Neuralgia medical therapy
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Treatment |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Medical Therapy
The goal of treatment is to reverse or control the cause of the nerve problem (if found), and provide pain relief. Treatment varies depending on the cause, location, and severity of the pain, and other factors. Even if the cause of the neuralgia is never found, the condition may improve on its own or disappear with time. Strict control of blood sugar may speed recovery in people with diabetes who develop neuralgia. Medications to control pain may include:
- Antidepressant medications (amitriptyline, nortriptyline, or duloxetine)
- Antiseizure medications (carbamazepine, gabapentin, lamotrigine, phenytoin, or pregabalin)
- Mild over-the-counter analgesics (aspirin, acetaminophen, or ibuprofen)
- Narcotic analgesics (codeine) for short-term relief of severe pain (however, these do not always work well)
- Topical creams containing capsaicin
Other treatments may include:
- Local injections of pain-relieving (anesthetic) drugs
- Nerve blocks
- Physical therapy (may be needed for some types of neuralgia, especially postherpetic neuralgia)
- Procedures (such as nerve ablation using radiofrequency, heat, balloon compression, or injection of chemicals) to reduce feeling in the nerve
Unfortunately, these procedures may not improve symptoms and can cause loss of feeling or abnormal sensations.
When other treatment methods fail, doctors may try motor cortex stimulation (MCS). An electrode is placed over part of the brain and is hooked to a pulse generator under the skin.