Best Medications for Nerve Pain

Studies suggest that 1 in 10 people suffer from chronic neuropathic pain. Neuropathic pain (nerve pain) originates from damaged nerves. It is often described as a stabbing, shooting, tingling, or burning sensation.

Fortunately, there are several effective pain management strategies for both acute and chronic pain. Many different types of medications, including anti-inflammatory medications, anti-seizure medications, opioid analgesics, and medications used to treat depression, can provide relief from nerve pain. 

Please continue reading to learn more about the best nerve pain medications.

What is the strongest drug for nerve pain?

Peer-reviewed studies have shown that gabapentin, pregabalin, amitriptyline, duloxetine, and venlafaxine are the most effective nerve pain medications. These drugs are the first-line therapy for neuropathic pain.

Opioid painkillers, such as tramadol, are some of the strongest drugs available for pain control. However, they are only used for neuropathic pain that does not respond to other treatments. Opioid analgesics carry the risk of addiction and other serious side effects. They are only prescribed for a short time. Chronic pain (long-lasting pain) is managed with other nerve pain medications.

Topical treatment with creams and gels in the affected area can also provide effective pain relief with a lower risk of systemic side effects.

How do doctors treat nerve pain?

Doctors treat nerve pain by treating the underlying condition. For example, if a tumor is pressing upon a nerve and causing neuropathic pain, then chemotherapy, radiation therapy, or surgery to shrink or remove the tumor can provide relief. 

In people with diabetes, keeping blood sugar levels under control can prevent neuropathic pain due to nerve damage. In addition, there are certain drugs that are more effective than other painkillers in treating this type of pain.

Which medication is commonly prescribed for nerve pain?

Anti-seizure medications 

Anti-epileptic drugs (medications prescribed for seizure disorders) are very effective in treating nerve pain caused by conditions such as diabetic peripheral neuropathy, chemotherapy-induced peripheral neuropathy, and post-herpetic neuralgia. Examples of these medications include: 

• Gabapentin (Neurontin) 

• Pregabalin (Lyrica) 

• Carbamazepine (Tegretol) 

• Topiramate (Topamax) 

• Lamotrigine (Lamictal) 

The most common side effects of these medications include blurred vision, dizziness, lethargy, weight gain, and peripheral swelling.

Antidepressants

Chronic nerve pain can cause depression symptoms. Therefore, doctors sometimes prescribe low-dose antidepressants to treat neuropathic pain. Examples of these medications include:

• Tricyclic antidepressants such as amitriptyline (Elavil) and nortriptyline (Pamelor) 

• Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac)

• serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) and venlafaxine (Effexor XR). 

Side effects of taking antidepressants may include indigestion, stomach ache, loss of appetite, dizziness, and headache. In addition, taking antidepressants can cause suicidal thoughts and behaviors, especially in young adults, and especially at the beginning of therapy.

Topical medications

Creams, ointments, gels, and patches with ingredients such as lidocaine or capsaicin can be applied to the painful area for pain relief. Combination therapy with oral and topical treatments is sometimes necessary to control pain. 

The most common side effects of topical treatments include skin irritation (redness, discomfort, itching, swelling) in the treated area. 

Opioid painkillers

Opioid pain medications are not the first-line therapy in treating neuropathic pain because of risks such as misuse, dependence, and addiction. These medications are only considered when all other therapies have failed. Examples of opioid pain relievers include:

• Tramadol 

• Oxycodone

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What is a good painkiller for nerve pain?

Many people find that tricyclic antidepressants like amitriptyline and anti-epileptic drugs like gabapentin and pregabalin are the most effective in treating nerve pain. 

Keep in mind that chronic nerve pain is complex in nature. Combination therapy and a multimodal approach involving medications, physical therapy, acupuncture, relaxation techniques, and psychological counseling may be required to achieve pain control.

Talk to your healthcare provider about the different types of medications and treatment options for nerve pain. Choosing an effective combination of medications to go along with the non-drug aspect of the treatment plan may give you maximum pain relief. 

What is the best over-the-counter medicine for nerve pain?

Common painkillers such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, and other pain relievers may provide some relief from mild nerve pain. However, other drugs are often more effective in treating pain signals originating from damaged nerve tissue.

What is the best NSAID for nerve pain?

Prescription NSAIDs such as diclofenac, etodolac, ketoprofen, and meloxicam are stronger painkillers than over-the-counter NSAIDs such as ibuprofen and naproxen and may provide greater pain relief. However, NSAIDs are not the most effective in treating neuropathic pain. Also, nonsteroidal anti-inflammatory medications can cause side effects such as stomach pain, dyspepsia, nausea, fluid retention, high blood pressure, and an increased risk of gastrointestinal bleeding, especially at higher doses or with long-term use. 

What is the best medicine for foot nerve pain?

Foot nerve pain is a common symptom of diabetic neuropathy. The best medicines to treat this type of pain include antidepressants like amitriptyline or duloxetine and antiepileptic drugs like gabapentin and pregabalin.

What is the best medicine for back nerve pain?

Sciatica (nerve pain in the lower back, buttock, and back of the thigh) can be relieved by topical medications (ointments, gels, and creams) that work by affecting blood flow, reducing inflammation, and numbing the painful area. 

Prescription medications for chronic pain from sciatica include muscle relaxants (for example, cyclobenzaprine), oral steroids (prednisone), antiepileptics (pregabalin, gabapentin), and antidepressants (duloxetine, venlafaxine).

What are some other treatments for neuropathic pain?

Nerve blocks (injections of steroids, local anesthetics, and other medications) can be given locally to block pain signals from the affected nerves. Botulinum toxin injections are also an option.

If nerve pain medications and nerve blocks are unsuccessful in controlling chronic pain, treatments such as spinal cord stimulation using electrical impulses may be recommended.

How do you get nerve pain to stop?

Besides nerve pain medications, the following measures may provide relief from neuropathic pain:

• Plenty of rest and sleep

• Warm baths

• Stretching, yoga, and meditation

• Massage and physical therapy

• Frequent changes in posture

• Ergonomic workstation

When to see a doctor for nerve pain?

Nerve pain usually develops gradually over time and can be evaluated on a non-emergency basis. However, any type of nerve compression requires immediate medical attention as it can potentially lead to loss of body function. Therefore, you should seek immediate medical attention if you experience symptoms such as progressive weakness, numbness, or severe pain. Learn more about common nerve damage symptoms.

What causes neuropathic pain?

Pain occurs when there is damage to body tissues. It is called neuropathic pain when the tissues of the nervous system are damaged. 

Various health conditions can cause neuropathic pain, a common one being diabetes. High blood sugar levels cause damage to nerves throughout the body. This condition is called diabetic neuropathy, and this type of nerve pain frequently affects the hands and feet. It is very common in people with poorly controlled diabetes.

Some other conditions that can cause neuropathic pain include shingles (postherpetic neuralgia), alcoholism, stroke, multiple sclerosis, Parkinson’s disease, and HIV/AIDS.  Other severe types of neuropathic pain can be more difficult to treat, for example, trigeminal neuralgia (facial nerve pain) and reflex sympathetic dystrophy, a type of chronic pain that occurs after surgery, stroke, or heart attack.

Certain medical treatments and medications can also cause neuropathic pain, for example, radiation therapy and chemotherapy drugs. Trauma, surgery, nerve compression by tumors, and nerve inflammation are other causes of neuropathic pain.