What Causes Neuralgia? Nerve Pain Causes, Symptoms and Treatment

What causes neuralgia comes down to a nerve that has been compressed, irritated, inflamed or damaged and starts firing pain signals it should not. The trigger might be a trapped nerve in your neck, a disc pressing on a nerve root in your lower back, a blood vessel resting against a nerve in the skull, or the after-effects of shingles. As GCC-registered chiropractors who have helped people searching for a chiropractor near me in Clapham since 2016, we see nerve pain every week, and the first step is always the same: find out which nerve is involved and why.

What Is Neuralgia?

Neuralgia simply means “nerve pain”. It describes pain that travels along the path of a specific nerve rather than sitting in one muscle or joint.

Nerve pain feels different from ordinary aches. Patients describe it as:

• Sharp, shooting or stabbing, often in brief bursts
• Electric-shock-like, sometimes set off by light touch
• Burning or tingling, with pins and needles or numbness
• Following a line, for example from the neck into the hand, or from the buttock down the leg

Neuralgia vs muscle pain

Muscle pain is usually a dull, broad ache that gets worse with use and eases with rest. Nerve pain is more precise, more electric and often travels well beyond the original problem area. That distinction matters, because it changes what treatment will help.

What Causes Neuralgia? The Main Triggers

There is no single cause. In practice, the causes fall into five groups.

1. Nerve Compression: The Trapped or Pinched Nerve

This is the cause we see most often. A pinched nerve happens when surrounding tissue, such as a bulging disc, an arthritic joint or tight muscle, puts pressure on a nerve or nerve root.

Common sites include:

• The neck (cervical radiculopathy): pain, tingling or weakness running into the shoulder, arm or hand
• The lower back (lumbar radiculopathy): pain travelling into the buttock and leg, commonly called sciatica
• The base of the skull: irritation of the occipital nerves, causing sharp pain at the back of the head

2. Viral Infection: Shingles and Postherpetic Neuralgia

Shingles is caused by the chickenpox virus reactivating along a nerve. For some people, pain continues long after the rash heals. This is called postherpetic neuralgia (PHN). UK government figures put the number at about 14,000 people developing PHN each year, with more than 1,400 admitted to hospital because of it, according to the shingles vaccination guidance from GOV.UK.

3. Blood Vessel Pressure on a Facial Nerve

Trigeminal neuralgia causes sudden, severe facial pain, usually on one side. The NHS explains that the classical form is usually caused by an artery or vein pressing on the trigeminal nerve near the brainstem. It tends to start between the ages of 50 and 60 and affects women more often than men.

4. Disease, Injury and Surgery

Conditions that damage the protective coating of nerves, such as multiple sclerosis, can cause neuralgia. So can direct trauma, scar tissue after surgery, and, rarely, a tumour pressing on a nerve.

5. Contributing Factors

Some factors make nerves more sensitive rather than causing neuralgia directly:

• Diabetes and poor blood sugar control
• Long periods of sitting or static posture
• Repetitive strain from work or sport
• Age-related changes in the spine
• High stress and poor sleep, which lower your pain threshold

Types of Neuralgia at a Glance

Type	Nerve Involved	Typical Cause	Where You Feel It	Who Should Lead Care
Cervical radiculopathy	Nerve roots in the neck	Disc bulge, joint arthritis, muscle tension	Neck, shoulder, arm, hand	Chiropractor, with GP if severe
Sciatica	Sciatic nerve roots	Disc bulge, narrowing in the lower spine	Buttock, back of leg, foot	Chiropractor, with GP if severe
Occipital neuralgia	Occipital nerves	Neck joint or muscle irritation	Back of head, scalp	Shared care: GP and chiropractor
Trigeminal neuralgia	Trigeminal nerve	Blood vessel compression, MS	One side of the face	GP and neurology
Postherpetic neuralgia	Nerve affected by shingles	Shingles virus	Band of skin where the rash was	GP

Trapped Nerve Pain: Symptoms to Recognise

Trapped nerve pain has a recognisable pattern. You may notice:

• Pain that radiates away from the spine into a limb
• Pins and needles, numbness or a “dead” feeling in a hand or foot
• Weakness, such as dropping objects or a foot that catches when you walk
• Symptoms that change with position, like worse when sitting or looking down at a phone
• Pain that flares with coughing or sneezing

Trapped Nerve in the Neck

A trapped nerve in the neck often starts as stiffness and neck pain, then spreads into the shoulder blade and arm. Desk workers who spend long hours with their head forward are a common group.

Trapped Nerve in the Lower Back

In the lower back, nerve irritation usually sits alongside lower back pain, with leg symptoms that can feel worse than the back itself. Prolonged sitting and driving are frequent aggravators, which is why our tips to avoid back pain when driving are worth reading if you commute by car.

