Neuropathic Pain — What It Feels Like and What You Can Do

Neuropathic pain (nerve pain) is different from regular aches. It often burns, pins-and-needles, or feels electric. You might have sharp jolts, numb patches, or a constant deep ache that doesn’t match what you see on the outside. That mismatch—severe pain without obvious injury—is the clue that nerves, not muscles or joints, are the problem.

Common causes and how doctors check for it

Diabetes, shingles (postherpetic neuralgia), chemotherapy, nerve compression, vitamin B12 deficiency, and some infections can damage nerves. Your doctor will ask about the pain pattern, do a focused exam (look for sensory loss or reflex changes), and may order blood tests for glucose, B12, and thyroid or do nerve conduction studies. If the problem started suddenly with weakness, or you have bowel/bladder issues, those are red flags that need urgent evaluation.

What actually helps — treatments that work

First-line options for many people include gabapentin or pregabalin, SNRIs like duloxetine, and tricyclic antidepressants such as amitriptyline. These medicines target nerve signalling rather than inflammation. For localized pain, prescription 5% lidocaine patches or high-concentration capsaicin patches can work with fewer systemic side effects. Opioids aren’t ideal long-term for neuropathic pain; they may help short-term but carry risks.

Expect to try a few treatments before you find the right one. Drugs can reduce pain and improve sleep, but they often take weeks to show full benefit and may cause drowsiness, dry mouth, or weight changes. Talk about dosing and side effects openly with your clinician—small dose changes can make a big difference.

Non-drug options matter. Physical therapy can improve mobility and reduce pain flare-ups. Cognitive-behavioral therapy and pain-focused counseling help with coping and sleep. For stubborn cases, nerve blocks, spinal cord stimulation, or referral to a pain specialist may be appropriate. A combined approach—medication plus rehab and mental health support—usually gives the best results.

Simple self-care helps more than you might expect. Keep blood sugar under control if you have diabetes, protect numb feet to avoid unnoticed injury, limit alcohol, maintain a regular sleep schedule, and stay active with gentle exercise like walking or swimming. Warm baths and paced stretching can reduce muscle tension that adds to the discomfort.

When should you see a doctor? If pain is new and severe, getting worse, or comes with muscle weakness, balance loss, or bladder/bowel changes, seek care right away. If your pain limits daily life or sleep despite basic measures, ask for a referral to neurology or a pain clinic.

Neuropathic pain is often manageable. It may not disappear completely, but with the right tests, a tailored treatment plan, and sensible self-care, most people see meaningful improvement. Talk with your clinician about realistic goals and steps you can try this month.