Table of ContentsView AllTable of ContentsWhat Is Neuropathy?OTC MedicationPrescription MedicationSide EffectsOther TreatmentsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is Neuropathy?
OTC Medication
Prescription Medication
Side Effects
Other Treatments
Frequently Asked Questions
When you haveneuropathy, pain is usually best managed with a multimodal treatment approach that incorporates different types of treatment instead of relying on just one. Treatments can includetraditional painkillers, nontraditionalpain medications, and other related pain treatments.
Traditional painkillers used alone, especially non-steroidal anti-inflammatory drugs (NSAIDs), are often ineffective at treating neuropathic pain.
The rightcombination of pain management strategieswill help you function better and have a better quality of life. Treatments vary from person to person—it all depends on your pain and your needs.
Paul Bradbury / Caiaimage / Getty Images
Neuropathy is disease or dysfunction in the nerves that can cause pain and other abnormal sensations, such as tingling, shooting, “zinging,” numbness, and weakness.Damaged nerves become hyperexcitable, or overly active, and instead of merely processing pain signals, they will often start creating them.
Pain from neuropathy is called neuropathic pain. While it can strike nerves of thecentral nervous system(brain and spinal cord), it’s more common in theperipheral nerves(those outside the central nervous system.)
Conditions involving neuropathic pain include:
Other conditions and factors that sometimes can lead to neuropathic pain include:
Over-the-Counter Options
There are a few over-the-counter (OTC) medications that may help ease neuropathic pain. Unless your pain is severe, it is a good idea to try these medications first before asking your healthcare provider for prescription options.
Patches and Creams
Topical medications are absorbed through your skin and enter the bloodstream. They’re often associated with a lower risk of side effects because they’re absorbed in smaller amounts than what you’d take in pill form. They don’t travel through your digestive system, where some painkillers can cause damage.
Different types of local analgesics work in different ways, and some are better than others for treating nerve pain.
Many topical products combine two or more of these ingredients. For example,Icy Hotcontains both methyl salicylate and menthol, while Icy Hot with Lidocaine contains lidocaine and menthol.
Warning: Topical Analgesics
Pain Relief Patches: When to Consider Them
Oral Pain Relievers
Oral pain relievers can be purchased over the counter. There are two main types:Non-steroidal anti-inflammatory drugs(NSAIDs) and acetaminophen.
Don’t Double Up!Acetaminophen liver toxicity is a real threat when taking combination opioids. This can be due to taking increasingly larger doses due to opioid tolerance, or accidentally combining these drugs with one or more of the hundreds of over-the-counter (OTC) products that contain acetaminophen.
Don’t Double Up!
Acetaminophen liver toxicity is a real threat when taking combination opioids. This can be due to taking increasingly larger doses due to opioid tolerance, or accidentally combining these drugs with one or more of the hundreds of over-the-counter (OTC) products that contain acetaminophen.
Supplements
Some people take supplements to help control neuropathic pain, but the research into the effectiveness of these is limited. Supplements may also interact with other drugs you are taking, so make sure to discuss the use of these supplements with your healthcare provider.
Some other supplements commonly used to treat neuropathic pain include:
Adjuvant analgesicsare drugs created to treat other conditions that also happen to have an impact on some types of pain.Anticonvulsantsandantidepressants, through their effects on the nervous system, can often combat neuropathic pain sensations.
Other prescription options include prescription-strength NSAIDs and opioids.
Anticonvulsants
Also called anti-seizure or anti-epileptic drugs, anticonvulsants calm hyperexcited nerves and have long been used to treat painful neuropathy.Epilepsyand neuropathic pain actually share certain molecular changes that are involved in nerve hyperexcitability, which may help explain why these drugs are effective against both conditions.
Anticonvulsants commonly prescribed for treating nerve pain include:
Don’t Stop Without Medical AdviceDon’t stop taking anticonvulsants suddenly. You should only discontinue these medications on the advice of a healthcare provider. Be certain to get guidance on how to gradually taper your dosage so you can avoid unpleasant withdrawal symptoms such as altered mental status, agitation, excessive sweating, and seizures.
Don’t Stop Without Medical Advice
Don’t stop taking anticonvulsants suddenly. You should only discontinue these medications on the advice of a healthcare provider. Be certain to get guidance on how to gradually taper your dosage so you can avoid unpleasant withdrawal symptoms such as altered mental status, agitation, excessive sweating, and seizures.
