Pain Management Physician

Peripheral neuropathy is a common cause of chronic pain.  Causes of peripheral nerve damage include diabetes, autoimmune disorders, nutritional deficiencies, alcohol abuse, inherited diseases, and toxic drug exposure.  Approximately 15% of diabetics experience some form of peripheral neuropathy.

Initially, patients develop numbness and/or weakness in the hands or feet.  Early on, this involves the fingers and toes, but can work its way up the limbs.  Patients experience burning pain in the extremities – most commonly involving the feet.

Treatment is centered on the underlying disease.  Pain therapy involves medication management centered on neuropathic pain medications. In some cases, Spinal Cord Stimulation can be an effective long-term therapy.

After limb amputation, chronic pain can be a major issue.  Pain at the stump site can be a nagging problem due to recurrent infection, skin breakdown, pressure ulcers from prosthetic devices, etc.  Neuromas (abnormal overgrowth of nerve fibers) can also form at the site of amputation and can cause severe neuropathic pain.

After amputation, patients often have phantom limb sensation.  They sense the feeling of the body part that is no longer there.  Normal sensation is generally not a problem, but occasionally these can be painful (Phantom Limb Pain).  Patients experience severe shooting and burning pain in the limb that was already amputated.

Treatment initially involves medication management centered on neuropathic pain medications.  Psychological / cognitive behavioral therapy is also very important.  Spinal Cord Stimulation has been shown to be a very effective long-term therapy.