Neuropathic Pain (Nerve Pain)

Neuropathic pain occurs when the nerves themselves have been damaged, become inflamed, or are no longer functioning properly. It is a different type of pain from what you might experience with a sprained ankle or a sore back after heavy lifting. In neuropathic pain, the pain does not come from the muscles or joints—it comes from the nerves themselves, which send abnormal signals to the brain.

Many people describe the pain as burning, stinging, or like electric shocks. Others experience tingling or pins and needles, or find that their skin becomes so sensitive that even the light touch of a blanket can be painful. Some people also experience numbness or a restless, vibrating sensation in the legs, particularly in the evening or at night.

What makes neuropathic pain unique is that it often persists—and may even worsen—long after the original injury has healed or can no longer be detected. This happens because, over time, the nervous system and brain can effectively “learn” to continue producing pain signals, almost like developing a habit that is difficult to break.

Neuropathic pain can have many different causes, including:

• Diabetes, which can gradually damage the nerves, particularly in the legs and feet
• Inflammation of the nerves
• Nerve injury following surgery or an accident
• Spinal cord injury
• Chemotherapy-induced nerve damage
• Facial pain (trigeminal neuralgia)
• Pain following shingles (postherpetic neuralgia)

What all of these conditions have in common is that the pain originates within the nervous system itself. As a result, it often responds poorly to conventional painkillers that are typically effective for muscle or joint pain.

When treating neuropathic pain with rTMS, we target a specific area of the brain known as the primary motor cortex (M1). This region plays an important role in how the brain processes and regulates pain signals. By stimulating this area, we aim to help the brain improve its own ability to suppress the persistent pain signals generated by damaged or dysfunctional nerves.

You can think of it a bit like training a muscle. With repeated stimulation over time, the brain’s networks can gradually adapt, making the pain feel less intense and increasing your pain threshold. The goal is to reduce your pain and improve your ability to function in everyday life.

Treatment takes place in the clinic while you are awake and comfortably seated in a chair. During the session, you will feel a gentle tapping sensation and hear clicking sounds from the device. The treatment is not painful, and you can return home immediately afterwards. The stimulation itself lasts no more than 20 minutes, and we set aside at least 45 minutes for each appointment to allow time for preparation and a short conversation.

A full course of treatment usually consists of 10 sessions over 2 to 6 weeks. During the first week, treatment is typically given five times, followed by one or two sessions per week during the following weeks.

You do not need to stop taking your current medication to receive rTMS. The treatment is often used as an addition to the medication and other therapies you are already receiving.

The benefits of rTMS vary from person to person. Some people experience a noticeable reduction in pain, while others see more moderate improvements. Unfortunately, a small number of people experience little or no meaningful benefit. When the treatment is effective, improvements usually develop gradually over several weeks rather than from one day to the next.

For many people, the benefits extend beyond pain relief alone. Treatment may also improve sleep, increase energy levels, and make it easier to take part in everyday activities such as going for walks, managing household tasks, or spending time with family and friends. For some, the benefits are long-lasting, while others may benefit from occasional maintenance sessions to help sustain the improvement.

The side effects of rTMS are generally mild and usually resolve quickly. The most common are a mild headache or slight discomfort during the stimulation itself, particularly during the first few treatment sessions.

Neuropathic pain is often treated with medication, physiotherapy, exercise, or other pain management strategies. These treatments provide important relief for many people, but for some the benefits are limited, or medication side effects make long-term treatment difficult.

What makes rTMS different is that it targets the brain itself, rather than only the area of the body where the pain is felt. In neuropathic pain, the brain and nervous system often play a central role in maintaining the pain, even when the original nerve injury is no longer getting worse. rTMS therefore aims to influence the brain networks responsible for how pain is processed and perceived.

The treatment does not require surgery, anaesthesia, or medication. Instead, magnetic pulses are delivered externally to specific areas of the brain while you remain fully awake and comfortably seated.

rTMS is not necessarily a replacement for the treatment you are already receiving. For many people, it works best as part of a comprehensive treatment plan, helping to reduce pain and make everyday life more manageable.