What is neuralgia?

  Neuralgia is the clinical descriptive term for pain at the site of nerve distribution. Sciatica is considered to be neuralgia of the sciatic nerve or sacral1 nerve root. Trigeminal neuralgia, the most common, is characterized by stabbing pain in one or more areas of the trigeminal nerve distribution. Neuralgia is very characteristic: it is an electrical, shock-like (shocklike) pain.  Pain that is caused by a peripheral nerve lesion and radiates to the area of innervation of that nerve is called neuralgia. If the cause is unknown, it is called primary neuralgia, and if there is a clear cause, it is called secondary (or symptomatic) neuralgia. The lesion may be located in the nerve root, plexus or nerve trunk. It is often named after the peripheral nerve involved in the lesion. Local pain caused by stimulation of peripheral receptors by other local lesions and somatic pain caused by lesions in sensory transmission pathways of the central nervous system generally do not fall into the category of neuralgia. Sciatica, trigeminal neuralgia and intercostal neuralgia are included in the scope of neuralgia.  Trigeminal neuralgia, with pain in the 2nd branch, is more common at the age of 40 to 50 years. The patient presents with a sudden onset of flashes of pain on one side of the face, lasting from a few seconds to more than 10 seconds. The pain is self-reported to be burning-like and unbearable. The patient often rubs the painful side of the face with his hand during the attack to relieve the pain. As a result of frequent rubbing, the skin of the face becomes rough and sometimes the eyebrows may fall off. There are intermittent episodes of varying lengths, with milder ones occurring once every few days or weeks, with longer intervals. The pain can be triggered by actions such as washing the face, brushing the teeth, or eating.  In sciatica, the pain can be radiating along the buttocks, posterior femur, lateral calf, dorsum of the foot, etc., and is accompanied by varying degrees of sensory impairment, lower extremity muscle weakness, and decreased or absent Achilles tendon reflexes.  Intercostal neuralgia, which can be caused by rib fracture, metastatic cancer of the thoracic spine, herpes zoster, etc. Those caused by herpes zoster may see skin damage within this painful area with heaps of clustered rash, normal skin between the rashes, or oozing or redness in severe cases.