First, a better understanding of what neuropathy is will give more insight into this problem
What is neuropathy?
Neuropathy is nerve damage. There can be many different causes, from diabetes to alcoholism to a severe case of shingles. When nerves are damaged, they may not register pain normally. Nerves, or neurons, can change structurally and functionally in response to injury. Some individuals are more susceptible to neuropathic pain because of inherent, perhaps genetic, factors. Most conditions that cause pain can trigger neuropathic pain in these susceptible individuals. Damaged nerves can create a “memory” of pain, and so even when the actual pain stimulus is gone, nothing is physically hurting, the nerves are still registering pain, and transmitting those pain sensations to the brain. Which means, you can still feel that pain. The pain is very real, even if the cause of it isn’t physical. That’s why it’s called neuropathy: because it is a problem in the nerves themselves.
Neuropathic presents differently from other pains. First, it’s usually caused by conditions that damage the nervous system, like nerve injuries, or diseases like diabetes, alcohol abuse, zoster, HIV, Lyme disease, or multiple sclerosis. The type of pain also helps in diagnosis. Neuropathic pain is usually a stabbing, shooting, burning, or searing pain. It’s often worse at night. The location of the pain also is distinctive, as neuropathic pain is often felt in large areas of a limb or region of the body instead of being centralized. A change in skin color, temperature, or texture in the area may also accompany neuropathy.
Why more pain at night?
The leading theory for why the pain is more noticeable at night has to do with how nerves work. Our brains are constantly receiving stimuli: sounds, sights, tastes, smells, textures, thoughts, emotions, memories. But, our brains can only receive a certain amount of stimuli at once. Nerves are sending pain signals all day, but our brains don’t receive them the same way when we are inundated with other, competing stimuli. The pain is still there, but is not in the forefront of our awareness. At night, those other stimuli diminish, and the neuropathy affect nerves have full access to the pain receptors in our brains, and our brains, and bodies, become much more aware of the discomfort.