Nerve pain medication

What is nerve pain?

Nerve pain is also called neuropathic pain or neuralgia. It is when pain that results from a disease or dysfunction of the nervous system. It can be caused by a number of conditions. Sometimes the cause is not known. Nerve pain can be complex and difficult to treat, especially if the cause is unclear.

Some conditions associated with nerve pain include:

• stroke or spinal cord injury
• multiple sclerosis (MS)
• chronic lower back pain
• diabetes
• human immunodeficiency virus (HIV)

Your doctor can help diagnose your pain and discuss the best treatment options with you.

How is nerve pain treated?

There are many treatments for nerve pain, including medicines. Sometimes the pain can be treated directly if the cause is known. Managing the cause may reduce the pain.

However, medicine alone will often only partially relieve the pain. Your doctor can help you explore non-medicine pain management strategies that may help.

These may include:

• regular exercise
• cognitive behavioural therapy (CBT)
• meditation
• acupuncture
• relaxation techniques

What types of medicine are used for nerve pain?

Pain relieving medicines such as paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioid medicines (such as codeine and morphine) don’t usually work for nerve pain.

Medicines used to treat nerve pain usually act on natural chemicals (neurotransmitters) in the body’s nervous system. Most work by ‘calming down’ nerve activity to reduce your nerves’ hypersensitivity to pain.

Many medicines used to treat nerve pain are also used in other conditions, including:

• antidepressant medicines such as amitriptyline and duloxetine (usually used at lower doses than those to treat depression)
• anti-seizure medicines including gabapentin and pregabalin

Less commonly, other medicines may be used including:

• tramadol, a pain medicine
• lignocaine, a local anaesthetic
• capsaicin
• botulinum toxin A (Botox)

Most medicines that work for nerve pain can only be bought with a doctor’s prescription. It may take time for your doctor to find a medicine or combination that works for you. Some medicines only work for nerve pain in about 1 in 7 people who try them.

Many medicines used for nerve pain may not ease the pain immediately. It’s important to build up the dose slowly so the side effects don’t outweigh the benefits.

What are the side effects of medicines used for nerve pain?

All medicines can have side effects. Ask your doctor or pharmacist about common side effects associated with the specific medicine you have been prescribed.

Common side effects of medicines such as antidepressants and anti-seizure medicines used for nerve pain include:

• drowsiness
• dry mouth
• blurred vision
• weight gain

Some people find that these side effects improve as their body gets used to the medicine.

When should I see my doctor?

You should see your doctor if you have pain that continues despite lifestyle changes and pain relieving medicines.

If your doctor diagnoses you with nerve pain, they will discuss with you the best treatment options, including medicines. They may also refer you to a specialist neurologist, pain specialist or pain clinic who can help.

You can also ask your doctor or pharmacist about:

• the side effects of your nerve pain medicines
• the benefits of your nerve pain medicines
• what to do if you miss a dose
• what to do if you experience side effects

Talk to your doctor if you feel unwell when taking your medicines.

Do not stop or change your medicines without talking to your doctor. If your doctor is not available, speak with your pharmacist.