How is neuropathic pain treated?

The goals of treatment are to:

  • Treat the underlying disease (for example, radiation or surgery to shrink a tumor that is pressing on a nerve).
  • Provide pain relief.
  • Maintain functionality.
  • Improve quality of life.

Multimodal therapy (including medicines, physical therapy, psychological counseling and sometimes surgery) is usually required to treat neuropathic pain.

Medicines commonly prescribed for neuropathic pain include anti-seizure drugs such as:

  • Gabapentin (Neurontin®).
  • Pregabalin (Lyrica®).
  • Topiramate (Topamax®).
  • Carbamazepine (Tegretol®).
  • Lamotrigine (Lamictal®).

Doctors also prescribe antidepressants such as

  • Amitriptyline (Elavil®).
  • Nortriptyline (Pamelor®).
  • Venlafaxine (Effexor®).
  • Duloxetine (Cymbalta®).

Getting a prescription from your pain specialist for anti-seizure drugs or antidepressants does not mean you have seizures or are depressed. However, it’s true that chronic pain can be made worse by anxiety or depression.

Topical treatments like lidocaine or capsaicin—patches, creams or ointments—can be used on the painful area. Opioid analgesics are less effective in treating neuropathic pain, and negative effects may prevent their long-term use.

The pain can also be treated with nerve blocks given by pain specialists, including injections of steroids, local anesthetics, or other medicines into the affected nerves.

Neuropathic pain that has not responded to the therapies mentioned above can be treated with spinal cord stimulation, peripheral nerve stimulation and brain stimulation.

Last reviewed by a Cleveland Clinic medical professional on 12/07/2020.

References

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