
Neuropathic Pain: Who It Affects, Causes, and Treatments
Neuropathic pain is a complex and often debilitating condition caused by damage or dysfunction in the nervous system. Unlike nociceptive pain, which arises from physical injury or tissue damage, neuropathic pain results from problems within the nerves themselves. This chronic condition can have a profound impact on quality of life, affecting sleep, mobility, and mental health.
In Australia, neuropathic pain is increasingly recognised as a significant public health issue, affecting people across different age groups and backgrounds. This article explores who neuropathic pain affects, its causes, the latest Australian data on the condition, and insights from experts in the field.
What is Neuropathic Pain?
Neuropathic pain occurs when the nerves responsible for transmitting signals to the brain become damaged or impaired. This can result in abnormal pain signals being sent to the brain, even in the absence of a physical injury or pain-causing stimuli. Individuals with neuropathic pain often experience sensations such as:
- Burning or tingling sensations.
- Shooting or electric shock-like pain.
- Numbness or weakness in the affected areas.
- Allodynia: Pain from stimuli that would not normally cause pain, such as light touch.
- Hyperalgesia: Increased sensitivity to pain from normal pain stimuli.
Who Does Neuropathic Pain Affect in Australia?
Neuropathic pain can affect anyone, but certain groups are more vulnerable:
-
Diabetes Patients: One of the most common causes of neuropathic pain in Australia is diabetic neuropathy, a complication of diabetes that affects the nerves, particularly in the feet and hands. According to Diabetes Australia, over 1.8 million Australians live with diabetes, and approximately 30-50% of these individuals will develop some form of neuropathy, including painful neuropathic symptoms​.
-
Cancer Patients: Chemotherapy-induced neuropathy is another major cause of neuropathic pain in Australia. Many cancer patients undergoing chemotherapy experience nerve damage, leading to chronic pain that can persist long after treatment. According to Cancer Australia, around 45% of patients receiving chemotherapy are at risk of developing neuropathic pain as a side effect​.
-
Elderly Population: Age-related conditions like herpes zoster (shingles) can lead to postherpetic neuralgia, a form of neuropathic pain. As Australia's population ages, the number of individuals experiencing this type of pain is increasing. The Australian Bureau of Statistics (ABS) reports that 1 in 3 Australians over the age of 60 will develop shingles, with about 20% of those experiencing postherpetic neuralgia.
-
Trauma and Surgery Patients: Nerve injuries resulting from accidents, surgeries, or amputations can lead to chronic neuropathic pain. Conditions like phantom limb pain affect a significant number of amputees in Australia, with 30-80% of amputees reporting some form of persistent neuropathic pain​.
-
Multiple Sclerosis (MS) Patients: Neuropathic pain is also common in individuals with multiple sclerosis, an autoimmune disease that affects the central nervous system. According to MS Australia, approximately 25,600 Australians live with MS, and neuropathic pain is a common symptom, experienced by over 50% of patients at some point in their illness​.
Causes of Neuropathic Pain
The causes of neuropathic pain are varied and often linked to underlying medical conditions or injuries:
-
Diabetes: Prolonged high blood sugar levels in people with diabetes can damage nerves, particularly in the extremities, leading to diabetic peripheral neuropathy.
-
Chemotherapy and Radiation Therapy: Certain cancer treatments, especially chemotherapy drugs like 'taxanes' and 'platinums', can damage peripheral nerves, causing long-lasting pain known as chemotherapy-induced peripheral neuropathy (CIPN).
-
Infections: Infections such as shingles (caused by the reactivation of the varicella-zoster virus) can result in long-term nerve damage, leading to postherpetic neuralgia.
-
Nerve Injuries: Trauma from accidents, surgeries, or sports injuries can damage nerves directly or cause pressure on nerves, resulting in persistent pain. This type of nerve damage can lead to conditions such as complex regional pain syndrome (CRPS).
