Anticonvulsant Medication May Help Relieve Neuropathic Neck and Back Pain

Neuropathic drugs treat radiating spine pain and include gabapentin (Neurontin) and pregabalin (Lyrica).

If you experience chronic burning, tingling, and shooting spinal pain (eg, sciatica, back pain, leg pain), relief is paramount to protecting your quality of life. One option that may help manage neuropathic pain—that is, pain that originates in your nerves—is a class of prescription medications called anticonvulsants. This type of drug may be prescribed as a first-line medication or adjuvant medicine to help reduce neuropathic pain caused by a neck or back disorder.
white pills poured out with stethoscope and spine x-rays in the background.Anticonvulsants may be prescribed as a first-line medication or adjuvant medicine to help reduce neuropathic pain caused by a neck or back disorder. Photo Source: doctor may refer to an anticonvulsant as an antiepileptic or an antiseizure agent, as these drugs are designed to treat epilepsy. As such, using them to treat chronic spinal pain is considered an off-label use.

Off-label means a product, medication, or device is used outside the U.S. Food and Drug Administration (FDA) indication. This may make you unsure about using anticonvulsants for chronic pain, but it’s not as concerning as it sounds. Aspirin is a good example to illustrate the safety of off-label use. It was initially approved to treat pain, but evidence shows aspirin also helps prevent cardiovascular problems. When doctors recommend aspirin to patients for heart health that is considered off-label use.

How Anticonvulsants May Help Relieve Chronic Spinal Pain

When most people think of back pain, they think of musculoskeletal pain—or pain that involves the muscles, bones, joints, and ligaments in your spine. But, there’s also neuropathic pain, and it’s much more elusive and challenging to treat.

Experts are still trying to understand exactly how anticonvulsants reduce neuropathic pain, but they believe these drugs interfere with pain signals in your central nervous system, which is comprised of your brain and spinal cord.

Unlike musculoskeletal pain, which may be relieved by non-steroidal anti-inflammatory drugs (NSAIDs), neuropathic pain does not typically respond to NSAIDs and other types of pain-reducing drugs. That’s why your doctor may suggest an anticonvulsant.

Below are examples of anticonvulsants commonly prescribed to treat nerve-related chronic back and neck pain (generic names are listed first, and a brand name example is in parentheses):

  • Carbamazepine (Tegretol)
  • Gabapentin (Neurontin)
  • Lamotrigine (Lamictal)
  • Pregabalin (Lyrica)

Safely Using Anticonvulsants

Anticonvulsants are available by prescription only. If your doctor recommends this type of drug to help you manage your nerve-related chronic pain, ask him or her about how to safely take the drug, specific side effects, and any red flags that warrant a call to your doctor.

Most anticonvulsants share the following side effects: drowsiness, swelling in the lower extremities, and poor balance. Fortunately, the possibility of these side effects subsides the longer you take the drug.

Some anticonvulsants carry life-threatening side effects that you should discuss with your doctor. For example, gabapentin has been linked to elevated suicide risk.

Anticonvulsants are not habit-forming, but you should talk to your doctor about safely weaning off the medication. Do not abruptly stop taking your medication without speaking with your doctor.

Finding Relief of Spinal Nerve Pain with Anticonvulsants

If you suffer from chronic back pain or neck pain, you know that even a small amount of relief can make a huge difference to your quality of life. Anticonvulsant medications may not eliminate your spine pain, but they may ease symptoms in some people who suffer debilitating nerve pain (eg, radiculopathy, neuropathic pain). Talk to your doctor about how anticonvulsants may be part of your multifaceted chronic pain treatment program.

Updated on: 08/05/19
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