Research evaluates medications for chronic nerve pain

A study published in JAMA Neurology has evaluated the effectiveness and tolerability of four medications used to treat cryptogenic sensory polyneuropathy (CSPN), a condition causing chronic nerve pain in the hands and feet without a clear underlying cause. Researchers at the University of Missouri, led by Dr. Richard Barohn, conducted a 12-week trial with 402 adults.

The study compared nortriptyline, duloxetine, pregabalin, and mexiletine. Nortriptyline provided meaningful pain relief for approximately 25% of patients, while duloxetine helped about 23%. Duloxetine demonstrated the lowest dropout rate at 37%, suggesting it offers a strong balance between efficacy and tolerability. Pregabalin showed improvement in 15% of participants, and mexiletine had the highest dropout rate at 58%.

In a separate context regarding postherpetic neuralgia (PHN), medical guidance warns that while ice packs may temporarily numb pain, improper use can lead to complications. Prolonged or direct exposure to cold can cause vasoconstriction, tissue injury, or nerve damage, particularly if applied to already numb skin or used without a cloth barrier.