Did you know that neuropathic pain is one of the most difficult types of pain when it comes to management? It occurs when nerves of any part of your body, your spinal cord, or your brain get damaged and cause many symptoms of pain like burning, stabbing, numbness, and tingling sensations, increased sensitivity to touch, etc. It can occur with many health conditions like stroke, infections, diabetes, etc. Luckily, many new treatment options can help you manage the condition and improve your quality of life. Learn about the advanced treatments for managing neuropathic pain in this article. Visit the best Pain Management Clinic in Brooklyn at Doral Health & Wellness or log on to www.doralhw.org. to schedule an appointment with us.
Advanced Treatments for Managing Neuropathic Pain
These are some of the new & advanced treatments for managing neuropathic pain:
- Suzetrigine
The FDA recently approved this medicine for treating acute to severe pain in adults. It is non-addictive because it blocks the pain signals from the peripheral nervous system before they reach the brain. In comparison, an opioid medication attaches to certain receptors of the body, including the brain, which not only blocks pain but also produces elicited pleasurable feelings, which can cause addictions to develop when the brain starts to crave those euphoric effects.
While most pain physicians have found it effective in pain relief without any side effects, it is not an option to cure the pain. It is only meant to be used for moderate to severe acute pain or pain(mostly after trauma or surgery) and is expected to last less than 3 months. This means it can be used in a hospital setting for a few days. This medicine is not intended for use in chronic pain; however, some clinical trials have shown efficacy in treating diabetic peripheral neuropathy (compared to standard treatment).
- HCN Blockers
This new non-opioid drug can treat chronic neuropathic pain by calming hyperactive pain-sensing neurons in the peripheral nervous system (as stated in a preclinical study). Usually, neuropathic pain occurs from damage to neurons of the peripheral nervous system (a network of nerves outside the brain). The neuropathic pain occurs when hyperexcitability of peripheral neurons leads to an abnormal level of activity in a family of proteins, called HCN ion channels(spanning the neuronal membrane).
Experts target HCN1 and HCN2 channels to treat peripheral neuropathic pain, but it has problems. This is because HCN2 channels are connected to heart tissues, and both HCN1 and HCN2 channels are found extensively in the brain. So, when targeting HCN2 along with HCN1 with a drug, it causes significant cardiac or neurological side effects. That’s why even the current opioid treatment is not effective and puts patients at risk of side effects. But, this drug stimulates a different class of ion channels called GABA receptors that inhibit neuronal activity, making it an effective inhibitor of central HCN channels with a strong preference for HCN1. Further testing is required to ensure it’s safe and effective to use.
- Transcranial and Epidural Stimulation
Transcranial magnetic stimulation (TMS) is a stimulation therapy where neural tissues, like the cerebral cortex, spinal nerve root, peripheral, and cranial nerves, are stimulated with a magnetic field. In this procedure, a non-conductor coil is placed over the scalp to send controlled magnetic pulses to stimulate nerve cells. It can provide either a single pulse of stimulation or repetitive stimuli at various frequencies, which can be split up at different intervals. This repetitive electromagnetic induction produces an analgesic effect in chronic neuropathic pain patients, which produces dopamine and helps in stimulating pain modulation pathways.
The exact process is not known, but two approaches used for conditioning repetitive TMS (rTMS) have recently been recommended. One is short-duration rTMS with low-intensity and high-frequency stimulation called theta-burst stimulation, and the other is the direct application of weak negative or constant positive currents on the scalp to make changes in brain impulses. In a recent study, it was found that 4 continuous rTMS sessions can recover refractory central neuropathic pain over 3 weeks, which makes this therapy an effective treatment option for neuropathic pain. These techniques are accessible with portable devices, which makes them convenient.
