What nerve pain usually means
Nerve pain has its own vocabulary. Patients describe burning, electric shocks, pins and needles, numbness, skin that hurts to touch, or feet that feel like they are wrapped in cotton. These are signs that the nerves themselves are damaged or irritated, rather than the tissues they run through.
- Peripheral neuropathy. Damage to the long nerves that supply the hands and feet. It usually starts in the toes and works upward, with numbness, tingling and burning that is worse at night. Diabetes is the most common cause, followed by chemotherapy, vitamin B12 deficiency, alcohol, thyroid disease and some inherited conditions. Sometimes no cause is found.
- Diabetic neuropathy. The same process driven by years of high blood sugar. Good glucose control slows it, but the pain still needs treating in its own right.
- Pain after back surgery. Some patients have persistent leg or back pain after a spinal operation, sometimes called failed back surgery syndrome. Scar tissue, a nerve that was damaged before surgery, or a new problem at the next level can all be responsible.
- Complex regional pain syndrome (CRPS). Severe burning pain in a limb after an injury or surgery, out of proportion to the original damage, often with swelling, color and temperature changes and skin that cannot bear light touch. Early treatment matters.
- Trapped nerves. Carpal tunnel syndrome, ulnar nerve entrapment at the elbow and nerve roots pinched in the neck or lower back all cause pain and tingling in a specific pattern that testing can confirm.
How our doctors treat it
AffordaHealth has neurologists and pain physicians in the same practice, which matters for nerve pain because the diagnosis comes first. Dr. Mason is double board-certified in neurology and pain management, and Dr. Scheim has treated nerve pain for more than twenty years.
The neurology consultation includes a detailed history, a neurological exam of sensation, strength and reflexes, and, when needed, an EMG and nerve conduction study. This test measures how well your nerves carry signals and shows which nerves are affected, how badly, and whether the problem is a trapped nerve, a generalized neuropathy or the spine. Blood tests may be ordered to look for a treatable cause.
Once we know what we are dealing with, the plan may include:
- Medication management. Nerve pain responds to different medications than joint pain: gabapentin, pregabalin, duloxetine and certain antidepressants and topical treatments, rather than opioids, which work poorly for neuropathy. The doctor starts low, adjusts at each visit and reviews side effects.
- Nerve blocks for pain confined to one nerve or region, including sympathetic blocks for CRPS and selective blocks for trapped nerves. Relief is documented so we know whether to repeat.
- Treating the cause: glucose control for diabetic neuropathy, B12 replacement for deficiency, a referral for release surgery for a trapped nerve.
- For persistent pain after back surgery, when medication and blocks have not been enough, we coordinate a referral for a spinal cord stimulator evaluation. Stimulator trials are not done in our offices, but we prepare the documentation and continue managing your care alongside the implanting physician.
Does insurance cover it? Neurology and pain management consultations, EMG and nerve conduction studies, follow-up visits, medication management and nerve blocks are covered by Medicare, Aetna, Blue Cross Blue Shield and Cigna when medically necessary. Some plans require prior authorization for nerve testing or injections, which our front desk handles. Read more about insurance and self-pay.
What to expect
- Before you come in, we verify your insurance and ask you to bring photo ID, your medication list, recent blood work if you have it, and any imaging or surgical reports.
- At the consultation, the doctor examines your nerves and explains whether testing is needed. If an EMG and nerve conduction study is ordered, it is usually done at a separate visit.
- You leave with a plan that names the diagnosis, the first medication or procedure, and what we are measuring.
- Follow-up is scheduled based on the plan, usually every four to twelve weeks, since nerve pain medications need careful adjustment.
Living with neuropathy
Neuropathy is often a long-term condition, and the goal is realistic: less pain, better sleep, safer walking and hands that work. Numb feet need daily checks for cuts and blisters and well-fitting shoes. Many patients improve substantially with the right medication, and the doctor will be honest about what to expect.
Do I need an EMG or nerve conduction study?
Not always. Testing is most useful when the diagnosis is unclear, when a trapped nerve or spinal cause is suspected, or when we need to know how severe the neuropathy is before choosing treatment.
Can neuropathy be reversed?
It depends on the cause. Neuropathy from B12 deficiency, thyroid disease or a trapped nerve can improve once the cause is treated. Diabetic neuropathy can usually be slowed and the pain controlled, but the nerve damage itself rarely reverses fully. Results vary.
I still have pain after back surgery. What can you do?
First, a proper evaluation to find out why. Then medication and nerve blocks. If those are not enough, we coordinate a referral for a spinal cord stimulator evaluation and continue to manage your care throughout.
Is nerve testing covered by insurance?
Yes, when it is medically necessary, which is the case for most patients with unexplained numbness, tingling or nerve pain. Some plans require prior authorization, which we handle.
Which clinic should I go to?
Both clinics offer neurology and pain management consultations, medication management and nerve blocks. Davie serves Broward County and Boynton Beach serves Palm Beach County. The front desk will tell you where and when nerve testing is scheduled.