Anticonvulsants for Chronic Pain
Tricyclic Antidepressants
For some people, these drugs can improve the balance of neurotransmitters and improve the way the brain functions. This can have effects on both mood and pain.
Tricyclics used for treating nerve pain include:
As with anticonvulsants, you need to taper off antidepressants rather than stop them suddenly. Your healthcare provider can offer you guidance on the proper way to wean yourself off of these drugs.
SNRIs
Serotonin-norepinephrine reuptake inhibitors slow the reuptake of both of these neurotransmitters. This class includes the only antidepressants to receive FDA approval for pain.
A Note on SavellaThis drug is an SNRI and is marketed in many countries as an antidepressant. However, in the U.S. it is only approved for fibromyalgia, not for depression, so it isn’t considered an antidepressant.
A Note on Savella
This drug is an SNRI and is marketed in many countries as an antidepressant. However, in the U.S. it is only approved for fibromyalgia, not for depression, so it isn’t considered an antidepressant.
SSRIs
Selective serotonin reuptake inhibitors specifically slow the reuptake of serotonin, leaving more serotonin available for use. This is believed to help in neuropathy because serotonin plays a key role in pain signals.
SSRIs generally cause fewer unpleasant side effects than tricyclics. However, studies suggest they have relatively small effects on neuropathic pain, so they’re not used as often as tricyclics and SNRIs.
SSRIs that are sometimes used for nerve pain include:
Warning: Suicide RiskAll antidepressants are required to carry aboxed warningon their labels about an increased risk of suicidal thoughts and behaviors.
Warning: Suicide Risk
All antidepressants are required to carry aboxed warningon their labels about an increased risk of suicidal thoughts and behaviors.
What You Need to Know: Antidepressant Withdrawal
NSAIDs
Both ibuprofen and naproxen are also available in prescription strengths.
Opioids
Opioids, also called opiates or narcotics, are powerful prescription painkillers. They’re alsoaddictiveand classified as controlled substances. Because of an epidemic of recreational opioid abuse and potentially deadly overdose, many healthcare providers limit the use of opioids and require pain contracts, pill counts, and other measures meant to prevent addiction and abuse.
When it comes to neuropathic pain, opioids are generally considered a last line of treatment and prescribed only when all adjuvant painkillers fail.
Some examples of opioids include:
What Is the Difference Between OxyContin and Oxycodone?
All medications can have side effects, even OTC medications. If you experience any side effects while using these medications, it’s important to discuss them with your healthcare provider. You may need to alter your dose or switch to a different medication.
OTC Side Effects
OTC medication can cause side effects. Some of these include:
Tylenol Overdose: What You Need to Know
Prescription Side Effects
Prescription medication can have various side effects, depending on the drug you’re taking and how much of it you take. Be sure to discuss these side effects and any others that aren’t listed with your healthcare provider.
If you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one are in immediate danger, call911.
Opioid Overdose SymptomsSigns of opioid overdose, which can be fatal, include:Loss of consciousnessExtremely small pupilsSlow and shallow breathingChoking or gurgling soundsGoing limpSkin that’s pale, blue, or coldCall 911 immediately if you suspect someone is having an opioid overdose.
Opioid Overdose Symptoms
Signs of opioid overdose, which can be fatal, include:Loss of consciousnessExtremely small pupilsSlow and shallow breathingChoking or gurgling soundsGoing limpSkin that’s pale, blue, or coldCall 911 immediately if you suspect someone is having an opioid overdose.
Signs of opioid overdose, which can be fatal, include:
Call 911 immediately if you suspect someone is having an opioid overdose.
Other Treatment Options
Other treatment options are available for neuropathic pain, including:
Summary
Nerve pain can be treated with both OTC and prescription medications. Some of the options include topical medications, painkillers like NSAIDs, and prescription medications like anticonvulsants, antidepressants, and opioids.
All medications have a risk of side effects. Make sure you understand the potential side effects you might experience with the medication you are taking and report them to your healthcare provider. You can work with your healthcare provider to adjust your medications and dose until you find one that works for you and has tolerable side effects.
A Word From Verywell
It’s common to end up taking more than one medication to treat nerve pain, and that can potentially lead to harmful drug interactions. Be sure to check with your healthcare provider and pharmacist before adding any over-the-counter drugs, supplements, or herbal products to your treatment regimen. It’s also a good idea to have your pharmacist review your medications anytime you’re prescribed something new.
