Nerve pain results from disorders that damage or disrupt the function of nerves that enable perception of sensations. Medications used to treat nerve pain vary, depending on the underlying cause. For example, nerve pain due to diabetes or ongoing pain after shingles may be treated with a topical medicine or antidepressant or antiseizure medication. Nerve pain due to abnormal nerve function or pressure on a nerve, such as with a herniated disc, may improve with injection of another type of medication.
Applying medication to the area of discomfort sometimes provides temporary relief of nerve pain. The numbing medicine lidocaine is available as a cream, gel, spray or patch. While lidocaine works well for some people, it must be reapplied throughout the day, and the patch can only be worn for 12 hours per day. Another option is capsaicin, a derivative of chili peppers. According to a February 2013 article published in the "Cochrane Database of Systematic Reviews," application of a high-dose, prescription capsaicin patch (Qutenza) appears most effective when treating conditions like nerve pain associated with shingles and human immunodeficiency virus, or HIV. Capsaicin patch treatment is effective for about 12 weeks. However, applying a capsaicin patch typically causes intense burning and requires pretreatment with numbing medicine.
Antidepressant medications taken daily can be effective for treating nerve pain in some people. It is thought that they work by altering the way nerve cells communicate. Duloxetine (Cymbalta) was effective in treating diabetic nerve pain, according to a January 2014 review published in the "Cochrane Database of Systematic Reviews." Amitriptyline (Elavil) is another antidepressant used for multiple types of nerve pain. If a person does not obtain relief from one antidepressant medicine, it is possible that another related medication may be effective.
Antiseizure medications, or anticonvulsants, also work by altering the way nerve cells communicate. Like antidepressants, these must be taken daily to be effective. Many antiseizure medications have been tried for the treatment of nerve pain. The medications gabapentin (Neurontin) and pregabalin (Lyrica) seem to be most successful at treating diabetic nerve pain and pain due to shingles, according to a November 2013 review published in the "Cochrane Database of Systematic Reviews." Doctors sometimes prescribe an antiseizure medication with an antidepressant medication for people who do not experience pain relief with either type of drug alone.
Opioid pain medications such as tramadol (Ultram) and oxycodone (Oxycontin) are sometimes prescribed if other medications fail. However, oxycodone carries a risk of dependence, and a June 2014 review in "Cochrane Database of Systematic Reviews" did not find that it helped people with diabetic nerve pain or shingles.
Nerve pain caused by nerve irritation -- as in conditions called neuralgias -- is sometimes treated by injecting the numbing medication lidocaine into the tissue directly around the affected nerves. Similarly, doctors sometimes inject lidocaine along with a medication to reduce inflammation to treat back pain caused by a herniated disc that's compressing a nerve. However, a July 2008 review in "Cochrane Database of Systematic Reviews" did not find evidence of definite benefit in reducing patients' pain with this treatment.
- Cochrane Database of Systematic Reviews: Topical Capsaicin (High Concentration) for Chronic Neuropathic Pain in Adults
- Cochrane Database of Systematic Reviews: Topical Lidocaine for Neuropathic Pain in Adults
- Cochrane Database of Systematic Reviews: Duloxetine for Treating Painful Neuropathy, Chronic Pain or Fibromyalgia
- Cochrane Database of Systematic Reviews: Amitriptyline for Neuropathic Pain and Fibromyalgia in Adults
- Cochrane Database of Systematic Reviews: Antiepileptic Drugs for Neuropathic Pain and Fibromyalgia -- An Overview of Cochrane Reviews
- Cochrane Database of Systematic Reviews: Injection Therapy for Subacute and Chronic Low-Back Pain
- Cochrane Database of Systematic Reviews: Oxycodone for Neuropathic Pain and Fibromyalgia in Adults