What Are the Best Treatments for Nerve Pain (Neuropathy)?

Neuropathic pain, or nerve pain, occurs when your nervous system is damaged or malfunctions. If you’re dealing with chronic nerve pain, you may be searching for the most effective treatments to relieve your symptoms and improve your quality of life. This type of pain can affect the central nervous system (brain and spinal cord) or peripheral nerves throughout the body.

When nerve fibers are damaged, they can send the wrong signals to pain centers in your body, resulting in neuropathic pain. Neuropathy can occur in one or more nerves and can present as spontaneous pain, extreme sensitivity, excessive (or lessened) responses to painful stimuli, or even insomnia.

Although nerve pain can vary in location, timeframe, and severity, its effect on your quality of life can be detrimental. The good news is, there are many ways to manage this painful condition. Below, Dr. Smith outlines several potential treatment options for chronic nerve pain.

What Causes Neuropathic Pain?

Understanding the cause of your nerve pain is an important step in choosing the most effective treatment.

Although diabetes is the most common cause of neuropathic pain (about 30% of cases), there are many other potential causes, including:

Central nervous system disorders like stroke, Parkinson’s disease, and multiple sclerosis (MS)
Complex regional pain syndrome (CRPS)
Facial nerve conditions
Alcohol use disorder
HIV/AIDS

Neuropathic pain can also be a side effect of medications such as:

Chemotherapy drugs (cisplatin, paclitaxel, vincristine)
Radiation therapy

Or, it can be a result of medical procedures or other seemingly unrelated conditions like:

Trauma or surgeries with resulting nerve damage
Amputation – leading to phantom limb pain
Spinal nerve compression or inflammation
Tumors that press on nerves

What Are the Best Treatments for Nerve Pain (Neuropathy)?

Every case of neuropathic pain is unique, and your pain management treatment will depend on factors such as the underlying cause, your lifestyle, and your medical history. Your provider will take all these factors into account to create a personalized plan for your treatment.

The main goals of nerve pain treatment are to:

Treat any underlying disease or injury that may be causing the neuropathy.
Provide pain relief via the most appropriate and comprehensive treatments possible.
Help maintain maximum functionality of your nervous system.
Improve your quality of life and allow you to continue or resume your daily activities.

Due to the complex nature of neuropathic pain, most patients will require a combination of treatments, typically recommended in a tiered approach.

Over-the-Counter (OTC) Treatments

Lidocaine Patches or Ointment: Numb the affected area and help relieve nerve pain
Capsaicin Cream: Derived from chili peppers, it reduces nerve pain signals
NSAIDs: Ibuprofen or naproxen can help in some cases

Prescription Medications for Nerve Pain

Anti-seizure medications: Medicines such as gabapentin (Gralise, Neurontin, Horizant) and pregabalin (Lyrica) were originally developed to treat epilepsy, but have been found to improve nerve pain in some cases.
Antidepressants:
- Certain tricyclic antidepressants, such as amitriptyline and nortriptyline (Pamelor), can help improve pain. These medicines interfere with chemical processes in the brain and spinal cord that cause you to feel pain.
- The serotonin and norepinephrine reuptake inhibitor (SNRI) duloxetine (Cymbalta) and the extended-release antidepressants venlafaxine (Effexor XR) and desvenlafaxine (Pristiq) also might improve peripheral neuropathy pain caused by diabetes.

However, many people experience significant side effects from these medications.

Interventional Procedures for Nerve Pain

For patients who don’t find sufficient relief with medications, more advanced interventional treatments can target the source of nerve pain directly and often provide longer-lasting relief.

Nerve Blocks / Injections: Steroid injections to reduce inflammation around the nerve. These injections can reduce inflammation that may be causing nerve pain and improve mobility in your arms, legs, and back.
Spinal Cord Stimulation: An implanted device used to relieve the pain signals that are being communicated through the spinal cord. The electrical pulses modify and mask the pain signal before it reaches your brain.
Nerve Ablation: A minimally invasive medical procedure that uses high-frequency electrical current to cauterize or “ablate” nerves in the body. Radio waves are sent through a precisely placed needle to heat an area of the nerve. The current destroys that area of the nerve, preventing it from sending pain signals to your brain.
Surgery: In some cases, surgical intervention may be necessary depending on the underlying cause

Lifestyle Changes and Therapeutic Treatments

Physical Therapy & Exercise: Building strength and mobility can help relieve pain and pressure over time and improve overall nerve pain management.
Acupuncture: Research suggests that acupuncture might release chemicals that numb pain, or that it blocks the pain signals sent from the nerves. However, results on nerve pain treatment have been mixed.
Massage Therapy: It can be especially helpful with painful muscle spasms
Talk Therapy: Life with chronic pain can make people depressed, and depression can make the feeling of pain more intense. Therapy can help you cope with the emotional stress of neuropathic pain.
TENS Units: A transcutaneous electrical nerve stimulation (TENS) unit helps stimulate nerves with low electrical stimulation. It can be administered for short periods to stimulate nerves and help treat nerve pain. It is typically administered by your doctor or physical therapist, but it is available for nerve pain treatment at home (if recommended by your doctor).
Healthy Diet: Anti-inflammatory foods can help calm nerve irritation. There are many foods with properties considered “anti-inflammatory” that can soothe oversensitive nerves, while others can intensify inflammation and worsen neuropathy symptoms. Maintaining a healthy diet full of lean proteins, whole grains, and plenty of fruits and vegetables can help support your nervous system and boost your body’s natural healing processes.
Quit Smoking: Smoking can reduce the blood supply to the nerves and worsen nerve pain through increased inflammation. Smoking increases your risk of cancer, as well as heart disease, vascular disease, respiratory problems, infertility, and lung diseases like COPD.
Reduce or Eliminate Alcohol: Excessive alcohol consumption can worsen inflammation, worsening nerve pain. Chronic alcohol use can also contribute to nutritional issues that can further nerve damage.

Always consult with your healthcare provider before implementing any lifestyle or exercise changes.

When Should You See a Pain Specialist?

If your nerve pain is persistent, worsening, or not responding to medications or lifestyle changes, it may be time to see a pain specialist. Advanced treatments like nerve blocks, nerve ablation, or spinal cord stimulation may provide relief when other options have not worked. Our team in San Antonio, TX can help determine the right approach for your condition.

Finding the Right Treatment for Your Nerve Pain

Treating chronic nerve pain requires a multi-step approach, and you may need to try several different treatments to find one that works best for you. At The PainSmith, we work with each patient to build an individualized, comprehensive treatment plan that reduces pain and improves quality of life.

Finding the Right Treatment for Your Nerve Pain

If you are struggling with chronic nerve pain or neuropathy, you don’t have to manage it alone. Start your pain assessment today to explore treatment options tailored to your condition at our San Antonio, TX pain clinic.