Nerve pain is a form of neuropathy, the general term for a nerve disorder. Neuropathic pain typically arises when inflammation, infection, metabolic disturbances or physical degeneration provokes repetitive pain signaling to the brain. Sensory nerves of the hands, feet and lower legs prove common sites of neuropathic pain, although other sites may be involved. Several types of medicines can relieve nerve pain, and patients may need to try several drugs to find one that provides adequate relief.
Antiseizure Medications
Seizures and neuropathic pain involve nerve overactivity. Through complex chemical processes, antiseizure medications quiet or prevent overactivity of brain cells. Antiseizure medications are prescribed for neuropathic pain based on the rationale that a similar quieting effect on pain nerves may provide symptom relief. The University of Chicago Center for Peripheral Neuropathy reports that the antiseizure medications carbamazepine and gabapentin are commonly prescribed for neuropathic pain. Less commonly used antiseizure medications for this indication include oxcarbazepine, phenytoin, topiramate, divalproex, valproic acid, tiagabine and lamotrigine.
Antidepressants
The perception and experience of pain involve complex brain processes that utilize signaling chemicals called neurotransmitters. Antidepressants alter the levels of neurotransmitters, providing relief for some people with neuropathic pain. The University of Chicago Center for Peripheral Neuropathy reports that tricyclic antidepressants such as nortriptyline and amitriptyline have been used for the treatment of neuropathic pain for more than two decades. Other types of antidepressants are also used for neuropathic pain treatment. The serotonin-norepinephrine reuptake inhibitors venlafaxine and duloxetine are newer antidepressants often prescribed for neuropathic pain. In a 2007 review article published by the "Cochrane Database of Systematic Reviews," Drs. Tiina Saarto and Philip Wiffen report that approximately one out of three neuropathy pain patients treated with tricyclic antidepressants or venlafaxine experiences significant symptom relief. The U.S. Food and Drug Administration has approved duloxetine for the treatment of diabetic peripheral neuropathic pain.
Topical Medications
Topical medications may provide relief from superficial pain. Prescription creams and patches containing local anesthetic medicines, such as lidocaine and prilocaine, temporarily numb the skin. Over-the-counter creams and lotions containing capsaicin may temporarily alleviate mild pain, notes the University of Chicago Center for Peripheral Neuropathy.
Pain Medications
Over-the-counter pain relievers may be useful for mild neuropathic pain. Chronic, resistant pain that remains unrelieved by other medicines or interventions may be treated with narcotic pain medications. Information provided by MayoClinic.com explains that frequent undesirable side effects and a risk for physical dependence and abuse lead to cautious use of narcotic pain relievers. Available options include meperidine, hydrocodone, fentanyl, hydromorphone, morphine, methadone and oxycodone. Tramadol, a synthetic drug closely related to the narcotic pain relievers, may also prove effective.
References
- University of Chicago Center for Peripheral Neuropathy: Anti-Seizure/Anticonvulsant Medications
- University of Chicago Center for Peripheral Neuropathy: Antidepressants
- "Cochrane Database of Systematic Reviews"; Antidepressants for Neuropathic Pain; Tiina Saarto, Philip J. Wiffen; 2007
- University of Chicago Center for Peripheral Neuropathy: Topical Medications
- MayoClinic.com: Peripheral Neuropathy
