Neuralgia

Diagnosis of neuralgia starts with a discussion about your symptoms and medical history. Our board-certified pain specialists will ask about your pain triggers, intensity and location. No specific tests exist to diagnose neuralgia. However, after performing a physical exam, we may order further testing to diagnose or rule out an underlying condition that might be causing symptoms.   

If neuralgia is diagnosed, it likely will be one of these three forms of the condition:  

• Trigeminal neuralgia is the most common type of neuralgia. It affects a nerve in the cheek and causes facial pain that can last days or months. The exact cause is unknown and it can usually be effectively managed with medications, injections or surgery.  
• Postherpetic neuralgia occurs throughout the body as a complication from shingles, an infection caused by the chickenpox virus that results in a painful rash and blisters. People with this form of neuralgia typically experience a burning, sharp, stabbing or deep and aching pain; sensitivity to light touch such as clothing; itching and numbness; muscle weakness; or mild paralysis. Treatment can ease symptoms and the condition improves over time. Administering the herpes zoster vaccine within 72 hours of the first sign of shingles can cut the risk of developing postherpetic neuralgia in half. 
• Occipital neuralgia involves the nerves running from the top of the spine at the base of the neck through the scalp. Typically, no exact cause is found. However, it can be associated with tension or tumors in the neck, injury to the back of the head, osteoarthritis, gout, diabetes or blood-vessel inflammation. Occipital neuralgia may initially be misdiagnosed as a severe headache or migraine. 

Neuralgia also can be caused by Lyme disease; HIV; pressure on nerves from bones, blood vessels or tumors; kidney disease; or aging.

Houston Methodist’s pain management team works together to design a treatment plan based on your symptoms and exams. We offer a full range of treatment options, from cutting-edge pain medications to advanced nerve surgery.  

Treatment for neuralgia may include a combination of: 

• Blood sugar regulation, if diabetes is the known cause  
• Cutting, heating or blocking the nerve  
• Implanted nerve stimulator 
• Injections such as steroids or Botox® (botulinum toxin) to relax overactive nerves 
• Medications  
• Physical therapy
• Stereotactic radiosurgery 
• Surgery to relieve pressure on the nerve  

Medications may include: 

• Over-the-counter pain relievers  
• Topical creams with lidocaine or capsaicin 
• Antidepressants  
• Anticonvulsants  
• Opioid pain relievers