Red Flags: When Nerve Pain Needs Urgent Care

Most nerve pain is not dangerous. However, some symptoms need same-day medical attention. Go to A&E or call 999 if you have back pain or sciatica with:

• Numbness around the genitals, buttocks or inner thighs
• New difficulty passing urine, or loss of bladder or bowel control
• Weakness or numbness in both legs

These can be signs of cauda equina syndrome, a medical emergency.

See your GP promptly if nerve pain comes with unexplained weight loss, fever, a history of cancer, or severe facial pain.

How Neuralgia Is Diagnosed

There is rarely a single test. Diagnosis is built from:

1. A detailed history: where the pain travels, what sets it off and what eases it
2. Neurological testing: reflexes, muscle strength and skin sensation
3. Nerve tension tests: such as a straight leg raise for sciatica
4. Imaging when needed: MRI is used when results are likely to change treatment, not as routine

At BackSpace, every new patient has a full assessment before any treatment. If we find signs that point away from a mechanical cause, we refer you to your GP.

Trapped Nerve Treatment: What Actually Helps

The right treatment depends entirely on the cause. Being honest about that is part of good care.

Medical Care for Trigeminal and Postherpetic Neuralgia

Trigeminal neuralgia and PHN are managed medically, usually with specific nerve pain medicines prescribed by a GP or specialist. Manual therapy does not treat these conditions, so we would always direct you to the right clinician.

Chiropractic Care for Mechanical Nerve Irritation

When a nerve is irritated by stiff joints, a disc or tight tissue, chiropractic care can reduce the pressure and calm the nerve down. Our approach to trapped nerve treatment combines:

• Joint adjusting of the spine and limbs to restore movement
• Soft tissue work to ease protective muscle spasm
• Dry needling to reduce muscle tension around the irritated area
• Muscle taping to support posture and movement between visits

This matches NICE guidance on low back pain and sciatica, which recommends considering manual therapy only as part of a treatment package that includes exercise.

Sports and Deep Tissue Massage

Muscles around an irritated nerve often tighten up to guard it, which adds to the compression. Sports and deep tissue massage can release that guarding, particularly in the neck, shoulders and the deep hip muscles linked to sciatica.

Rehab Exercises and the McKenzie Method

Exercise is what keeps results. We use the McKenzie method to identify movements that centralise pain, meaning they draw symptoms back out of the limb and towards the spine. Patients then follow a home programme through our free app.

Where Shockwave Therapy Fits

Shockwave therapy works on tendons and soft tissue, not nerves. We only add it when a tendon problem, such as tennis elbow, sits alongside nerve symptoms.

Approach	Best Suited To	Not Suited To
Chiropractic adjusting and soft tissue work	Trapped nerve in the neck or lower back, sciatica	Trigeminal neuralgia, PHN
Sports and deep tissue massage	Muscle guarding around an irritated nerve	Acute severe nerve inflammation
McKenzie method and rehab	Disc-related nerve root irritation	Red flag symptoms
Shockwave therapy	Tendon problems alongside nerve pain	Nerve pain on its own
GP or specialist care	Trigeminal neuralgia, PHN, red flags	Uncomplicated mechanical pain alone

Case Study: Arm Pain From a Trapped Nerve in the Neck

This example is a composite of common presentations we treat. Details are illustrative and do not describe a single patient.

The presentation: A software developer in their late thirties arrives with three weeks of neck stiffness and sharp pain into the right forearm, with tingling in the thumb and index finger. Symptoms are worse after long video calls.

The assessment: Reduced neck rotation, positive nerve tension testing on the right, normal strength and reflexes, and no red flags.

The plan:

• Weeks 1 to 2: joint adjusting of the neck and upper back, soft tissue work and dry needling to the upper shoulder
• Weeks 2 to 4: McKenzie-based neck exercises and a revised desk set-up
• Weeks 4 to 6: strengthening and fewer visits as symptoms settle

The outcome: Arm pain eases first and the tingling settles over the following weeks, a typical pattern as nerve irritation calms.

Can You Prevent Neuralgia?

Not every type can be prevented, but you can lower your risk:

• Get vaccinated against shingles when eligible. The NHS offers Shingrix to people aged 65 and 70 to 79, to severely immunosuppressed adults from 18, and the programme is extending to everyone aged 60 and over by 2028.
• Break up long sitting periods every 30 to 45 minutes
• Set up your workstation with your screen at eye level
• Keep active, as regular movement keeps nerves gliding freely
• Manage blood sugar if you have diabetes
• Treat early, because a trapped nerve is easier to settle in weeks than months

Getting Help for Nerve Pain in Clapham

BackSpace is a multi-award-winning chiropractic and sports massage clinic at 15 Clapham Park Road, London SW4 7EE, a one-minute walk from Clapham Common Underground station (Northern line). You can meet our GCC-registered chiropractors before you visit, read our answers to common patient questions, call 020 7498 7998, or book an assessment online.

Frequently Asked Questions

Nerve pain is your body’s signal that something needs attention, and the sooner the cause is found, the sooner it can settle.