Frequently Asked QuestionsYou can treat nerve pain at home with OTC medications and topical analgesics. You may also find that rest, stress reduction, and other lifestyle changes help.Most people with neuropathic pain require help from a healthcare provider or medical team to make significant improvements. Involve your healthcare provider in any self-treatment decisions and lifestyle modifications.Neuropathic pain is commonly treated with drugs known as adjuvant analgesics. These are typically antidepressants and anticonvulsants prescribed for off-label use. Medications often prescribed for nerve pain include:AmitriptylineCymbaltaDepaconGabapentinLyricaProzacTegretolVenlafaxineYes, but not without risks. Opioids like codeine, tramadol, and oxycodone block pain signals that the body sends to the brain. As a result, you don’t feel the pain.However, opioids also come with negative side effects and a high risk of addiction. They are considered the last line of treatment for neuropathic pain and should only be used for short time periods. Long-term opioid use leads to physical dependence. Stopping opioids abruptly can lead to painful withdrawal symptoms and sickness.
You can treat nerve pain at home with OTC medications and topical analgesics. You may also find that rest, stress reduction, and other lifestyle changes help.Most people with neuropathic pain require help from a healthcare provider or medical team to make significant improvements. Involve your healthcare provider in any self-treatment decisions and lifestyle modifications.
You can treat nerve pain at home with OTC medications and topical analgesics. You may also find that rest, stress reduction, and other lifestyle changes help.
Most people with neuropathic pain require help from a healthcare provider or medical team to make significant improvements. Involve your healthcare provider in any self-treatment decisions and lifestyle modifications.
Neuropathic pain is commonly treated with drugs known as adjuvant analgesics. These are typically antidepressants and anticonvulsants prescribed for off-label use. Medications often prescribed for nerve pain include:AmitriptylineCymbaltaDepaconGabapentinLyricaProzacTegretolVenlafaxine
Neuropathic pain is commonly treated with drugs known as adjuvant analgesics. These are typically antidepressants and anticonvulsants prescribed for off-label use. Medications often prescribed for nerve pain include:
Yes, but not without risks. Opioids like codeine, tramadol, and oxycodone block pain signals that the body sends to the brain. As a result, you don’t feel the pain.However, opioids also come with negative side effects and a high risk of addiction. They are considered the last line of treatment for neuropathic pain and should only be used for short time periods. Long-term opioid use leads to physical dependence. Stopping opioids abruptly can lead to painful withdrawal symptoms and sickness.
Yes, but not without risks. Opioids like codeine, tramadol, and oxycodone block pain signals that the body sends to the brain. As a result, you don’t feel the pain.
However, opioids also come with negative side effects and a high risk of addiction. They are considered the last line of treatment for neuropathic pain and should only be used for short time periods. Long-term opioid use leads to physical dependence. Stopping opioids abruptly can lead to painful withdrawal symptoms and sickness.
The Most Common Chronic Pain Conditions
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cruccu G, Truini A.A review of neuropathic pain: From guidelines to clinical practice.Pain Ther. 2017;6(Suppl 1):35-42. doi:10.1007/s40122-017-0087-0National Institutes of Health, National Cancer Institute.Neuropathy.Harvard Medical School, Harvard Health Publishing.Drugs that relieve nerve pain.Colloca L, Ludman T, Bouhassira D, et al.Neuropathic pain.Nat Rev Dis Primers. 2017;3:17002. doi:10.1038/nrdp.2017.2National Institutes of Health, National Cancer Institute.Neuropathy.University of Michigan, Michigan Medicine.Lidocaine topical.National Institutes of Health, U.S. National Library of Medicine: DailyMed.Icy Hot pain relieving stick-menthol and methyl salicylate stick; Icy Hot pain relieving balm-menthol and methyl salicylate ointment; Icy Hot pain relieving cream-menthol and methyl salicylate cream.National Institutes of Health, U.S. National Library of Medicine: DailyMed.Label: Icy Hot with Lidocaine pain relieving-lidocaine hcl and menthol cream.University of Michigan, Michigan Medicine.Capsaicin, lidocaine, mentho, and methyl salicylate (topical).The Foundation for Peripheral Neuropathy.Peripheral neuropathy pain management & treatments.Chai Z, Ma C, Jin X.Homeostatic activity regulation as a mechanism underlying the effect of brain stimulation.Bioelectron Med. 2019;5:16. doi:10.1186/s42234-019-0032-0Sidhu HS, Sadhotra A.Current status of the new antiepileptic drugs in chronic pain.Front Pharmacol. 