Options for nerve pain management can include medication, electrical stimulation, nerve blocks, and neurotomy procedures to sever stubborn nerves. Some patients may consider alternative or complementary therapy like acupuncture, trigger point massage, or herbal medicines. A medical practice may encourage patients to use complementary medicine, mixing different approaches in search of an effective method of pain control. Nerve pain can be persistent and complex, and it may take several months to find an appropriate treatment method.
The first line of treatment for patients with neuralgia, the formal term for nerve pain, is medication. Sometimes patients benefit from nonsteroidal antiinflammatory drugs, or NSAIDS. Others may need more aggressive pain management medications like morphine. Anticonvulsants and muscle relaxers can be useful in some cases as well. A mixture of medications may be necessary to provide adequate pain control, and patients may require adjustments over time.
Doctors may also recommend certain antidepressants in the tricyclic class for nerve pain management. This is not because they think the pain is in the patient’s head, but because these drugs appear to effectively suppress some of the neurotransmitters involved in chronic neuralgia. They can also prevent spasms associated with nerve pain, which can make patients feel more comfortable.
If these measures are not effective, doctors can consider more aggressive treatment. One option is electrical stimulation, where a low electrical current is used to short-circuit the nerve signals before they can send pain messages. If a topical device worn on the skin helps, the doctor might recommend an implanted stimulator. Other patients benefit from periodic sessions in a doctor’s office for electrical stimulation.
Nerve blocks are another choice for nerve pain management. An anesthesiologist can inject numbing drugs into the nerves responsible for pain to cut off their signals. Patients may start with a temporary block to see if it addresses the pain. If it does, the anesthesiologist can use a longer-lasting medication to offer long-term nerve pain management.
Surgery is the option of last resort for nerve pain management. Sometimes nerve pain is caused by pressure from a blood vessel, in which case a surgeon can move the vessel to resolve the problem. In other instances, a patient may need a neurotomy, where a surgeon cuts through the offending nerve. This is not always an option, and can come with a risk of complications. These include loss of sensation or a recurrence of pain if something goes wrong during the healing process.
