Medicines and Products for nerve pain

Ordinary painkillers often work poorly for nerve pain. Doctors use medicines that act on nerve signalling. Treatment is chosen by a doctor, and the cause is treated at the same time.

Medicines often used

• Gabapentin and pregabalin: reduce nerve pain, but can cause drowsiness, dizziness and swelling. Do not stop suddenly.
• Amitriptyline and nortriptyline: low-dose night-time use for nerve pain. They can cause dry mouth, constipation and drowsiness, and need caution in older adults and heart disease.
• Duloxetine: helpful in diabetic nerve pain, with possible nausea and sleep effects
• Carbamazepine: the first-line medicine for trigeminal neuralgia, needing blood monitoring
• Topical treatments: lidocaine patches and low-dose capsaicin cream for localised pain
• Opioids: rarely and only under strict medical supervision

Treating the cause

• Vitamin B12 supplements or injections when low
• Diabetes control
• Antivirals early in shingles
• Physiotherapy, injections or surgery for a pinched nerve

Cautions

• Do not combine sedating medicines or drink alcohol with them
• Avoid driving if you feel drowsy
• Tell your doctor about pregnancy, kidney disease and all your medicines
• Do not use high-dose B6 or unknown herbal products
• Not for children without paediatric advice

Remember

Start low, go slow and follow your doctor's advice. Relief often takes days to weeks.

When to get help

See a doctor if you have burning, tingling or numbness that lasts, spreads or is linked to diabetes, or if there is weakness. Do not self-medicate for long periods, avoid unknown herbal products, and do not use oils, herbs or home remedies on infants or young children without a paediatrician's advice. In an emergency call 112 or 102.