- Post-operative nerve pain refers to chronic pain that persists after surgery, caused by nerve damage or dysfunction. While it’s common to experience some discomfort after surgery, nerve pain differs because it results from injury to the nerves themselves, either during surgery or as a complication of the healing process.
-
Autoimmune Diseases: Conditions like multiple sclerosis or lupus can cause the immune system to attack nerve tissue, leading to chronic pain as a result of nerve inflammation or damage.
-
Spinal Cord Injuries: Injury to the spine, including herniated discs or spinal cord injuries, can compress or damage nerves, resulting in neuropathic pain.
Nerve Pain in Older Australians
As Australia's population ages, more older Australians are experiencing chronic conditions, including nerve pain (neuropathic pain). This type of pain is caused by damage to the nerves and is prevalent among older adults due to age-related conditions like diabetes, cancer treatments, and spinal cord issues. The impact of nerve pain on older Australians is significant, affecting their mobility, mental health, and overall quality of life.

Age-specific rates of neuropathic pain
Most Common Causes of Nerve Pain in Older Australians
-
Diabetes: As the leading cause of diabetic neuropathy, diabetes affects the nerves in the feet, hands, and other parts of the body. Diabetic peripheral neuropathy is common among older Australians, as diabetes becomes more prevalent with age. This condition leads to numbness, burning pain, and extreme sensitivity, often starting in the feet and progressing to the legs.
-
Shingles and Postherpetic Neuralgia: Shingles, caused by the reactivation of the varicella-zoster virus, commonly occurs in older adults. Up to 1 in 3 Australians over the age of 60 will develop shingles, with about 20% of those cases resulting in postherpetic neuralgia, a type of long-lasting nerve pain that persists after the shingles rash has cleared.
-
Spinal Degeneration: Age-related spinal degeneration, including conditions like herniated discs and spinal stenosis, can put pressure on nerves, leading to neuropathic pain. Older adults often experience this pain as burning, tingling, or shooting pain that radiates down the legs or arms.
-
Arthritis and Joint Pain: While arthritis is commonly associated with nociceptive pain (pain from tissue damage), it can also cause nerve compression, particularly in advanced cases of osteoarthritis or rheumatoid arthritis, leading to neuropathic pain​
You are not alone
Neuropathic pain is a growing concern in Australia, both in terms of prevalence and its economic burden on the healthcare system.
-
Prevalence: It is estimated that 1 in 5 Australians suffer from some form of chronic pain, with neuropathic pain making up a significant portion of these cases. Among individuals with diabetes, about 30-50% experience neuropathic pain, and cancer survivors often report lingering neuropathy years after treatment​.
-
Healthcare Costs: Neuropathic pain contributes to Australia's overall healthcare expenditure on chronic pain, which exceeds $34 billion annually, according to Pain Australia. This includes costs related to hospital admissions, pain management treatments, and disability support.
-
Impact on Quality of Life: Studies show that individuals with neuropathic pain often experience higher levels of disability, anxiety, and depression than those with other types of pain. Many patients report difficulties in daily activities, sleep disturbances, and a significant reduction in overall quality of life​.
Expert Insights
Professor Michael Nicholas, director of the Pain Management Research Institute at the University of Sydney, emphasises the complexity of treating neuropathic pain:
"Chronic nerve pain, particularly in older Australians, is often under-treated because the focus tends to be on managing physical health. However, without addressing the psychological effects of chronic pain, it becomes difficult for individuals to regain their quality of life."
Similarly, Professor Lorimer Moseley, a leading pain scientist in Australia, highlights the role of early intervention in managing neuropathic pain:
"Early diagnosis and intervention are critical in preventing chronic neuropathic pain from becoming debilitating. Once the pain becomes chronic, it’s not just about managing the pain but also addressing the psychological and social impacts."
Managing Neuropathic Pain
Effective management of neuropathic pain often requires a combination of treatments tailored to the individual’s specific condition and symptoms. Common treatment options include:
-
Traditional Medications: Antidepressants (like amitriptyline), anticonvulsants (such as gabapentin or pregabalin), and topical treatments (like lidocaine patches) are often prescribed to manage neuropathic pain.
