Different Types of Medications for the Treatment of Nerve Pain

What Causes Nerve Pain?

Around fifteen million people in the United States and Europe suffer from long-term or chronic nerve pain. Neuralgia can be an extremely debilitating condition, making even simple every-day tasks such as washing and dressing both time-consuming and agonizingly painful.

There are millions upon millions of nerves in the body, linked via the central nervous system. These nerves transmit electrical signals between the brain and the rest of the body, controlling movement and other functions, and sending and receiving sensory information. Nerves can sustain damage that makes them work incorrectly, often as a result of a chronic disease such as diabetes or an event such as a stroke. Nerve pain can also arise when an injury causes the nerve to become compressed or pinched. Damage occurring for these reasons can cause nerves in certain areas to begin sending incorrect sensory information to the brain. Sometimes, the consequence of this is chronic pain.

The type of pain experienced is not typical in terms of what we normally think of as pain. People with neuralgia are more likely to experience pain such as that felt with severe pins and needles, or sensations similar to an electric shock. In addition, sensitivity to pain can be vastly increased, to the point where simply wearing clothes or being covered by a bed sheet can cause pain.

Other signs and symptoms that can accompany the pain include loss of reflexes and muscle mass in the affected area, nerve tenderness, lack of sweating, and the existence of trigger points that are painful when touched.

Medication for Nerve Pain Treatment

Most types of nerve pain are treated with oral medications. The three types of oral medication most commonly used to treat nerve pain are antidepressants, narcotic analgesics, and anti-seizure drugs. The combination and quantity of medications used to treat a specific person depends on the type of nerve pain he or she experiences, and the severity of the pain.

A class of antidepressant known as tricyclics can help relieve nerve pain. This class of medication includes amitriptyline, imipramine, and desipramine. Other non-tricyclic antidepressants such as citalopram and paroxetine can also treat nerve pain. These medications help relieve pain even if the person taking them is not depressed. However, chronic nerve pain can often cause depression, and these medications can help relieve both the pain and the depression.

Anti-seizure medications such as gabapentin and pregabalin help relieve nerve pain by blocking ion channels that are involved in transmitting pain signals in nerve cells. These medications are likely to be prescribed along with tricyclic antidepressants, as these two classes of drug work well in combination.

Narcotic pain-killers, or analgesics, include codeine and similar medications. Many of these work by inhibiting cell receptors involved in transmitting pain signals. These drugs are not often used to treat nerve pain, as they are more effective in the treatment of muscular and soft tissue pain. Stronger narcotics such as morphine, pethidine, and methadone, are more effective at treating nerve pain; however their tolerance and habit-forming effects mean they are prescribed only when absolutely necessary.

Other Treatments for Nerve Pain

Sometimes, oral medications do not provide sufficient or long-lasting relief from nerve pain. In these cases a person might receive other types of treatment, such as:

• Local injections of anesthetic medication.
• Nerve block procedure to completely block sensation. These can provide several weeks or months of pain relief.
• Surgery to permanently reduce feeling in the affected nerves.

References

American Chronic Pain Association: Understanding Nerve Pain (PDF)

National Institute of Health MedlinePlus: Neuralgia

The Pain Clinic: Medication Types