Neuralgia

Neuralgia is a type of nerve pain caused by irritation, inflammation, or damage to a nerve. It is often described as sharp, stabbing, shooting or burning, and may come in sudden bursts or be present as ongoing discomfort.

Neuralgia can affect different parts of the body depending on which nerve is involved. In some cases it follows an infection such as shingles, while in others it may be caused by nerve compression, injury, or an underlying medical condition.

At the Royal Buckinghamshire Hospital, we provide consultant-led assessment to identify the most likely cause of your symptoms and recommend a tailored management plan to reduce pain, improve function and support quality of life.

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Types of Neuralgia

Neuralgia is an umbrella term and can be classified by the nerve affected. Common forms include:

• Trigeminal neuralgia
  Severe facial pain affecting one side of the face, often triggered by touch, chewing, speaking, brushing teeth or cold air.
• Occipital neuralgia
  Pain affecting the back of the head and upper neck, sometimes spreading towards the scalp or behind the eyes.
• Post-herpetic neuralgia
  Persistent nerve pain that continues after shingles has healed.
• Intercostal neuralgia
  Nerve pain along the ribs or chest wall, sometimes after injury, surgery or viral infection.
• Glossopharyngeal neuralgia
  Rare nerve pain affecting the throat, tongue, ear or tonsil area.

Some people may experience localised neuralgia after surgery or injury where a nerve has become sensitive during healing.

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Common Causes of Neuralgia

Neuralgia may be caused by:

• Nerve compression (for example by blood vessels, joints or spinal changes)
• Shingles and nerve irritation caused by viral infection
• Injury or trauma affecting a nerve pathway
• Inflammation or irritation of the surrounding tissues
• Surgery or medical procedures
• Diabetes and peripheral nerve damage
• Multiple sclerosis or other neurological conditions
• Tumours or structural causes (less common, but important to rule out)
• In some cases, a clear cause is not identified

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Symptoms of Neuralgia

Symptoms vary depending on the nerve involved, but commonly include:

• Sharp, stabbing or electric shock-like pain
• Burning pain or deep aching discomfort
• Pain that comes in brief attacks or repeated episodes
• Tenderness over the affected area in some cases
• Sensitivity to touch (even light contact can trigger pain)
• Pain triggered by everyday activities (such as chewing, brushing teeth, or turning the head)
• In some cases: numbness, tingling, or altered sensation
• Sleep disturbance and fatigue due to repeated pain flare-ups

Neuralgia pain often follows a specific nerve distribution, meaning it may feel like it “travels” along a particular path.

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Diagnosis at Royal Buckinghamshire Hospital

Diagnosing neuralgia involves identifying the nerve involved and ruling out other causes of pain. Your assessment may include:

• Detailed history of symptoms, pattern, triggers and duration
• Clinical examination of sensation, reflexes, strength and nerve function
• Review of any related conditions (such as shingles, diabetes, spinal issues or migraine)
• Blood tests where appropriate (for example glucose and vitamin levels)
• Imaging such as MRI/CT if a structural or neurological cause needs investigation
• Referral for specialist input where needed (for example neurology, ENT, dentistry, or pain management)

You will receive a clear explanation of the likely diagnosis and next steps.

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Treatment & Management

Treatment aims to reduce pain, manage triggers, and improve daily function. This often involves a combination of approaches.

Medication options

Neuralgia often responds best to medications that calm nerve signalling, rather than standard painkillers alone. Your consultant may discuss:

• Nerve pain-modulating medication
• Topical treatments for localised neuralgia in selected cases
• Short-term medication to help control flare-ups, where appropriate

Managing triggers and supporting recovery

Depending on the type of neuralgia, recommendations may include:

• Treating underlying causes (for example shingles or diabetes-related nerve irritation)
• Physiotherapy for neck-related or posture-related nerve pain patterns
• Sleep and stress support, as these can worsen nerve pain sensitivity
• Practical strategies to reduce flare-ups and improve confidence with movement

Specialist referral pathways

If neuralgia is severe, persistent or significantly affecting quality of life, your consultant may recommend onward referral for:

• Specialist pain management input
• Nerve blocks or other interventional options (in selected cases)
• Further neurological investigation if needed

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When to seek urgent help

Seek urgent medical advice if you experience:

• Sudden severe headache or facial weakness
• New vision changes or slurred speech
• New limb weakness, loss of balance, or walking difficulty
• Persistent severe pain with fever or feeling unwell
• Rapidly worsening numbness or loss of function

These symptoms may indicate a different condition requiring urgent assessment.

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If you are experiencing sharp or burning nerve pain that is affecting your daily life, contact Royal Buckinghamshire Hospital for assessment and guidance. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly any costs will always be discussed.