What nerve (neuropathic) pain is
The Walton Centre describes neuropathic pain as a common type of chronic pain caused by nerve disease or nerve damage. UCLH explains that it happens when nerves are irritated or damaged. The pain is felt in the area supplied by the affected nerve.
Not all pain from a damaged area is nerve pain, and not everyone with nerve damage has pain: some people mainly notice numbness or weakness. Nerve pain is also different from muscle or joint pain, which is why the Walton Centre stresses that it is treated differently from other pains.
How it feels: burning, shooting, electric
According to the Walton Centre and UCLH, people often describe nerve pain as:
- burning
- aching
- shooting or stabbing
- like electric shocks
The Walton Centre adds that many people also have pins and needles, numbness and weakness in the same area, also caused by the damaged nerve. These descriptions are useful to share with a doctor, but no list of sensations is enough to diagnose nerve pain on your own.
Common causes: diabetes, shingles, compression, chemotherapy
The Walton Centre lists shingles, diabetes, surgery and stroke among the causes of nerve pain. UCLH’s information, written for people with cancer, explains that nerve pain can also be caused by an illness or its treatment. Other situations where nerves are irritated or damaged include compression of a nerve, as in carpal tunnel syndrome or sciatica, and injuries.
Pain after shingles, diabetic nerve damage and nerve compression each have their own pattern and treatment, which is why finding the cause matters more than the label of “nerve pain” alone.
Central vs peripheral nerve pain
Nerve pain can come from the peripheral nerves, those outside the brain and spinal cord that supply the limbs and organs, or from the central nervous system itself. The Walton Centre includes stroke, which damages the brain, among the causes, alongside diabetes and shingles, which affect peripheral nerves.
This distinction helps explain why nerve pain is not the same as peripheral neuropathy: peripheral neuropathy is one cause, but not the only one, and it can also occur without pain. The type and location of the nerve problem influence which tests and treatments are considered.
How it is diagnosed
The Walton Centre explains that, because nerve pain is treated differently from other pains, an accurate diagnosis is important. The assessment includes a physical examination, and scans or other tests may also be needed.
When a doctor needs to locate damage to a peripheral nerve or nerve root, they may request electromyography (EMG) and nerve conduction studies. If your doctor has asked for these tests, our clinical neurophysiology service in Bilbao performs them (consultations are in Spanish); it does not offer pain treatment, and the diagnosis and treatment plan remain with your doctor.
Medicines: groups, not doses
UCLH explains that nerve pain does not always respond well to usual painkillers like paracetamol or ibuprofen, so doctors may try other types of medicine. Some were originally used for epilepsy or depression and were found to help nerve pain because they affect how the nervous system works. Examples include amitriptyline, gabapentin and pregabalin; in cancer care, steroids such as dexamethasone may be used for short periods to reduce inflammation around nerves.
UCLH notes that these medicines usually start at a low dose that is increased gradually, that they can take a few weeks to work, and that the main side effect is drowsiness, which often improves after a week or two. Other possible effects include dry mouth, constipation and dizziness. The Walton Centre explains that GPs start treatment with medicines recommended by national guidelines, and refer to a specialist pain clinic if these are not enough.
Non-drug approaches and specialist treatments
The Walton Centre explains that treatment is tailored to each person. In specialist centres, options may include hospital-only treatments such as a capsaicin (chili pepper) patch or infusion therapy, neuromodulation such as spinal cord stimulation, and, for selected patients, neurosurgical procedures. Some people benefit from rehabilitation when chronic pain has had a major effect on their quality of life.
These treatments are for selected people after specialist assessment, not options for everyone. Supplements, manual therapies or injections are not universal solutions; any treatment should be agreed with the team managing the pain.
Living with nerve pain: sleep, mood, work
Chronic pain can affect sleep, mood and work, and rehabilitation focused on quality of life can help, as the Walton Centre notes. Psychological support is part of managing chronic pain because pain affects daily life, not because the pain is imagined.
UCLH gives important safety advice for people taking nerve pain medicines:
- avoid alcohol until you are used to the medicine, as it increases drowsiness
- do not drive, use machinery or do anything that needs full alertness if you feel drowsy
- do not stop these medicines suddenly, especially after several weeks: withdrawal can cause anxiety, sweating, nausea, trouble sleeping and the return of pain
- talk to your doctor or nurse if side effects bother you or the medicine is not helping
Where the sources differ
The Walton Centre page (no visible date) describes nerve pain in general and the specialist services of a neurology centre, including intrathecal drug delivery, a specialized hospital treatment rather than a standard option. UCLH’s page (March 2026) is written for people with cancer and lists specific medicines and their side effects; its use of steroids applies to that context and should not be extrapolated to all nerve pain.
Neither source gives doses, and none are given here: medicine choice, dose changes and stopping are decided with your doctor. Neither promises a life completely free of pain; the goal is usually to reduce pain and improve function and quality of life.
In summary
Nerve pain is caused by irritated, diseased or damaged nerves and often feels burning, shooting or like electric shocks, sometimes with numbness, tingling or weakness. Common causes include diabetes, shingles, surgery, stroke, nerve compression and cancer treatments. An accurate diagnosis matters because it is treated differently from other pain. Medicines first used for epilepsy or depression are common; they take weeks to work and must not be stopped suddenly.
For treatment reviews, it helps to keep a simple table: a functional goal (for example, sleeping through the night or walking further), whether the treatment has helped towards it, and any side effects such as drowsiness or dizziness. Seek urgent help for rapidly worsening weakness, bladder or bowel problems or breathing difficulty.
Frequently asked questions about nerve pain
These answers are general information and do not replace an examination or individual medical advice.
What does nerve pain feel like?
It is often described as burning, aching, shooting or like electric shocks, sometimes with pins and needles, numbness or weakness in the same area.
What is the most common cause of nerve pain?
Causes include diabetes, shingles, surgery, stroke, nerve compression and cancer or its treatment. The most likely cause depends on the person and the location of the pain.
What makes nerve pain flare up?
Triggers vary between people and conditions. Keeping a record of when pain worsens can help your doctor adjust treatment.
Which medicines are used for nerve pain?
Often medicines originally used for epilepsy or depression, such as gabapentin, pregabalin or amitriptyline, because usual painkillers may not work well. Doses and choices are decided by your doctor.
Can nerve pain go away?
It depends on the cause. Treatment is tailored to each person and usually aims to reduce pain and improve daily function and quality of life.
When should I see a doctor about nerve pain?
When burning, shooting or electric pain persists or affects daily life. Seek urgent help for rapidly worsening weakness, bladder or bowel problems or breathing difficulty.
Sources
- The Walton Centre NHS Foundation Trust · Neuropathic pain (nerve pain)
- University College London Hospitals NHS Foundation Trust · Medicines for nerve (neuropathic) pain
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.