Neuropathic pain. What does this mean?

Slosh

I saw my GP yesterday to review my meds and update him on my most recent Orthapedic consultant appointment.
He said that the pain in my shoulders and arms was neuropathic and so increased my dose of duloxetine to 60mg a day from 30 and said it could be further increased.
I know my arms/shoulders can get extremely painful when I use them.
Is this typical of this type of pain and what exactly is it? I know there is pressure on my spinal nerve at the base of my neck where I have my OA.
Thanks.

dreamdaisy

I do not have any form of neuropathy but there are some on here who do, hopefully they will be able to answer your question. DD

PS I am very pleased that Beardy Bloke has gone - how hissy was that fit?

Slosh

Thanks for taking the trouble to reply when you are having such a tough time at present.

Yes I agree about beardy bloke. Mary and Paul were not impressed. It will be interesting to see what he says, and what is said to him on Friday's show with Jo Brand. Must admit I do like the builder and Martha is very impressive for a 17 year old.

frogmella

It is just nerve pain in normal speak! I used to have it in my legs and feet due to pressure on the nerves from the base of my spine. I found gabapentin the best thing for that pain but the side effects took some time to get used to. In my experience "normal" painkillers did nothing for the pain. Have you been offered facet joint injections or such like? They worked for me and, in fact, cemented the idea that surgery would be good for me.

Boomer13

Slosh wrote:

I know there is pressure on my spinal nerve at the base of my neck where I have my OA.

I think this is the main problem. Pressure on a nerve = swelling and irritation and can affect the entire length of the nerve below the region under pressure. The nerve coming of the spinal cord then branches off to various parts in your shoulder and arm. Since yours is at the nerve root in your neck, you feel pain all the along that nerve below the irritation. It's worse with use because the nerve is firing more which leads to more irritation and pain. The irritated nerve is releasing more chemicals which the brain "reads" as pain. It's the same as pain felt in the foot of a sciatica sufferer, but the injury to the nerve is occurring at the root of the nerve in the spine. This is my understanding as a nerve pain sufferer but I'm no expert! Hope that helps.

Slosh

Thank you both so much for your replies, that makes it much clearer.
Frogmella initially they were considering injections but then due to worsening symptoms my consultant decided to go straight to surgery instead.
He put me on the Duloxetine as I had previously been on amytriptiline but it hadn't helped. My GP has now increased the dose of this and can do this again if needed.

Boomer13, that makes perfect sense, it sounds so silly when I complain that using my arms really becomes painful, even down to things like slicing bread.

Got a copy of the consultant's letter today from my last appointment with him.
Lovely start, he describes me as a "a very nice lady".

villier

Firstly Slosh ((((())))) my sympathies to you I have lived with neuropathic pain for twelve years getting worse day by day(nothing to do with OA), the nervous system is so complex and so hard to understand. I would tend to agree with Boomer, yes, the nerves will be firing more and sending signals to the brain, Duloxitine is one of the better neuropathic drugs and if memory serves me rightly can be given up to quite a high dose, lets hope the 60mg will be suffice in controlling your pain. I am sure yours has been down to your operation and the nerves will repair themselves. Unfortunately the rare condition I have affects the sensory neurons at the dorsal root ganglion and cannot regenerate and none of the neuropathic drugs were any good so I get intravenous immunoglobulin every few weeks which helps a bit. Keeping fingers crossed you get some relief soon....................Marie x

Slosh

Thanks for that., The pain isn't due to the operation as I had it before, unfortunately the op didnothing to ease the pain. My GP said the max dose of Duloxetine is 120mg so I have a way to go. While it kicks in I have another two weeks of Oxycodone and then hopefully I'll be able to cope on the Duloxetine and Meptazinol. Unfortunately I can no longer take NSAIDS.
My orths consultant thinks I have a neurological problem as well as OA due to my weakness in my left leg and a few other symptoms so I am just waiting for a neurology appointment.

It was just while I knew I had nerve pain I hadn't heard the word neuropathic before.
Feel much more informed now which is great.

This forum is wonderful.

villier

Apologies Slosh I assumed it was your op that has caused your neuropathic pain, I didn't appreciate you already had it before. What type of symptoms do you have? I hope you get an appointment soon also a diagnosis sooner rather than later, it has taken ten years to for me to get a proper diagnosis. x

Slosh

No need to apologise.
Pain wise it's my shoulders and upper arms that are mainly affected, my shoulders often get very stiff and painful to move but GP has said this is not OA and I've blood tests done. It's definitely linked to what I've been doing e.g typing, cooking etc. but it sounds daft when you tell someone that moving your arms/shoulders causes extreme pain. I also get pins and needles in my left hand.
The other reason I have been referred to neurology is that I have muscle weakness in my left shoulder and arm and worsening weakness in my left leg which means I now have to use crutches.
My Orths consultant has told me to phone if I didn't hear from Neurology within 4 weeks of his referral as he is concerned about what is going on.