ConditionNerve pain
Nerve (neuropathic) pain
Neuropathic pain behaves differently from other pain: light touch can hurt, symptoms can appear where sensation is reduced, and ordinary painkillers often do very little. Recognising it correctly changes the whole treatment approach.
Also calledBurning nerve painPost-shingles neuralgiaDiabetic nerve pain
What it is
Pain generated by damage or disease affecting the nerves themselves, rather than by injury to tissue. Causes include shingles, diabetes, surgery, trauma, chemotherapy and nerve entrapment.
What it feels like
- Burning, shooting or electric-shock pain
- Skin that hurts to touch — clothing or bedsheets become painful
- Numbness and pain occupying the same area
- Symptoms worse at night, disturbing sleep
How we assess it
Careful mapping of the affected area, sensory testing, and a review of the timeline against the likely cause. Screening questionnaires help, but the diagnosis is clinical.
Treatment options
- A structured medication trial — one change at a time, with a defined review
- Topical treatment for well-localised skin hypersensitivity
- Diagnostic and therapeutic nerve blocks
- Lidocaine or ketamine infusion in selected cases
- Spinal cord stimulation where pain is severe, localised and medication-resistant
- Pain psychology and desensitisation work alongside, not instead
What recovery looks like
The realistic goal is usually substantial reduction rather than abolition, with sleep and function improving first. Every trial is reviewed; medication that is not helping is stopped rather than accumulated.
Risks and honest limits
Neuropathic medications have side effects — drowsiness, unsteadiness, weight change — which is precisely why they are trialled deliberately and reviewed. We will not leave you on a drug that is not earning its place.
A note on this page
This is general information, written to help you prepare for a conversation. It is not a substitute for an individual assessment — what is right for you depends on your history, your examination and your own goals.
Common questions
Asked before, answered here
They act on tissue-injury pain. Neuropathic pain arises in the nervous system itself and responds to a different class of medication.
Usually two to six weeks at an adequate dose. Trials are given a fair chance and a firm end point.
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Have this assessed properly
Send a few lines about your pain and how long it has been going on. We will reply with a time and what to bring.
Visit
Level 2, 48 Macquarie StreetSydney, NSW 2000Response
Enquiries are answered within one to two business days. Urgent clinical matters are triaged the same day by the practice team.