Neuropathic Pain
Cause: damage to or disease of the nervous system (peripheral or central).
Mechanism: nerves send abnormal pain signals even in the absence of a stimulus.
Character: burning, stinging, tingling, numbness, electric shock-like sensations.
Examples: postherpetic neuralgia, painful post-traumatic trigeminal neuropathy, post-stroke pain, diabetic polyneuropathy, sciatica.
Treatment: anticonvulsants (gabapentin, pregabalin), antidepressants (duloxetine, amitriptyline), nerve blocks in some cases, and physiotherapy.
Psychosomatic Pain
Cause: psychological factors (stress, anxiety, depression) that amplify or trigger real physical pain.
Mechanism: the body responds physically to a psychological state (e.g., muscle tension, gastrointestinal disturbances, headaches).
Character: highly variable — from headaches, abdominal pain, and back pain to muscle pain. Often no identifiable cause is found on examination.
Examples: tension-type headaches, irritable bowel syndrome, neck pain associated with chronic stress.
Treatment: psychotherapy, relaxation techniques, management of anxiety and depressive disorders, pharmacological support when needed.
Natalia — since 2014 I've been living with trigeminal nerve pain. I write in plain language, based on reliable sources and personal experience. Read my story →
Frequently Asked Questions
What is trigeminal neuralgia?
Trigeminal neuralgia is a chronic facial pain condition. It manifests as sudden, severe, usually one-sided pain attacks — often described as an electric shock. A single attack typically lasts from a few seconds to about two minutes.
What is the difference between neuralgia and neuropathy?
In simple terms: neuralgia primarily involves paroxysmal pain along a nerve, usually without loss of sensation. Neuropathy involves nerve damage that more often causes constant pain along with numbness and sensory loss.
Do regular painkillers help with neuropathic pain?
Usually not. Neuropathic pain responds poorly to paracetamol or anti-inflammatory drugs. Instead, medications that act on nerves are used, such as anticonvulsants like carbamazepine.
What is the difference between gabapentin and pregabalin?
Both are anticonvulsant medications used for neuropathic pain. They differ in absorption and dosing characteristics. The choice and dosage should be determined by a physician.
What is postherpetic neuralgia?
This is chronic nerve pain following shingles (herpes zoster), resulting from nerve damage caused by the virus. It is a distinct condition and can be challenging to treat.
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Track your attacks, triggers, and medications — and show your doctor a clear picture of your condition.