The most commonly prescribed medicines for nerve pain (neuropathic pain) are gabapentin, pregabalin (gabapentinoids), amitriptyline, duloxetine, and venlafaxine, often used as first-line treatments because they calm overactive nerves, with topical lidocaine patches also popular for localized pain. While opioids are strong, they're generally reserved for severe cases due to addiction risks, making these other classes the go-to options for widespread nerve pain management.
There isn't one single "strongest" drug for nerve pain, as effectiveness varies, but strong options include opioids (like fentanyl, morphine, oxycodone) for severe, short-term pain and anticonvulsants (gabapentin, pregabalin) or antidepressants (duloxetine, amitriptyline) for chronic nerve pain, often used as first-line treatments due to addiction risks with opioids. Topical treatments like lidocaine or capsaicin offer localized relief, while stronger, often third-line, options like tramadol (a weaker opioid) might be used for stubborn cases.
For diabetic neuropathy, you may want to try:
At-Home Tips for Relief
Stretch your hamstrings and calves to take pressure off the back of the knee. Try nerve gliding exercises under guidance from a provider. Sleep with a pillow under your knees to reduce nerve tension. Apply heat or ice depending on whether symptoms are from inflammation or stiffness.
Geniculate neuralgia results in severe, deep ear pain which is usually sharp—often described as an "ice pick in the ear"—but may also be dull and burning. Ear pain can also be accompanied by facial pain. This pain can be triggered by stimulation of the ear canal, or can follow swallowing or talking.
Symptoms may include:
Overview
People with neuropathic pain might need a combination of different treatments, including medication, physical therapy, psychological counseling and surgery.
Relieving nerve pain
Many NSAIDs are also available at higher prescription doses. The most powerful pain relievers are opioids, sometimes called narcotics. They include strong prescription pain relievers such as oxycodone, hydrocodone, or morphine. Opioids are sometimes used to treat moderate to severe pain.
If you have diabetes, you can develop nerve problems at any time. Sometimes, neuropathy can be the first sign of diabetes. Significant nerve problems (clinical neuropathy) can develop within the first 10 years after a diabetes diagnosis. The risk of developing neuropathy increases the longer you have diabetes.
A neurologist, or a physician who specializes in the treatment of disorders of the central and peripheral nervous systems, is the best physician to treat neuropathies.
To stop nerve pain immediately, topical lidocaine or capsaicin creams/patches can provide quick numbing relief, while prescription options like anti-seizure drugs (gabapentin) or strong painkillers (tramadol) offer faster but not always instant relief; gentle stretches, TENS, and relaxation techniques can also help manage acute flare-ups by blocking pain signals or relaxing muscles.
Researchers think that over time, uncontrolled high blood sugar damages nerves and interferes with their ability to send signals. This process may lead to diabetic neuropathy. High blood sugar also weakens the walls of the small blood vessels called capillaries that supply the nerves with oxygen and nutrients.
What types of medicine are used for nerve pain?
By reducing prostaglandin levels, Celebrex effectively decreases inflammation, lowers elevated body temperature, and reduces pain transmission through nerve endings.
Amitriptyline and Nortriptyline are from a group of medicines called tricyclic antidepressants. The body converts amitriptyline to nortriptyline, therefore the effects of both medicines are similar. Tricyclic antidepressants are thought to work by correcting imbalances of certain chemicals in the brain.
Opioid drugs, including oxycodone, are commonly used to treat neuropathic pain, and are considered effective by some professionals. Most reviews have examined all opioids together. This review sought evidence specifically for oxycodone, at any dose, and by any route of administration.
Amitriptyline may affect your blood sugar levels. If you have diabetes and you usually test your blood sugar levels, you may have to do this more often for the first few weeks of treatment. Talk to your diabetes doctor if your blood sugar goes too high or low.
Nerve blocks, or neural blockades, are procedures that can help prevent or manage many different types of pain. They are often injections of medicines that block pain from specific nerves. They can be used for pain relief as well as total loss of feeling if needed for surgery.
A nerve conduction velocity (NCV) test measures how fast an electrical impulse moves through your nerve. NCV can identify nerve damage. This test is also called a nerve conduction study. During the test, your nerve is stimulated, often with electrode patches put on your skin.
A neurologist is a medical doctor who diagnoses, treats and manages disorders of the brain and nervous system (brain, spinal cord and nerves). A neurologist knows the anatomy, function and conditions that affect your nerves and nervous system. Your nervous system is your body's command center.
Stage Four: Numbness Increases, Pain Decreases
You feel no pain because the nerves no longer communicate with your brain. Numbness is all you have. Your ability to walk can be compromised, balance may become an issue. Temperature sensitivity is decreased, and reflexes are damaged.
13 most painful medical conditions
Nerve pain is also called neuralgia or neuropathic pain. It occurs when there is damage to your nerves, due to disease or injury. Nerve pain can feel different from other kinds of pain.