Analysis highlights best treatments for neuropathic pain
In the journals
- Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
If you suffer from neuropathic pain — that is, pain due to nerve problem — a recent analysis offers recommendations on the best possible treatments.
Neuropathic pain causes sharp, burning, or tingling sensations and occurs from nerve irritation, damage, or injury. Conditions that can trigger neuropathic pain include diabetes, cancer or cancer treatment, sciatica, shingles, and multiple sclerosis.
Researchers examined 313 trials, involving a total of nearly 50,000 people, that explored various medications and noninvasive treatments for managing neuropathic pain. They found that amitriptyline and other tricyclic antidepressants, the anticonvulsants gabapentin (Neurontin) and pregabalin (Lyrica), and serotonin-norepinephrine reuptake inhibitors like duloxetine (Cymbalta) were the most effective drugs, which supported their frequent use as first-line treatment.
Second-line therapies, such as 8% capsaicin patches, capsaicin cream, and 5% lidocaine patches, were not rated highly. Opioids, botulinum toxin A (Botox), and repetitive transcranial magnetic stimulation (a procedure that uses magnetic pulses to stimulate specific areas of the brain) had weak support due to limited evidence and safety concerns. The results were published in the May 2025 issue of The Lancet Neurology.
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About the Author
Matthew Solan, Executive Editor, Harvard Men's Health Watch
About the Reviewer
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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