Dr Željko Kojadinović — NEUROHIRURGIJA I LEČENJE BOLA
Dr Zeljko Kojadinovic — Pain Treatment & Neurosurgery
When Nerve Pain Persists Despite Standard Treatment
This short hub gathers patient-friendly guides on neuralgias and neuropathic pain, especially for patients whose pain persists despite standard treatment. Many nerve pain syndromes continue because the exact pain generator has not been identified, the diagnosis is too broad, or the treatment protocol does not match the real mechanism of pain. Each page explains typical and atypical pain patterns, key tests, treatment options, and when a telehealth consultation can help map the exact source of nerve irritation.
Trigeminal Neuralgia — Facial Pain
Facial pain diagnosed as trigeminal neuralgia may be typical electric-shock TN or atypical persistent facial pain. This guide explains why pain may continue despite standard TN treatment, when MRI findings matter, and how to distinguish vascular compression, dental, TMJ, viral, peripheral nerve, and central sensitization mechanisms.
Atypical Trigeminal Neuralgia — When Treatment Fails
Persistent, burning, dental-like, post-dental, postherpetic, or MRI-negative facial pain may not behave like classical trigeminal neuralgia. This guide explains why standard treatment, medication, nerve blocks, Gamma Knife, rhizotomy, or microvascular decompression may fail when the true trigeminal pain generator has not been identified.
Pudendal Neuralgia
Perineal burning, tingling, or pelvic nerve pain worsened by sitting. This guide explains how pudendal neuralgia differs from pelvic, urological, gynecological, or spine-related causes and when targeted medication, pelvic PT, nerve blocks, or second opinion may help.
Postherpetic Neuralgia (after Shingles)
Persistent burning, stabbing, or hypersensitive skin pain after shingles. This guide explains why nerve pain may continue after the rash heals and how topical therapy, desensitization, neuropathic medication, and targeted pain treatment may be combined.
Intercostal Neuralgia
Rib, chest wall, or upper abdominal nerve pain that may mimic heart, lung, stomach, or spine disease. This guide explains pain mapping, diagnosis, nerve blocks, pulsed radiofrequency, rehabilitation, and when persistent symptoms need reassessment.
Occipital Neuralgia & Occipital Headache
Back-of-head stabbing, burning, or radiating scalp pain that may spread toward the eye. This guide explains how occipital neuralgia differs from migraine, cervical pain, or muscle-related headache and when nerve blocks, PT, PRF, or ONS may be considered.
Need help identifying why nerve pain persists?
If standard treatment has not helped, the problem may be an incomplete diagnosis or a pain generator that has not been precisely mapped. A focused telehealth pain consultation can help clarify the mechanism of pain and whether medication adjustment, targeted nerve blocks, Botox, interventional treatment, surgery, or an online second opinion is appropriate.
If standard treatment has not helped, the problem may be an incomplete diagnosis or a pain generator that has not been precisely mapped. A focused telehealth pain consultation can help clarify the mechanism of pain and whether medication adjustment, targeted nerve blocks, Botox, interventional treatment, surgery, or an online second opinion is appropriate.
Last medically reviewed: June 7, 2026
Image: Schematic Diagram of Body Nerves