It is also helpful in early diagnosis and prognostic predictions of multiple sclerosis, psychogenic paresis, plexus neuropathy, stroke, and cervical spondylosis. However, it is not recommended for patients with deep brain electrodes, aneurysm clips, cochlear implants, cardiac pacemakers, or a history of epilepsy. Similarly, transcranial direct current stimulation (tDCS) and epidural motor cortex stimulation (EMCS) are mostly used to manage refractory cases. tDCS is beneficial in several peripheral neuropathies, whereas a meta-analysis shows the effectiveness of EMCS in around 60-65% of patients.
- PENS (Percutaneous neuromodulation therapy)
Percutaneous neuromodulation therapy (PENS) is a minimally invasive approach to lower pain hypersensitivity. It is an electro analgesic therapy that combines transcutaneous and electrical nerve stimulation with electroacupuncture by applying removable acupuncture needle-like probes percutaneously to stimulate peripheral sensory nerves in the region of neuropathic pain. It is a good alternative for patients who don’t get pain relief from transcranial electrical nerve stimulation or electroacupuncture. This procedure involves 30-minute sessions, either once or twice a week, requiring around 8 to 10 sessions in total.
While the exact process of PENS-induced analgesia is not known, it is believed that the electrical stimulation blocks the transmission of pain signals and releases endorphins and serotonin within the central nervous system. It is reported that PENS is highly effective in short-term pain management because it improves patients’ quality of life by improving mood, functionality, and quality of sleep. It can be used to treat several pain conditions, but it is not a replacement for conventional pain medications; it’s a supplementary therapy to decrease the dosage of your medications.
- Gene Therapy against Neuropathic Pain
This therapy is used to replace flawed genes with healthy ones or add genes to counteract the disease-causing effect of defective genes. It can increase the effectiveness of specific proteins that are involved in the formation of receptors, ion channels, neurotransmitters, and biochemical mediators, which play a crucial role in maintaining physiological conditions in the body.
This offers several advantages over traditional pharmacological treatments because it can find targets at a genetic level that not only treat the symptoms of the disease but also lower the unwanted adverse effects of medicines. It is target-specific and can be combined with other conventional treatment methods. This allows experts to work on mechanisms that were not previously accessible with pharmacotherapy. More research is being conducted in this field to find interesting approaches for this therapy. The most popular ones are essential molecular targets in gene therapy for pain relief, such as spinal opioid gene therapy and anti-inflammatory cytokine gene therapy.
Alternative Treatments for Managing Neuropathic Pain
Several alternative treatments can be used to get additional benefits in managing pain. These include:
- Acupuncture: This approach can stimulate specific points in the body, which alleviates pain and promotes healing.
- Massage therapy: It helps to relieve muscle tension and improve circulation, which reduces pain and discomfort.
- Herbal remedies: Some herbal supplements, like capsaicin or St. John’s wort, help due to their analgesic properties.
- Mind-body techniques: These include mindfulness meditation or tai chi to manage your pain perception and enhance overall well-being.
- Biofeedback: In this technique, the therapist teaches you how to manage your physiological responses, which helps to lower pain intensity.
When to go to a specialist?
If you’re in constant pain or dealing with a chronic condition like diabetes or a health condition that may lead to neuropathy, you should see a specialist for timely diagnosis and treatment to manage your condition.
Managing neuropathic pain in everyday life can be difficult. However, keeping an eye on the advanced treatments for managing neuropathic pain allows you to get early access to these treatments when they are approved, helping you manage your symptoms better, and enhance your quality of life.
Need help with neuropathic pain? Visit our pain management clinic in Brooklyn to get professional medical help. Call us to book your appointment now!!!! If you’re ready to take the next step in managing your pain, we recommend consulting with our healthcare provider to explore the right treatments or therapies for you. Always listen to your body and adjust your daily routine to prioritize your well-being. Visit Doral Health & Wellness Pain Relief Department in Brooklyn, to get professional help and guidance on how to manage your problem. Call us on + 1-718-367-2555 to get a consultation. If you need help learning coping methods, register your information and make direct contact with our doctors at https://yuz88hfiyh7.typeform.com/Doralintake. Log on to www.doralhw.org. Or visit us at 1797 Pitkin Avenue, Brooklyn, NY 11212.
