Neuralgia: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Neuralgia?
A neurologist, a doctor who treats nerve and brain disorders, often leads care for neuralgia. A pain specialist, a doctor who treats long-lasting pain, can help when the pain is severe. A primary care doctor can start the work-up. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is neuralgia?
Neuralgia is a sharp, shocking pain that follows the path of a nerve. It is due to irritation or damage to the nerve. It is also called nerve pain or neuropathic pain.
Common types include postherpetic neuralgia, which is pain that continues after a bout of shingles. Another type is trigeminal neuralgia, which is stabbing or electric-shock-like pain in parts of the face. These two are the most common forms. Neuralgia is more common in older people, but it may occur at any age.
Symptoms
Symptoms may include:
- Skin along the damaged nerve that is so sensitive that any touch or pressure is felt as pain.
- Sharp or stabbing pain along the nerve, in the same place each time. It may come and go, or be constant and burning.
- Weakness or complete paralysis (loss of movement) of muscles supplied by the same nerve.
In trigeminal neuralgia, the pain is sudden, intense, and shock-like or stabbing, typically on one side of the face. Attacks typically last only a few seconds, but can last up to two minutes.
Causes and who gets it
Causes of neuralgia include:
- Infections, such as shingles, HIV/AIDS, Lyme disease, and syphilis.
- Diabetes and chronic kidney disease.
- Pressure on nerves from nearby bones, ligaments, blood vessels, or tumors.
- Injury, including surgery.
- A nervous system disorder, such as multiple sclerosis.
In many cases, the cause is unknown. In the most common type of trigeminal neuralgia, a blood vessel is pushing on part of the trigeminal nerve root. In secondary trigeminal neuralgia, another disorder, such as multiple sclerosis or a tumor, is the cause. Only 15% of trigeminal neuralgia cases are secondary.
How doctors diagnose it
Your health care provider will do a physical exam and ask about your symptoms. The exam may show odd feeling in the skin, reflex problems, or tenderness along a nerve. It may also show trigger points, which are areas where even a slight touch triggers pain. If the pain is in your face or jaw, you may also need to see a dentist. A dental exam can check for dental problems that may cause facial pain.
There are no specific tests for neuralgia. But some tests may be done to find the cause of the pain:
- Blood tests to check blood sugar and other possible causes.
- An MRI, a scan that takes pictures inside the body.
- A nerve conduction study with electromyography, which tests how nerves and muscles work.
- Testing of any blisters to see if the skin is infected with the shingles virus.
Treatment
Treatment depends on the cause, location, and severity of the pain. Medicines to control pain may include antidepressants and antiseizure medicines. Other choices are over-the-counter or prescription pain medicines, and skin patches or creams.
Other treatments may include:
- Shots with pain-relieving (anesthetic) medicines, and nerve blocks.
- Procedures to reduce feeling in the nerve, such as nerve ablation using radiofrequency, heat, balloon compression, or injection of chemicals.
- Surgery to take pressure off a nerve.
- Alternative therapy, such as acupuncture or biofeedback.
Procedures may not improve symptoms. They can cause loss of feeling or odd sensations.
For trigeminal neuralgia, medicine is usually the first treatment. Common pain relievers such as aspirin and ibuprofen are not usually helpful. Surgery may be considered if medicine does not relieve pain. It may also be considered if side effects are hard to bear, such as memory loss or extreme tiredness. Microvascular decompression relieves pressure from blood vessels touching the nerve. It is the most effective surgery at preventing pain long-term. Surgery has risks, including hearing loss, balance problems, infection, and, in rare cases, stroke.
When to see a doctor
Contact your provider if you develop shingles. Also contact your provider if you have symptoms of neuralgia, especially if over-the-counter pain medicines do not help. If your pain is severe, see a pain specialist, a doctor who treats long-lasting pain. Most neuralgias are not life threatening. Call 911 or go to the emergency room if you have sudden weakness, trouble speaking, or a sudden change in vision.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can review your symptoms and order blood tests that look for causes of nerve pain.
Common questions
Is neuralgia life threatening?
No, most neuralgias are not life threatening. They are also not signs of other life-threatening disorders. It can still cause disability from pain.
Does neuralgia go away on its own?
Sometimes it does. It may get better or go away with time, even when the cause is not found. Most neuralgias respond to treatment. In some people, attacks may become more frequent with age.
Can neuralgia be prevented?
Sometimes it can. Strict control of blood sugar may prevent nerve damage in people with diabetes. The shingles vaccine (herpes zoster vaccine) greatly lowers the risk of shingles and postherpetic neuralgia. Antiviral medicines, if given early, may prevent neuralgia after shingles.
Sources
- MedlinePlus - Neuralgia
- National Institute of Neurological Disorders and Stroke - Trigeminal Neuralgia
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
