Neuropathic Pain: what it feels like and what helps

If you have burning, tingling, electric shocks, or numbness that won't quit, you might be dealing with neuropathic pain. This type of pain comes from damaged or irritated nerves — not from a pulled muscle or a broken bone — so it needs a different approach. Below I cover what to expect, common medicines, and practical steps you can try today.

How to recognize neuropathic pain

Neuropathic pain often has a few telltale signs: sharp or shooting pain, pins-and-needles, heightened sensitivity to touch, or areas that feel numb but still hurt. It can be constant or come in bursts. Causes range from diabetes and shingles to nerve compression and some medications. If symptoms come on after an illness, injury, or long-term condition, mention that to your doctor — it helps narrow the cause.

Common medications and safer alternatives

Medications used for neuropathic pain are different from standard painkillers. Doctors commonly start with drugs like gabapentin or pregabalin — they calm overactive nerves. Antidepressants such as duloxetine or tricyclics (amitriptyline) also work well for many people. For localized pain, lidocaine patches or capsaicin creams can help without systemic side effects.

If gabapentin isn’t working or causes intolerable side effects, there are valid alternatives. Pregabalin often works similarly but may be better tolerated for some. Duloxetine is a good option when pain and mood or sleep are affected. Your clinician can also discuss topical options or referral to a pain specialist for nerve blocks or other targeted treatments.

Be careful with NSAIDs and opioids: NSAIDs like ketorolac are generally more useful for inflammatory pain than nerve pain, and opioids may give short-term relief but carry higher risks long-term. Always talk with your prescriber about benefits, side effects, and monitoring needs.

Beyond prescriptions, some people find benefit from supplements such as vitamin B12 when deficiency is present, or alpha-lipoic acid for certain types of neuropathy. These aren’t magic fixes and should be used under medical guidance, especially if you take other medicines.

Practical self-care tips you can try now: keep blood sugar under control if you have diabetes, protect numb feet from injury, use comfortable shoes, try gentle exercise to improve circulation, keep a regular sleep schedule, and use heat or cold packs for short-term relief. TENS (a home nerve stimulation device) helps some people — ask your provider whether it’s suitable for you.

If pain suddenly gets worse, you develop weakness, or you lose control of bladder or bowel function, seek urgent medical care. For ongoing pain, keep a symptom diary (timing, triggers, treatments and their effects) — it makes follow-up visits more productive and helps tailor treatment faster.

Want to explore medication options or alternatives in detail? Check articles on our site about gabapentin alternatives, topical treatments, and practical tips for living with chronic nerve pain. Talk openly with your healthcare team — small changes in treatment or daily habits often make a big difference.