Neuropathy treatments: what works and what to try first

Neuropathy can feel like burning, stabbing, tingling, or electric shocks. That variety is why one treatment rarely fixes everything. This page gives clear, practical options you can discuss with your doctor — from medicines that ease nerve pain to self-care steps you can start today.

Which medicines usually work

Doctors often start with drugs meant specifically for nerve pain, not standard painkillers. Gabapentin and pregabalin are common choices. Many people respond to one or the other; some need a switch or combination. If you want detail, check our piece “Pregabalin vs Gabapentin: Which Relieves Neuropathic Pain Better?” for side-by-side info.

• Gabapentin — often started low (for example one small nightly dose) and increased over days. Typical effective ranges vary widely, so follow your prescriber’s plan.
• Pregabalin — works faster for some people and may require smaller doses than gabapentin. It can also cause sleepiness and dizziness early on.
• Antidepressants like duloxetine or tricyclics (amitriptyline) help nerve pain at low doses. They treat mood and sleep too, which helps some patients feel better overall.
• Topicals such as lidocaine patches or capsaicin cream can reduce localized burning without many systemic side effects.
• Opioids are usually a last resort for severe cases because of dependence and limited long-term benefit.

Self-care and non-drug options

Drug therapy often gives the biggest relief, but adding self-care makes a real difference. For diabetic neuropathy, tight blood sugar control slows damage. Keep feet checked daily, wear comfortable shoes, and treat cuts right away to avoid ulcers.

Try these practical steps: gentle daily exercise (walking or swimming), balance and strength work to reduce falls, and paced activity to avoid flare-ups. Physical therapy and TENS (a small electrical stimulator) help some people reduce pain and improve function.

Supplements like vitamin B12 help when a deficiency is present; alpha-lipoic acid has shown benefit in some studies at common doses around 600 mg/day, but always talk to your clinician before starting anything new.

When picking treatments, watch for side effects that matter to you: drowsiness, weight gain, swelling, or interactions with other meds. Start low and go slow — that reduces side effects and helps find the right dose. If you buy medications online, use reputable pharmacies and keep your prescriber informed.

If pain limits sleep, work, or walking, ask your doctor for a focused plan: a targeted medication trial, a brief physical therapy program, and a follow-up within a few weeks. Nerve pain rarely disappears overnight, but the right mix of medicine, lifestyle, and rehab often brings clear improvement.

Want specifics on options and comparisons? See our full article comparing pregabalin and gabapentin, and contact your healthcare provider to make a safe plan that fits your situation.