Over-the-counter pain relievers are the most frequently purchased medicines. They can help treat mild-to-moderate pain associated with peripheral neuropathy. There are two main types of over-the-counter pain relievers.

Acetaminophen

Acetaminophen is used to treat mild-to-moderate pain and reduce fever, but it is not very effective at reducing inflammation. Acetaminophen provides relief from pain by elevating the amount of pain you can tolerate before you experience the feeling of pain. The best-known brand of acetaminophen is Tylenol®, but there are also many generic versions available.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain, swelling, stiffness and inflammation. Two drugs in this category, ibuprofen and naproxen, also reduce fever. NSAIDs work by reducing the body’s production of prostaglandin, an enzyme that sends pain messages to the brain. When these drugs are taken regularly, they build up in the blood to levels that fight pain caused by inflammation and swelling, and also provide general pain relief.

There are several different types of NSAIDs.

These include:

• Aspirin (Bayer® Aspirin, Ecotrin®, Excedrin®, St. Joseph’s®, and many others)
• Ibuprofen (Advil®, Motrin®, and others)
• Ketoprofen (Orudis®)
• Naproxen (Aleve®)

Many over-the-counter pain medications are also available in generic formulas.

Topical medications are creams, ointments, gels, lotions, or patches that you apply directly on your skin to provide relief from nerve pain and inflammation. The active drugs in these medications are absorbed through the skin and provide localized pain relief.

Two types of topical medications used to treat neuropathy pain are:
Local anesthetics
Analgesics

Local anesthetics are used to treat localized pain. They work by numbing the area and blocking the pain where they are applied. Some local anesthetics are:

Nonprescription topical pain relievers (analgesics) — which are rubbed on the skin — are available to treat pain from neuropathy. These medications contain capsaicin (Capzasin-P®, Dolorac®, Zostrix® are brand names). A substance made from the seeds of hot chili peppers, capsaicin may reduce the ability of nerve cells to transmit pain messages to the brain. Capsaicin and other topical pain relievers provide temporary relief from minor pain located close to the skin’s surface.

When over-the-counter pain medications do not relieve the pain associated with peripheral neuropathy, other types of medications and therapies are available, including prescription non-steroidal anti-inflammatory drugs, narcotics, antidepressants, and topical medications.

Sometimes, drugs developed and used to control other conditions are effective pain relievers. In addition to relieving depression, many anti-depressant drugs can relieve chronic pain. These drugs also may improve sleep quality, which may in turn help reduce pain. In some cases, antidepressants work by treating accompanying depression that makes chronic pain more difficult to handle.

• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) (e.g., Cymbalta®)
• Norepinephrine Reuptake Inhibitors (e.g., Wellbutrin®)
• Serotonin Receptor Modulators (SRM)

Neuropathic Pain Medications – To view a list of most commonly prescribed neuropathic pain medications including starting and maximum dosage, side effects, precautions, interaction and other benefits.

• Alpha-2 Andrenergic Agonists
• Corticosteroids
• COX-2 Inhibitors (includes Celebrex®)
• Intravenous Immunoglobulin (IVIg, IgG)
• Medical Cannabis
• Mexiletine
• Narcotics (Opioids)
• Nerve Block
• Norepinephrine reuptake inhibitors (NRIs)
• Plasmapheresis
• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Serotonin receptor modulators
• Topical Medications
• Tramadol (Ultram®)