When would I need medicines for nerve pain?

Nerve pain is also called neuropathic pain or neuralgia. It is usually caused by an injury or disease that affects your nervous system. Sometimes the cause is not known. Nerve pain can be difficult to treat, especially if the cause is unclear.

Your doctor can help diagnose your pain and discuss the treatment options with you. Sometimes nerve pain can be treated directly if the cause is known. Treating the cause should lower your pain levels.

There are several possible treatments for nerve pain, including medicines.

However, a medicine will often only lessen and not completely stop nerve pain. Talk to your doctor about non-medicine pain management options that may help too.

How do medicines for nerve pain work?

Medicines used to treat nerve pain usually act on natural chemicals (neurotransmitters) in the body's nervous system. Most work by 'calming down' nerve activity to reduce your nerves' hypersensitivity (strong reaction) to a pain cause.

What types of medicine are used for nerve pain?

Many medicines used to treat nerve pain are also used in other conditions.

Antidepressant medicines

Your doctor might suggest an antidepressant medicine. These can be used for nerve at lower doses than are used for depression:

• amitriptyline
• nortriptyline
• duloxetine
• venlafaxine

Anti-seizure medicines

Another alternative is an anti-seizure medicine, such as:

• gabapentin
• pregabalin

Other medicines

Less commonly, you may be prescribed:

• tramadol, a pain medicine
• lignocaine, a local anaesthetic
• capsaicin

Most medicines that work for nerve pain are available only with a doctor's prescription. It may take time for you and your doctor to find a medicine or combination that works for you. Medicines for nerve pain may not work for everyone.

Many medicines used for nerve pain may not ease the pain immediately. It's important to build up the dose slowly so the side effects don't outweigh the benefits.

Many standard pain-relief medicines don't work well for nerve pain. These include paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioid medicines (such as codeine and morphine).

What are the possible side effects or risks of medicines used for nerve pain?

All medicines can have side effects, but not everyone will get them. Ask your doctor or pharmacist about common side effects with the specific medicine you have been prescribed.

Common side effects of medicines such as antidepressants and anti-seizure medicines used for nerve pain include:

• drowsiness
• dry mouth
• blurred vision
• weight gain
• oedema (swelling, usually of the ankles)

You might find that these side effects improve as your body gets used to the medicine.

It is best to avoid or limit alcohol while taking medicines for nerve pain, as the sedating effects can add up.

When should I see my doctor?

You should see your doctor if you have pain that continues despite lifestyle changes and medicines for nerve pain.

If your doctor diagnoses you with nerve pain they may refer you to a specialist neurologist, pain specialist or pain clinic who can help.

Talk to your doctor if you feel unwell when taking your medicines.

Do not stop or change your medicines without talking to your doctor. If your doctor is not available, speak with your pharmacist.

You can also ask your doctor or pharmacist about:

• the benefits of your nerve pain medicines
• what to do if you miss a dose
• the side effects of your nerve pain medicines
• what to do if you experience side effects

Are there any alternatives to these medicines?

Medicine alone will often only relieve some of the pain. Talk to your doctor about non-medicine pain management options that may help. These may include:

• regular exercise
• cognitive behavioural therapy (CBT)
• acupuncture
• relaxation techniques
• transcutaneous electrical nerve stimulation (TENS)

Resources and support

If you are concerned about the effects of your medicine, ask your doctor or pharmacist for advice.

You can find out more about your medicine by reading the Consumer Medicine Information (CMI).

Call 1300 MEDICINE (1300 633 424) to speak with a pharmacist who can answer your questions about medicines.

Pain Australia has information and support for people living with pain in Australia.

Chronic Pain Australia has resources, events and support groups for people living with chronic pain in Australia. You can also contact their helpline on 1300 340 357.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.