The main medicines recommended for neuropathic pain include:
Certain types of antidepressants, particularly tricyclic antidepressants (TCAs) like amitriptyline and nortriptyline, as well as serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta), are used to treat nerve pain.
During recovery, exercise is incredibly important not just to help your muscles regain function, but also to increase blood flow throughout your body. This, in turn, speeds nerve healing. Likewise, inactivity slows progress. You don't want to overdo it, but the more you move your muscles, the better.
Anticonvulsants such as pregabalin (Lyrica) and gabapentin (Neurontin) are among the most effective drugs for nerve pain, though they may cause side effects such as lethargy, blurred vision, and weight gain. Doctors may prescribe multiple treatments together to provide better pain management.
Autonomic neuropathy can also cause erectile dysfunction (ED) when it affects the nerves that control erection with sexual arousal. However, sexual desire does not usually decrease. Diarrhea can occur when the nerves that control the small intestine are damaged. The diarrhea occurs most often at night.
Symptoms of peripheral neuropathy might include: Gradual onset of numbness, prickling, or tingling in your feet or hands. These sensations can spread upward into your legs and arms. Sharp, jabbing, throbbing or burning pain.
The muscles and nerves around your rectum and anus need to work together for your bowels to work correctly. Nerves control the muscles of the rectum. They signal when the rectum is full. Damage to these nerves can interfere with bowel control.
Some people with neuropathic pain turn to familiar over-the-counter painkillers like acetaminophen, aspirin, ibuprofen, and topical medicines like capsaicin cream.
The signs of nerve damage include the following:
Tramadol. Tramadol is a powerful painkiller related to morphine that can be used to treat neuropathic pain that does not respond to other treatments a GP can prescribe. Like all opioids, tramadol can be addictive if it's taken for a long time.
Signs that a nerve is healing often include a gradual return of sensation, tingling, or a “pins and needles” feeling in the affected area. You might also notice improved muscle strength or coordination over time. Healing can be slow, and progress may come in small increments.
Damaged nerves take a long time to regrow (an inch a month or millimeter per day). And, in the process, you can lose muscle. A peripheral nerve neurosurgeon works to restore nerves (reinnervate) before this happens. They'll also focus on helping you improve your movement (motor function) and sensation.
Nerve damage: Injury, disease, or a problem with your central nervous system can also cause tremors. Your doctor will call this peripheral neuropathy. It can affect your hands and feet.
What types of medicine are used for nerve pain?
Tramadol, classified as an opioid analgesic, is primarily used for moderate to severe pain, often post-surgery or for chronic conditions like arthritis. Gabapentin, initially developed for epilepsy, has found extensive use in treating neuropathic pain conditions, such as diabetic neuropathy and postherpetic neuralgia.
Neuropathic pain (Nerve pain)
Neuropathic pain comes from problems with signals from the nerves. There are various causes. Traditional painkillers such as paracetamol, anti-inflammatories and opiates (Codeine, Morphine) usually don't help very much and opiates can in fact lead to a worsening of this pain.
EMG and nerve conduction studies are used to help check for many kinds of muscle and nerve disorders. An EMG test helps find out if muscles are responding the right way to nerve signals. Nerve conduction studies help to check for nerve damage or disease.
Diabetes, chronic alcohol use, certain medications, and autoimmune disorders are common contributors. Additionally, repetitive strain, vitamin deficiencies (particularly B12), and poor circulation can mimic neuropathic pain.
Lidocaine or capsaicin may help ease neuropathic pain. You can apply these creams, ointments or patches directly to the affected areas. Nerve blocks. These injections can provide temporary pain relief.
For most neuropathic pain, there will most likely be a choice of Amitriptyline, Duloxetine, Gabapentin or Pregabalin as initial treatment. Carbamazepine may be offered as initial treatment for trigeminal neuralgia. If you cannot tolerate taking these medications, Capsaicin cream may be offered instead.
Vicks VapoRub has other popular off-label uses. Some of these have actual benefits based on research. For instance, Vicks VapoRubis may be useful in relieving muscle aches, neuropathic (nerve-related) pain, treating toenail fungus, and softening callouses.
Naproxen is considered one of the strongest OTC medications because it is longer acting than ibuprofen. Other medications such as Celebrex, diclofenac, indomethacin, and meloxicam are also longer acting and may be stronger than ibuprofen.
Nerves may be squeezed or pinched by surrounding tissues, which increases pressure on the nerve and may disrupt function. This can lead to muscle weakness, a burning or tingling sensation, numbness or pain.
Loss of Bladder or Bowel Control in Extreme Cases
In the most critical scenarios, severe nerve compression at L4-L5 risks loss of bladder or bowel control — a medical emergency. This alarming sign, known as cauda equina syndrome, needs immediate treatment to avoid permanent damage and loss of independence.