When it hurts to touch the sheets

Pain tells us that something is happening in the body. This is very clear when we get injured, but a little less so when there is no obvious cause for the pain. For example, when an otherwise painless stimulus hurts, or when there is no stimulus at all and the pain is unbearable. That’s when we think of neuropathic pain. Imagine feeling unbearable pain from bedsheets being pulled across the skin.

At this point, you may be asking yourself, how is this possible?

Let’s get back to the basics of feeling pain. Pain stimuli are transmitted from the site of injury (for example, a cut) via special sensory nerves to the brain. The brain translates the message (“ouch, it hurts!”), allowing us to take appropriate action. In the case of neuropathic pain, however, the pain is caused by damage or disease to the nerve that transmits the pain stimuli. Nerve damage thus results in a change in the function of the nerve at the site of the injury and in the surrounding area.

Neuropathic pain often feels like a shooting, stabbing, burning sensation, or electric shock-like pain; tingling, numbness, or a “pins and needles” feeling.

The prevalence of neuropathic pain in general population is 7% to 10%. There are several known causes of neuropathic pain. It is usually the result of an injury or disease affecting the central nervous system (brain and spinal cord) or the nerves leading to the muscles and organs. It is common in patients with diabetes, cancer, low back pain, Herpes Zoster virus infection, stroke, amputation, spinal cord injury, surgery … and there are many, many more causes.

What is more, neuropathic pain can interfere with different aspects of patients’ life – not only physical but even psychological and social. In fact, neuropathic pain is often associated with depression and anxiety, which further impair patients’ quality of life.

Drugs that have a beneficial effect on nerve structures and thus effectively relieve neuropathic pain should be used when treating neuropathic pain. It is important to persist with the treatment as it usually takes a few weeks before the medication starts to work and beneficial effects are seen. Doctors may advise also to have additional treatments such as electrical stimulation of the nerves and brain (e.g. TENS), physiotherapy, acupuncture or psychological treatments.

Did you know that one of the most famous painters of the 20th century, Frida Kahlo, also suffered from neuropathic pain?

Reference

1. Baskozos G, Hébert HL, Pascal MM, Themistocleous AC, Macfarlane GJ, Wynick D, Bennett DL, Smith BH. Epidemiology of neuropathic pain: an analysis of prevalence and associated factors in UK Biobank. Pain Rep. 2023 Mar;8(2):e1066.
2. Nevropatska.si. Available from: https://www.nevropatska.si/.
3. Cherif F, Zouari HG, Cherif W, Hadded M, Cheour M, Damak R. Depression Prevalence in Neuropathic Pain and Its Impact on the Quality of Life. Pain Res Manag. 2020 Jun 16;2020:7408508.
4. Smith BH, Torrance N. Epidemiology of neuropathic pain and its impact on quality of life. Curr Pain Headache Rep. 2012;16(3):191-198.
5. Carol A. Courtney, Michael A. O’Hearn, Carla C. Franck, Frida Kahlo: Portrait of Chronic Pain, Physical Therapy, Volume 97, Issue 1, January 2017, Pages 90–96