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 12 therapies linked to Neuralgia support.
| Therapy | Evidence | Notes |
|---|---|---|
| Cognitive Behavioural Therapist |
strong
|
Helps you reframe unhelpful thoughts about nerve pain and reduce the distress, avoidance and low mood that often amplify neuralgia. |
| Pain Reprocessing Therapist |
strong
|
Works to retrain the brain's perception of persistent nerve pain, easing fear around the sensations and lowering how threatening they feel. |
| Acupuncturist |
moderate
|
Acupuncture is often used to ease neuralgic pain, with some evidence it may calm nerve signalling and offer symptomatic relief for affected areas. |
| Biofeedback Practitioner |
moderate
|
Biofeedback teaches control over muscle tension and stress responses that can aggravate neuralgia, supporting calmer nerve activity. |
| Counsellor |
moderate
|
Counselling offers a space to process the frustration and isolation of living with chronic nerve pain, supporting emotional wellbeing alongside treatment. |
| EMDR Practitioner |
moderate
|
EMDR may help where neuralgia is linked to traumatic injury or distress, reducing the emotional charge tied to the pain experience. |
| EFT Practitioner |
moderate
|
Tapping is used as a supportive self-help approach for neuralgia; evidence is limited, so it is best alongside, not instead of, proper medical care. |
| Hypnotherapist |
moderate
|
Hypnotherapy can guide you into a relaxed state to alter your experience of nerve pain, supporting coping and reducing perceived intensity. |
| Massage Therapist |
moderate
|
Massage may ease the muscle tension and stiffness that surround neuralgia, offering relaxation and short-term relief in affected regions. |
| Mindfulness Practitioner |
moderate
|
Mindfulness practice can help you observe neuralgia sensations without struggle, easing tension and the anxiety that tends to heighten the pain. |
| Myofascial Release Practitioner |
moderate
|
Myofascial release targets tight fascia and trigger points near affected nerves, which may relieve compression-related neuralgic discomfort. |
| OldPain2Go Practitioner |
moderate
|
OldPain2Go is a supportive approach aimed at lingering nerve pain; evidence is limited, so use it alongside appropriate medical care, not in place of it. |
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.