Nerve Pain: Causes, Symptoms & Practical Treatments

Nerve pain, or neuropathic pain, feels different from ordinary aches. It can burn, tingle, shock, or make normal touch hurt. People often describe electric jolts, numb patches, or a constant aching that doesn't fit a typical injury pattern. Knowing what to expect helps you make better choices with doctors and treatments.

What causes nerve pain?

Diabetes is the most common cause worldwide — high blood sugar damages small nerves over time. Other causes include shingles (postherpetic neuralgia), nerve compression like sciatica, traumatic injury, chemotherapy and some medications, alcohol misuse, vitamin deficiencies (especially B12), autoimmune disorders, and some infections. Sometimes no clear cause appears and doctors call that idiopathic neuropathy.

Symptoms vary. Burning, stabbing pains, pins-and-needles, numbness, and sensitivity to light touch are typical. Pain often follows a nerve path: along a leg, arm, or across a band of the torso. Symptoms can be constant or come in flares. They usually worsen at night and can disturb sleep, mood, and daily tasks.

How to manage nerve pain today

Start with a simple plan: see your doctor for a diagnosis, check blood sugar and B12, and review medications. For many people, first-line drugs are gabapentin or pregabalin, or antidepressants such as duloxetine or nortriptyline. Topical options like lidocaine patches or capsaicin cream work well for localized pain and have fewer side effects. If one drug fails, doctors often try another or combine low doses.

Physical therapy helps when pain links to nerve compression or muscle weakness. Gentle exercise, stretching, and balance work reduce flare-ups and improve function. TENS units or targeted nerve blocks may benefit persistent cases. For severe, refractory pain, specialist options include spinal cord stimulators or referral to a pain clinic.

Self-care matters. Keep blood sugar controlled if you have diabetes, limit alcohol, and maintain a balanced diet with enough B vitamins. Use comfortable shoes and avoid tight clothes over painful areas. Sleep hygiene and stress management lower pain sensitivity; cognitive behavioral therapy can change how pain affects your life.

Watch for red flags: sudden weakness, bowel or bladder trouble, or rapidly spreading numbness. Those require urgent evaluation. Also tell your provider about side effects like dizziness, mood change, or breathing problems from medications.

Testing can help guide treatment. Your doctor may order nerve conduction studies, EMG, blood tests for B12, thyroid and autoimmune markers, and imaging like MRI when compression is suspected. Understanding test results makes choices clearer — for example, a pinched nerve on MRI points to surgery or injections, while a metabolic cause steers toward medical control. Keep a pain diary: note time of day, triggers, sleep quality, and what eases pain. This record helps your doctor pick the right drug or therapy and shows small improvements over weeks.

Talk openly, keep notes, and adjust care together.