Medical Health Encyclopedia

Other treatments may include nerve blocks, local injections of anesthetic agents, or surgical procedures to decrease sensitivity of the nerve. Some procedures involve the ablation (surgical destruction) of the affected nerve using different methods, such as local radiofrequency, heat (thermocoagulation), balloon compression, and injection of chemicals (such as glycerolysis).

Unfortunately, these procedures do not guarantee improvement and can cause sensory loss or abnormal sensory phenomena.

Another strategy sometimes used for resilient cases of neuralgia is called motor cortex stimulation (MCS), which consists of surgically placing an electrode over the sensory cortex of the brain. The electrode is hooked to a pulse generator pocketed under the skin. Such surgical procedures, however, are tried only when more conservative approaches have failed.

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For postherpetic neuralgia, injections of anesthetics and steroids (potent anti-inflammatory drugs) in the subarachnoid space through a spinal tap may provide pain relief. For both trigeminal and glosso-pharyngeal neuralgias, a procedure called microvascular decompression, may result in symptom improvement. This surgical procedure consists of removing any possible compression exerted by neighboring blood vessels over the affected nerve.

Physical therapy may be helpful for some types of neuralgia, especially postherpetic neuralgia. Treatment of shingles with antiviral medication may decrease the incidence of postherpetic neuralgia.