Burning, boring, stabbing, and constant are frequent descriptors of nerve pain. This pain typically follows some sort of trauma or is the result of degeneration of the nervous system. The trauma can be direct injury to a nerve following an accident or a surgery, it can also occur on a more microscopic level leading to a complex regional pain syndrome. Degenerative causes of nerve pain can be peripheral neuropathy, diabetes, multiple sclerosis, or ALS. As a group, these types of pain are some of the most severe that we treat. We are fortunate to be able to offer many promising, newer therapies.
Because of the difficulty in treating this type of pain we frequently encounter patients who have suffered for decades with the identical pain syndrome. When a result of trauma, the patient can usually relate the day , the particular pain began. There is nothing more gratifying for us in our practice to hear from these patients that their particular pain that they have been living with for so long is now essentially gone.
Post Surgical Pain
Mrs Jones (not her real name), 55 years old, came to a musculoskeletal specialist seeking advice for a 3-year history of progressively worsening pain in both knees. Her knees were stiff for about 20 minutes when she arose in the morning and for a few minutes after getting up from a chair during the day. She had difficulty walking > 30 minutes because of pain, and her symptoms were exacerbated by kneeling, squatting, or descending stairs. Although sitting, resting, and reclining relieved her pain, she became stiff if she stayed in one position for too long. Her symptoms were worse on humid or cold days, and she occasionally felt as if one of her knees would “give out.”