-
Physical Therapy: Physiotherapy can help maintain mobility and improve the function of affected areas by using exercises that reduce pain and enhance strength.
-
Psychological Support: Cognitive behavioural therapy (CBT) and other psychological interventions can help individuals cope with the emotional and psychological toll of living with chronic neuropathic pain.
-
Neuromodulation Techniques: Treatments such as spinal cord stimulation or transcutaneous electrical nerve stimulation (TENS) can help alleviate neuropathic pain by altering the way pain signals are processed by the nervous system.
Alternative Medicine Treatments for Nerve Pain
For individuals seeking complementary and alternative medicine treatments for neuropathic pain, a variety of natural therapies can provide relief. These approaches, including the use of natural medicine, are often used in conjunction with traditional medical treatments to reduce pain, improve quality of life, and manage symptoms holistically.
Alternative medicine is increasingly being recognised for its potential in treating chronic pain, including neuropathic pain. It contains active compounds which interact with the body's endocannabinoid system to modulate pain signals.
1. Acupuncture
Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to relieve pain and promote healing. It is thought to regulate the body's energy flow, or qi, and stimulate the release of natural painkillers, like endorphins.
-
Effectiveness: Some studies have found that acupuncture can be beneficial for individuals with neuropathic pain by improving nerve function, reducing pain perception, and promoting relaxation.
-
Common Uses: Acupuncture is often used to treat diabetic neuropathy, chemotherapy-induced neuropathy, and postherpetic neuralgia.
2. Capsaicin Cream
Capsaicin is the active ingredient in chilli peppers and is known for its ability to reduce pain. When applied topically as a cream or patch, capsaicin works by depleting substance P, a chemical in the body that transmits pain signals to the brain.
-
Effectiveness: Studies have shown that capsaicin cream can be effective in reducing neuropathic pain caused by conditions like diabetic neuropathy and postherpetic neuralgia.
-
How It Works: Capsaicin desensitises the nerves in the skin, reducing their ability to send pain signals.
3. Mind-Body Therapies
Mind-body therapies, such as meditation, yoga, and Tai Chi, focus on the connection between the mind and body to manage pain. These therapies help reduce stress, improve mental health, and enhance the body’s natural ability to cope with pain.
-
Meditation: Practices like mindfulness meditation can help individuals with chronic pain become more aware of their bodies and reduce the emotional impact of pain.
-
Yoga and Tai Chi: These gentle movement-based therapies combine physical postures, breathwork, and meditation to improve flexibility, balance, and muscle strength, which can help reduce pain and improve mobility in neuropathy patients​.
4. CBD (Cannabidiol) Products
CBD is a non-psychoactive component of cannabis that is often used for pain relief. Unlike THC, it does not produce a "high" but has been shown to interact with the body's endocannabinoid system to reduce inflammation and alleviate pain.
-
Forms: CBD is available in various forms, including oils, tinctures, capsules, and topical creams. It can help manage symptoms of neuropathic pain.
-
Research: Emerging research suggests that CBD may be effective in treating conditions like multiple sclerosis-related pain and chemotherapy-induced neuropathy.
7. Physical Therapy
Physical therapy is a common alternative treatment for neuropathic pain. Physical therapy helps maintain mobility, strength, and flexibility, which can reduce the severity of pain in the muscles and nerves.
Summary
Neuropathic pain is a complex and often debilitating condition that affects a significant portion of Australians, particularly those with diabetes, cancer survivors, and the elderly.
Early diagnosis and intervention are crucial for managing the symptoms and preventing the condition from severely impacting quality of life. With proper treatment, including medications, physical therapy, and psychological support, individuals can find relief and regain control of their daily lives.
Sources
- Australian Institute of Health and Welfare (AIHW)
- Diabetes Australia
- Pain Australia
- Cancer Australia
- MS Australia