Lupus is categorized as an autoimmune disorder. Any body system can be affected, but mainly the joints, kidneys and skin. Peripheral neuropathy is commonly seen in patients with lupus. It is estimated that about 15 percent of lupus patients experience peripheral neuropathy and nerve pain. The nerve pain usually results from the nerves becoming inflamed. Cranial neuropathy may also occur, but is less common, affecting only one to two percent of lupus patients.
Treating the Underlying Condition
Before getting the nerve pain under control, the patient's lupus needs to be under control. There are a variety of treatments for lupus. Patients may be prescribed non-steroidal anti-inflammatory drugs or corticosteroid creams. Low-dose systemic corticosteroids and hydroxychloroquine, an antimalaria drug, may also be beneficial for patients. Cytotoxic drugs are also helpful for some patients.
Certain lifestyle changes can help in alleviating nerve pain. It is important to maintain a healthy weight. Extra weight can cause the pain to be worse. Regular exercise is important and a doctor and/or physical therapist can help in creating an exercise plan. Eating a healthy diet and correcting any vitamin deficiencies is beneficial. Other helpful lifestyle changes include avoiding alcohol and avoiding exposure to toxins.
Over-the-counter pain medications are effective for many patients. These include aspirin, ibuprofen and acetaminophen. These medications should be taken as advised by a doctor.
Some patients require prescription drugs for relief of their pain. Certain drugs usually prescribed for epilepsy and seizures have been shown effective in treating nerve pain in some patients. These include gabapentin, phenytoin, pregabalin and carbamazepine.
Tricyclic antidepressants are helpful for some patients. Amitriptyline may be prescribed. A drug usually prescribed for irregular heart rhythms, known as mexiletine, may be helpful. However, this drug is associated with severe side effects in some cases.
Lidocaine injections help some patients. There are also transdermal patches of Lidocaine that some patients use.
Certain topical anesthetics may be used in the treatment of nerve pain in lupus. This type of medication is applied to the skin, directly onto the painful area.
Plasmapheresis is a medical procedure in which a machine is used to cleanse the blood and then return it back into the body. It may be helpful in suppressing immune system activity and limiting inflammation. Abnormal immune system activity may also be suppressed by immunoglobulins, which are a type of protein that works like antibodies.
Surgery is reserved for the most severe cases. With surgery, a doctor is able to surgically destroy nerves, which in turn, is purported to block pain signals to alleviate the patient's pain. However, the procedure may produce complications, and the results are usually just temporary.
Author unknown, "The Nervous System," Lupus Foundation of America. (2011), https://www.lupus.org/webmodules/webarticlesnet/templates/new_newsroom.aspx?articleid=2323&zoneid=8
Neblett, Andrea, "Lupus and Nerve Damage," (2009), Quality Health: https://www.qualityhealth.com/pain-articles/lupus-nerve-damage