Neuralgia

Question 1

Neuralgia

Answer 1

Neuralgia = pain in the distribution of a nerve or nerves, that is often described as burning or stabbing in nature. Common types include:

• Sciatic neuralgia (or ‘sciatica’) — compression or irritation of the sciatic nerve causing pain into the buttocks, posterior leg and often into the foot. Typically accompanied by pins and needles, numbness and weakness.
• Trigeminal neuralgia — a chronic condition affecting any or all of the three branches of the trigeminal nerve (cranial nerve V). Produces sudden and severe stabbing pains in the face

Question 2

Causes include

Answer 2

• Structural — e.g., lumbar intervertebral disc herniation (sciatica), piriformis compression (sciatica), tumour, blood vessels.
• Infections — e.g., viruses such as herpes simplex and zoster.
• Inflammation — e.g., due to poor posture, inflammatory diet, obesity, intestinal permeability (LPS leakage → inflammatory mediators).
• Demyelinating diseases — e.g., MS.
• Chronic stress (SNS dominance → muscle shortening).

Question 3

Natural approach:

Answer 3

• Focus on anti-inflammatory foods (whole plant foods, skinless oily fish etc.). Remove dairy, gluten, refined sugars, coffee, alcohol.

Question 4

Vitamin B1, B6, B12 (consider a complex)

Answer 4

inhibit the perception of pain by neurons in the spinal cord; reduce neuronal hyperexcitability in injured dorsal root ganglia; B12 supports myelination; B6 — GABA

Question 5

St John’s wort (2 tsp tea infused x 3 cups daily, or homeopathic (hypericum) 30C potency 3‒4 times daily until improvement seen)

Answer 5

its compounds interact with several neuronal systems that modulate nociception. Inhibits serotonin and dopamine reuptake. Its polyphenols are neuroprotective against excitotoxicity and mitochondrial dysfunction.

Question 6

Omega-3 (500-1000 mg / day)

Answer 6

EPA / DHA ↓ inflammation/nociception

Question 7

Acetyl L-carnitine (1‒2 g / day)

Answer 7

crucial role in fatty acid metabolism and thought to enhance nerve growth factor receptor binding

Question 8

Magnesium (200‒400 mg / day)

Answer 8

supplementation reduces the inflammatory cascade detrimental to nerve regeneration; prevents Schwann cell apoptosis; promotes sciatic nerve regeneration

Question 9

Turmeric (2 tsp daily)

Answer 9

regulates inflammatory cytokines; a nociceptive activity — inhibits of protein kinase signaling pathways