Why do anti-inflammatories not help my nerve pain?

Because there is often nothing inflamed. Neuropathic pain is generated by nerve signaling itself, which is why medications developed for nerve pain, targeted blocks, and neuromodulation tend to work where anti-inflammatories do not.

Is diabetic neuropathy treatable?

The nerve damage is generally not reversible, but the pain frequently is treatable. Glucose control remains the foundation. For pain that persists despite medication, spinal cord stimulation is FDA-approved for painful diabetic peripheral neuropathy and has strong published outcomes.

What is CRPS, and why does early treatment matter?

Complex regional pain syndrome is a disproportionate pain response after an injury or surgery, often with color, temperature, and swelling changes. It responds better the earlier it is addressed, which is why we would rather see someone early than confirm it late.

Will spinal cord stimulation work for me?

You find out before committing. The trial places temporary leads for 5 to 7 days at home. If it reduces your pain by at least 50% and improves function, we proceed to an implant; if it does not, the leads are removed in seconds in the office and we look at other options.

Is the stimulator permanent?

No. SCS is fully reversible — both the trial and the permanent system can be removed. Modern systems are also MRI-conditional, and the device manufacturer provides a wallet card with the exact parameters your imaging facility needs.

Will I feel the stimulation?

Modern paresthesia-free waveforms deliver relief without the tingling older systems produced. Most patients are unaware of the device working in the background.

Do I have to stop my pain medication?

We do not require it. Most patients find they need significantly less after a successful trial and implant, and we coordinate any changes with you over time rather than imposing them.

Pain Center

Neuropathic Pain

Burning, electric, or tingling pain caused by injury or irritation of the nerves themselves.

Schedule Appointment 832.990.8600

A clinician in blue scrubs presses both thumbs into the sole of a patient's bare foot resting on a white towel in a clinic room.

Overview

Understanding neuropathic pain.

Neuropathic pain comes from the nervous system itself rather than from damaged tissue, and it behaves differently because of it. Patients describe burning, electric shocks, crawling, or an area that is numb and painful at the same time. Light touch — a bedsheet, a sock, a shirt seam — can be intolerable while firm pressure is not. It frequently worsens at night, when there is nothing else to attend to.

It also does not respond to the treatments that work for tissue pain. Anti-inflammatories do relatively little, and escalating opioids tends to produce side effects rather than relief. What does help is identifying which nerves are involved and treating at that level — with medication chosen for nerve pain, targeted blocks, and, for refractory cases, neuromodulation.

Common Symptoms

Burning, electric, or shooting pain
Tingling, pins-and-needles, or numbness
Sensitivity to light touch (allodynia)
Pain that worsens at night or with rest

Common Causes

Diabetic peripheral neuropathy
Postherpetic neuralgia (after shingles)
Nerve injury after surgery or trauma
Radiculopathy from spine pathology
Complex regional pain syndrome (CRPS)

Treatments at HTx Pain

How we approach neuropathic pain.

Spinal Cord Stimulation

Among the most effective therapies for refractory neuropathic pain.

Learn more

Targeted Nerve Blocks

Diagnostic and therapeutic for sympathetic-mediated pain.

Learn more

Diagnosis & workup

History of the character, distribution, and timing of the pain — burning and electric qualities point away from tissue pain.
Neurologic examination mapping sensory change, allodynia, weakness, and reflexes.
Identification of an underlying cause where one exists — diabetes, prior shingles, surgery, trauma, or spine pathology.
MRI of the relevant spinal region when a radicular pattern suggests nerve root involvement.
Diagnostic nerve or sympathetic block to confirm the pain pathway before committing to a longer-term therapy.

When to see a specialist

Burning or electric pain that has not responded to first-line nerve pain medication.
Pain following shingles that persists after the rash has healed.
Numbness or burning in the feet or hands from diabetes that is limiting sleep or walking.
Color, temperature, or swelling changes in a limb after injury or surgery — assess early, as CRPS responds better to early treatment.
Escalating medication doses without a matching improvement in function.

Recovery & outlook

What to expect over time.

Neuropathic pain is usually managed rather than cured, and honest expectations matter. Sympathetic and peripheral nerve blocks can provide meaningful relief and, just as importantly, tell us whether the pathway we suspect is the right one. Spinal cord stimulation has the strongest evidence for refractory cases and is FDA-approved for painful diabetic peripheral neuropathy. You try it first through a 5 to 7 day temporary trial at home, and we proceed to an implant only if it reduces your pain by at least 50% and improves function. After implant, light activity for 4 to 6 weeks while the leads anchor, and most patients return to work within 1 to 2 weeks. The system is fully reversible.

Common Questions

Direct answers — no jargon.

If your question isn’t here, ask us at your consultation.

Because there is often nothing inflamed. Neuropathic pain is generated by nerve signaling itself, which is why medications developed for nerve pain, targeted blocks, and neuromodulation tend to work where anti-inflammatories do not.

Why HTx Pain Institute

How we treat neuropathic pain, differently.

Nerve pain is where guessing costs the most, because the wrong treatment is not merely ineffective — it delays the right one while the pain becomes more established. We diagnose it as a pathway rather than a location, confirm that pathway with a block where the answer is not clear, and stay candid about the difference between eliminating pain and restoring function.

Other conditions we treat.

See all conditions

Reviewed by Edward Baumgartner Jr., MD · Last reviewed September 10, 2026. Information on this page is not medical advice. Always consult your physician.

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