Nerve pain is part of many different types of pain syndromes. A few common pain syndromes in which nerves are the source of the pain include peripheral neuropathy, carpal tunnel syndrome, ulnar neuropathy, postherpetic neuralgia (following shingles), meralgia paresthetica, post-surgical pain syndromes, and sciatica. Typically there has been some level of injury to the nerve such as infection, compression, stretch, or metabolic abnormalities. Treatment of nerve pain is as various as the causes. Medical management with drugs that are specifically approved for nerve pain can be employed. However, most medications used for nerve pain are medications used “off label”, yet there are many research studies supporting the use of these medications for treatment of nerve pain (such as anti-seizure medications and antidepressants). There may be topical medications that can be useful, and commonly these would be ordered through a local compounding pharmacy. Injections are helpful when the nerve pain is localized and amenable to being blocked with a local anesthetic.