2016;7:276. doi:10.3389/fphar.2016.00276Li CT, Watson JC.Anticonvulsants in the treatment of pain. In: Deer T, Pope J, Lamer T, Provenzano D, eds.Deer’s treatment of pain.Springer, Cham. 2019:149-161. https://doi.org/10.1007/978-3-030-12281-2_19Prescribers' Digital Reference.Neurontin - Drug summary.Prescribers' Digital Reference.Lyrica - drug summary.Prescribers' Digital Reference.Carbamazepine - Drug summary.Prescribers' Digital Reference.Trileptal - Drug summary.Prescribers' Digital Reference.Valproate sodium - Drug summary.Vernachio K, Lovett AW, Williams J.A review of withdraw strategies for discontinuing antiepileptic therapy in epilepsy and pain management.Pharm Pharmacol Int J. 2015;3(1):232-235. doi:10.15406/ppij.2015.03.00045Prescribers' Digital Reference.Amitriptyline hydrochloride - Drug summary.Prescribers' Digital Reference.Nortriptyline hydrochloride - Drug summary.Cleveland Clinic.Depression medicines.Prescribers' Digital Reference.Duloxetine - Drug summary.Prescribers' Digital Reference.Milnacipran hydrochloride - Drug summary.Prescribers' Digital Reference.Venlafaxine hydrochloride - Drug summary.National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Milnacipran.American Society of Anesthesiologists: Made for This Moment.What are opioids?Cleveland Clinic.Acetaminophen vs. ibuprofen: Which works better?U.S. Food & Drug Administration.Medication guide for non-steroidal anti-inflammatory drugs (NSAIDs).Epilepsy Foundation.Side effects.National Institutes of Health, National Institute on Drug Abuse.What are prescription opioids?Centers for Disease Control and Prevention.Preventing an opioid overdose.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cruccu G, Truini A.A review of neuropathic pain: From guidelines to clinical practice.Pain Ther. 2017;6(Suppl 1):35-42. doi:10.1007/s40122-017-0087-0National Institutes of Health, National Cancer Institute.Neuropathy.Harvard Medical School, Harvard Health Publishing.Drugs that relieve nerve pain.Colloca L, Ludman T, Bouhassira D, et al.Neuropathic pain.Nat Rev Dis Primers. 2017;3:17002. doi:10.1038/nrdp.2017.2National Institutes of Health, National Cancer Institute.Neuropathy.University of Michigan, Michigan Medicine.Lidocaine topical.National Institutes of Health, U.S. National Library of Medicine: DailyMed.Icy Hot pain relieving stick-menthol and methyl salicylate stick; Icy Hot pain relieving balm-menthol and methyl salicylate ointment; Icy Hot pain relieving cream-menthol and methyl salicylate cream.National Institutes of Health, U.S. National Library of Medicine: DailyMed.Label: Icy Hot with Lidocaine pain relieving-lidocaine hcl and menthol cream.University of Michigan, Michigan Medicine.Capsaicin, lidocaine, mentho, and methyl salicylate (topical).The Foundation for Peripheral Neuropathy.Peripheral neuropathy pain management & treatments.Chai Z, Ma C, Jin X.Homeostatic activity regulation as a mechanism underlying the effect of brain stimulation.Bioelectron Med. 2019;5:16. doi:10.1186/s42234-019-0032-0Sidhu HS, Sadhotra A.Current status of the new antiepileptic drugs in chronic pain.Front Pharmacol. 2016;7:276. doi:10.3389/fphar.2016.00276Li CT, Watson JC.Anticonvulsants in the treatment of pain. In: Deer T, Pope J, Lamer T, Provenzano D, eds.Deer’s treatment of pain.Springer, Cham. 2019:149-161. https://doi.org/10.1007/978-3-030-12281-2_19Prescribers' Digital Reference.Neurontin - Drug summary.Prescribers' Digital Reference.Lyrica - drug summary.Prescribers' Digital Reference.Carbamazepine - Drug summary.Prescribers' Digital Reference.Trileptal - Drug summary.Prescribers' Digital Reference.Valproate sodium - Drug summary.Vernachio K, Lovett AW, Williams J.A review of withdraw strategies for discontinuing antiepileptic therapy in epilepsy and pain management.Pharm Pharmacol Int J. 2015;3(1):232-235. doi:10.15406/ppij.2015.03.00045Prescribers' Digital Reference.Amitriptyline hydrochloride - Drug summary.Prescribers' Digital Reference.Nortriptyline hydrochloride - Drug summary.Cleveland Clinic.Depression medicines.Prescribers' Digital Reference.Duloxetine - Drug summary.Prescribers' Digital Reference.Milnacipran hydrochloride - Drug summary.Prescribers' Digital Reference.Venlafaxine hydrochloride - Drug summary.National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Milnacipran.American Society of Anesthesiologists: Made for This Moment.What are opioids?Cleveland Clinic.Acetaminophen vs. ibuprofen: Which works better?U.S. Food & Drug Administration.Medication guide for non-steroidal anti-inflammatory drugs (NSAIDs).Epilepsy Foundation.Side effects.National Institutes of Health, National Institute on Drug Abuse.What are prescription opioids?Centers for Disease Control and Prevention.Preventing an opioid overdose.
