Treatment:

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.

Surgery to remove pressure on the nerve from nearby bones, ligaments, blood vessels, or tumors may be needed.

See:

• Carpal tunnel syndrome
• Trigeminal neuralgia

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.

Expectations (prognosis):

Most neuralgias are not life-threatening and are not signs of other life-threatening disorders. However, pain can be severe. For severe pain that does not improve, see a pain specialist so that you can explore all treatment options.

Most neuralgias will respond to treatment. Attacks of pain usually come and go. However, attacks may become more frequent in some patients as they get older.

Complications:

• Complications of surgery
• Disability caused by pain
• Side effects of medications used to control pain
• Unnecessary dental procedures before neuralgia is diagnosed

Calling your health care provider:

Contact your health care provider if:

• You develop shingles
• You have symptoms of neuralgia, especially if over-the-counter pain medications do not relieve your pain
• You have severe pain (see a pain specialist)