muscles or if your neuropathy is caused by a pre-existing condition such as diabetes then you may benefit from an intervention such as a diabetes management review.
Neuropathic pain is not like other forms of pain, such as a pulled muscle or strain in which common pain killers like paracetamol such as paracetamol and/or ibuprofen can help. The medicines which are prescribed for neuropathic pain are different and can take longer to work.
When you start treatment with medicines for your neuropathic pain you may begin on a low dose, which your doctor may choose to increase over time, gradually, until you gain the most benefit. Some people find that they do not wish to increase the dose as they may experience side effects on a higher dose.
The most common side effects of medicines to treat neuropathic pain are tiredness, dizziness or feeling ‘drunk’. If you are experiencing these side effects, please have a discussion with your doctor. Do not drive or operate machinery if you experience drowsiness or blurred vision and follow advise by the doctor or pharmacist, also avoid alcohol.
Everyone is different and responds differently to drug treatment – some people find that their medicine starts to help straight away, and for others it takes a bit more time. It is important to keep talking to your doctor and /or pharmacist about how you are feeling, whether things are improving, and what you can do to help yourself.
If your symptoms worsen at any point please ensure you contact your prescribing doctor.
If you would like more information please click on the following NHS websites. Please note these are not in any way influences by Viatris https://www.nhs.uk/conditions/peripheral-neuropathy/treatment/
Part of your pain management plan could be looking at goals you would like to achieve and what steps you need to take to get there. When setting goals, we like to use the SMART system.
Specific- What do you want to do?
Be specific when setting your goal so that you know exactly what you are aiming for. Do you want to be able to join your family on their Sunday walks? Then your goal is to be able to walk for 2 hours or more.
Measurable- How will you know when you reach it?
This helps you to understand your goal better and know when you can celebrate that you’ve reached it
Realistic- can you realistically achieve the goal?
Similar to achievable, don’t set yourself up for a failure with an unrealistic goal.
Achievable- Is it possible to achieve?
It can be hard but try not to set an unachievable goal. You can set smaller goals which can take you steps towards a bigger goal
Timely- by when do you want to have achieved this goal?
Lastly, all goals should be time-bound. This helps with the planning and holding yourself accountable to achieve them.
The card that you were given has space to write out three goals on it. You may have already chosen your goals with your pharmacist but if not, why not try now? Using the SMART system, think of a goal you’d like to set and commit to it in writing. Remember, your neuropathic pain is a result of faulty signalling to the brain, therefore try to not associate specific activities with worsening of your neuropathic pain. That being said, allow extra time to work towards your goals, taking into account that some days, if you are experiencing a flare-up you might want to have a rest day.
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. Please report side effects with any medicine or vaccine to the medicines regulator MHRA through the Yellow Card Scheme. It is easiest and quickest to report side effects online via the Yellow Card website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Alternatively, prepaid Yellow Cards for reporting are available by writing to FREEPOST YELLOW CARD (no other address details necessary), by emailing yellowcard@mhra.gov.uk, by telephoning the Commission on Human Medicines (CHM) free phone line: 0800-731-6789, or by downloading and printing a form from the Yellow Card section of the MHRA website.