Cruccu G, Truini A.A review of neuropathic pain: From guidelines to clinical practice.Pain Ther. 2017;6(Suppl 1):35-42. doi:10.1007/s40122-017-0087-0
National Institutes of Health, National Cancer Institute.Neuropathy.
Harvard Medical School, Harvard Health Publishing.Drugs that relieve nerve pain.
Colloca L, Ludman T, Bouhassira D, et al.Neuropathic pain.Nat Rev Dis Primers. 2017;3:17002. doi:10.1038/nrdp.2017.2
University of Michigan, Michigan Medicine.Lidocaine topical.
National Institutes of Health, U.S. National Library of Medicine: DailyMed.Icy Hot pain relieving stick-menthol and methyl salicylate stick; Icy Hot pain relieving balm-menthol and methyl salicylate ointment; Icy Hot pain relieving cream-menthol and methyl salicylate cream.
National Institutes of Health, U.S. National Library of Medicine: DailyMed.Label: Icy Hot with Lidocaine pain relieving-lidocaine hcl and menthol cream.
University of Michigan, Michigan Medicine.Capsaicin, lidocaine, mentho, and methyl salicylate (topical).
The Foundation for Peripheral Neuropathy.Peripheral neuropathy pain management & treatments.
Chai Z, Ma C, Jin X.Homeostatic activity regulation as a mechanism underlying the effect of brain stimulation.Bioelectron Med. 2019;5:16. doi:10.1186/s42234-019-0032-0
Sidhu HS, Sadhotra A.Current status of the new antiepileptic drugs in chronic pain.Front Pharmacol. 2016;7:276. doi:10.3389/fphar.2016.00276
Li CT, Watson JC.Anticonvulsants in the treatment of pain. In: Deer T, Pope J, Lamer T, Provenzano D, eds.Deer’s treatment of pain.Springer, Cham. 2019:149-161. https://doi.org/10.1007/978-3-030-12281-2_19
Prescribers' Digital Reference.Neurontin - Drug summary.
Prescribers' Digital Reference.Lyrica - drug summary.
Prescribers' Digital Reference.Carbamazepine - Drug summary.
Prescribers' Digital Reference.Trileptal - Drug summary.
Prescribers' Digital Reference.Valproate sodium - Drug summary.
Vernachio K, Lovett AW, Williams J.A review of withdraw strategies for discontinuing antiepileptic therapy in epilepsy and pain management.Pharm Pharmacol Int J. 2015;3(1):232-235. doi:10.15406/ppij.2015.03.00045
Prescribers' Digital Reference.Amitriptyline hydrochloride - Drug summary.
Prescribers' Digital Reference.Nortriptyline hydrochloride - Drug summary.
Cleveland Clinic.Depression medicines.
Prescribers' Digital Reference.Duloxetine - Drug summary.
Prescribers' Digital Reference.Milnacipran hydrochloride - Drug summary.
Prescribers' Digital Reference.Venlafaxine hydrochloride - Drug summary.
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Milnacipran.
American Society of Anesthesiologists: Made for This Moment.What are opioids?
Cleveland Clinic.Acetaminophen vs. ibuprofen: Which works better?
U.S. Food & Drug Administration.Medication guide for non-steroidal anti-inflammatory drugs (NSAIDs).
Epilepsy Foundation.Side effects.
National Institutes of Health, National Institute on Drug Abuse.What are prescription opioids?
Centers for Disease Control and Prevention.Preventing an opioid overdose.
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