This information explains the causes, symptoms, and treatment of neuropathic pain.

Neuropathic pain (nerve pain) results from injury to a nerve, nerve root, or the spinal cord. It is often felt in the hands and feet, but it can occur in other parts of the body. It can last from months to years.

Causes

Some of the more common causes of neuropathic pain include:

  • Chemotherapy drugs, such as:
    • Cisplatin
    • Paclitaxel 
    • Oxaliplatin
    • Vincristine
  • Radiation therapy
  • A tumor pushing on a nerve
  • Surgery for cancer
  • Trauma or new injury
  • Infections, such as herpes zoster (shingles)
  • Chronic conditions, such as diabetes

Symptoms

Neuropathic pain often does not feel the same in every person. It may vary from day to day. Typically, it does not feel like the pain after an injury or surgery. It is commonly described as:

  • Burning
  • Cramping
  • Electric shock-like
  • Jolting
  • Knife-like
  • Numbness
  • Pressure
  • Shooting
  • Squeezing
  • Stabbing
  • Tingling

In some people, light touch from clothing or bed sheets causes marked unpleasant sensations on the skin. This is called allodynia (al-o-DIN-e-uh). It can occur with some types of neuropathic pain. Any form of pressure, such as from socks or shoes or tight clothes, can cause pain in some people.

Assessment

Your doctor or nurse will ask you questions about your pain when they see you in the office or hospital. Some common questions are:

  • On a scale of 0 to 10, where do you rate your pain? Zero is no pain at all and 10 is the worst pain you have had. If you cannot rate your pain using numbers, they may ask you to use words such as none, mild, moderate, severe, or excruciating.
  • Where is your pain? What part of your body hurts?
  • Does the pain stay in one place or does it move to other sites?
  • Can you describe your pain?
  • Is your pain constant or does it come and go?

Treatment

The goals of treatment are to:

  • Decrease or eliminate the cause of the pain. For example, shrink a tumor that is pressing on a nerve.
  • Provide pain relief
  • Allow you to maintain your usual activity level
  • Improve your quality of life

Treatment is usually with 1 or more medications. Common medications used to treat neuropathic pain are:

  • Antiseizure medications. If you are given a prescription for one of these, it does not mean you have a seizure disorder.
  • Antidepressants. If you are given a prescription for one of these, it does not mean you are depressed or that you are being treated for depression.
  • Opioids
  • Topical and local anesthetics
  • Steroid medication

The pain can also be treated with nerve blocks. These are injections of steroids, local anesthetics, or other medications into the affected nerves. This is done by a pain specialist.

Your doctor or nurse will tell you how and when to take your medication(s). They will give you information about the medication(s) and the possible side effects. While these medications work well to treat neuropathic pain, they can take up to 2 weeks to start working. Your dose may have to be increased over the first few weeks to get to a dose that works well in relieving your pain. It is common to try several medications before finding 1 or more that work well for you.