Neuralgia — pain originating from a damaged or irritated nerve — can be one of the most intense and debilitating pain experiences, often described as burning, shooting, stabbing or electric-shock-like. It can occur in any nerve in the body, with trigeminal neuralgia, postherpetic neuralgia (after shingles) and peripheral neuropathic pain being the most common presentations. Medical, physical and psychological approaches are used in combination for best outcomes.
See therapies that may helpNeuralgia is a specific type of pain that arises from damage, irritation or dysfunction of a nerve rather than from tissue injury. The pain is characteristically severe, episodic or continuous, and follows the distribution of the affected nerve. Common types include: trigeminal neuralgia (intense facial pain); postherpetic neuralgia (persisting after shingles); occipital neuralgia (pain in the back of the head and scalp); intercostal neuralgia (pain around the ribs); and pudendal neuralgia (pelvic pain).
Neuralgic pain is notoriously difficult to treat because it arises from the nervous system itself rather than from tissue inflammation, making standard analgesics less effective. Treatment typically requires specialist approaches combining medical, physical and psychological components.
Neuralgia symptoms typically include:
Management of neuralgia typically requires a multidisciplinary approach:
A GP is the appropriate first contact for neuralgia diagnosis and initial management. Referral to a neurologist, pain clinic or relevant specialist (dentist for dental neuralgia; pelvic floor physiotherapist for pudendal neuralgia) may be appropriate. The British Pain Society and Pain Concern (painconcern.org.uk) provide resources and support.
Showing 22 therapies linked to Neuralgia support.
| Therapy | Evidence | Notes |
|---|---|---|
| Cognitive Behavioural Therapist |
strong
|
CBT for pain management in neuralgia. |
| Mindfulness Practitioner |
moderate
|
Mindfulness for pain management. |
| Pain Reprocessing Therapist |
strong
|
Pain reprocessing therapy for neuralgia. |
| Acupuncturist |
moderate
|
Used for neuropathic pain conditions. |
| Biofeedback Practitioner |
moderate
|
Biofeedback for neuralgia pain management. |
| Counsellor |
moderate
|
Counselling for neuralgia pain distress. |
| Craniosacral Therapist |
moderate
|
Used for pain management in neuralgia. |
| EMDR Practitioner |
moderate
|
EMDR for pain management in neuralgia. |
| EFT Practitioner |
moderate
|
EFT for pain management. |
| Hypnotherapist |
moderate
|
Used for pain management in neuralgia. |
| Massage Therapist |
moderate
|
Used for pain management in neuralgia. |
| Meditation Practitioner |
moderate
|
Meditation for pain management. |
| Myofascial Release Practitioner |
moderate
|
Myofascial release for neuralgia pain. |
| OldPain2Go Practitioner |
moderate
|
OldPain2Go for neuralgia. |
| Osteopath |
moderate
|
Used for pain management in neuralgia. |
| Physiotherapist |
moderate
|
Used for pain management in neuralgia. |
| Psychotherapist |
moderate
|
Psychotherapy for neuralgia pain distress. |
| Sports Therapist |
moderate
|
Sports therapy for neuralgia pain management. |
| Tension and Trauma Practitioner |
moderate
|
TRE for pain management. |
| Body Stress Release Practitioner |
limited
|
Used for pain management. |
| Bowen Technique Practitioner |
limited
|
Bowen used for neuralgia pain. |
| Structural Integration Practitioner |
limited
|
Used for neuralgia pain management. |
Trigeminal neuralgia is a severe, episodic facial pain affecting the trigeminal nerve, typically experienced as intense electric-shock or stabbing pain triggered by light touch, eating, speaking or cold air. It is considered one of the most painful conditions known and significantly impairs quality of life. It responds to anticonvulsant medication and in some cases to surgical intervention.
Postherpetic neuralgia is pain that persists in the area affected by shingles after the rash has healed, caused by damage to nerves by the varicella-zoster virus. It affects around 10–15% of people who have shingles and can be severe and persistent. It is more common in older adults. Early antiviral treatment of shingles reduces the risk of developing it.
Yes — shingles vaccination (Shingrix, now available on the NHS from age 70) significantly reduces both the risk of shingles and the severity and duration of any shingles that does occur, including postherpetic neuralgia. It is recommended for adults from age 70 in the UK.
Standard analgesics (paracetamol, NSAIDs) work primarily by reducing inflammation or peripheral pain transmission — mechanisms that are not the primary driver of neuropathic pain. Neuralgic pain arises from aberrant nerve signalling itself, which requires agents that modulate nerve activity (anticonvulsants, certain antidepressants) rather than reducing inflammation.
Yes — psychological approaches including CBT, ACT and mindfulness do not remove neuralgic pain but significantly reduce its impact. They address pain catastrophising, fear-avoidance, sleep disruption and the depression and anxiety that commonly develop alongside severe chronic pain. Pain management psychology is now a core component of specialist pain clinic care.