Understanding Nerve Pain: Why It Happens and What Can Help

If you live with chronic nerve pain, you’re not alone. An estimated 7–10% of people experience neuropathic pain, and for many, it can be one of the hardest pain types to understand and manage[1].

Nerve pain symptoms - such as burning, tingling, electric shocks, pins and needles, or numbness - can feel confusing and even frightening. The pain may seem unpredictable, sometimes appearing without a clear trigger.

The good news? We now understand far more about nerve pain than we did even a decade ago. Research shows there are effective, evidence-based strategies that can help people reduce fear, regain confidence, and move more comfortably in their bodies.

Disclaimer

This information is provided for educational purposes only and is not a substitute for medical advice. Anyone seeking treatment for chronic nerve pain should consult their trusted healthcare team.

What Is Nerve Pain?

Nerve pain, also called neuropathic pain, occurs when there is dysfunction within the nervous system - either in the peripheral nerves, spinal cord, or the brain’s pain-processing centres.

The International Association for the Study of Pain defines neuropathic pain as:

Pain caused by a lesion or disease of the somatosensory nervous system.

Put simply, nerve pain happens when the nerves that normally carry sensory information are irritated, injured, or disrupted.

How Nerve Pain Is Different From Other Pain Types

• Nociceptive pain – pain from injured or inflamed tissues (e.g. sprains, strains,  inflammation)
  
• Nociplastic pain – pain driven by a sensitised or “overprotective” nervous system (e.g. fibromyalgia, central sensitization)

In neuropathic pain, the problem lies within the nervous system itself - not the surrounding muscles, joints, or tissues.

Common Nerve Pain Symptoms

People often describe nerve-related pain as:

• Burning
  
• Tingling
  
• Shooting or electric-shock sensations
  
• Crawling or trickling feelings
  
• Tightness or squeezing
  
• Numbness or reduced sensation
  

These sensations can be unsettling, but they are well-recognised signs of nerve irritation - not signs that damage is worsening. Education plays a key role in helping people understand that these symptoms are part of how irritated nerves behave, rather than something to fear.

Nerve pain often follows a specific pathway, such as down an arm or leg, because nerves supply defined regions of the body. Importantly, the source of irritation may be located elsewhere (for example, leg pain originating from the spine).

What Causes Nerve Pain?

Nerve pain can develop from a range of conditions or injuries, including:

• Nerve compression (e.g. sciatica)
  
• Diabetes-related neuropathy
  
• Post-herpetic neuralgia (after shingles)
  
• Direct trauma to a nerve
  
• Chemotherapy-induced neuropathy
  
• Central nervous system injury (stroke or spinal cord injury)
  

Many people experience mixed pain types, such as mechanical back pain alongside neuropathic leg pain.

It’s also important to note that not all nerve injuries cause pain. For example:

• Nerve pain occurs in around 70–80% of people with diabetic neuropathy
  
• Only about 40% of people with sciatica experience nerve-related pain [2,3]
  

Nerve Pain and Nervous System Sensitization

Nerve pain can also be associated with sensitization, where the nervous system becomes more excitable and responds more strongly to danger signals from the body.

This is a normal physiological process - the nervous system’s attempt to protect you. Sometimes, however, it becomes overprotective. Sensitization can occur in all pain types, including nociceptive, neuropathic, and nociplastic pain.

How Is Nerve Pain Diagnosed?

Diagnosis of neuropathic pain is primarily clinical and may include:

• A clear history suggesting nerve injury or disease
  
• Questions about classic nerve pain symptoms
  
• Assessment of whether pain follows a nerve distribution
  
• Detailed sensory testing (looking for both sensory loss and sensory gain, such as allodynia)
  
• Investigations like MRI or nerve conduction studies when appropriate
  

Screening tools such as PainDETECT and DN4 can be helpful, though they may miss up to 20% of people.

Research shows neuropathic components are often under-recognised, particularly in low-back–related leg pain [2]. In practice, a diagnosis of probable neuropathic pain is usually sufficient to guide appropriate care.

In general, clinical reasoning remains key and so a diagnosis of probable neuropathic pain is usually enough to begin appropriate treatment.

Treatment of Nerve Pain

Neuropathic pain responds best to a multimodal approach - one that combines movement, education, behavioural support, and targeted medical management when needed.

1. Movement and Exercise

Exercise plays a powerful role in nerve health. Preclinical research shows that exercise can:

• Support nerve regeneration
  
• Reduce neuropathic pain behaviours
  
• Provide benefits even with low-intensity movement [4]

Human studies show improvements in diabetic neuropathy and chemotherapy-induced neuropathy. 

The good news? Any movement counts. Graded activity and pacing help build confidence and capacity without flare-ups.

Neural mobilization, such as gentle “sliders” or “gliders” can also help in some cases.

2. Education and Reassurance

Understanding nerve pain reduces fear and helps people stay active. Key messages include:

• Nerves heal slowly, often over months
  
• Strange or shooting sensations are common
  
• Pain may appear far from the source (e.g., leg pain from the back)
  
• Using the limb is safe and supports recovery
  

Validation is essential. Nerve pain is real, challenging, and treatable. Many people need repeated, consistent messages of safety from their clinicians - especially when sensations are sharp or unpredictable.

3. Addressing Risk Factors for Nerve Health

Certain health factors slow nerve regrowth:

• Poorly controlled diabetes
  
• Vitamin B12 deficiency
  
• Smoking
  
• High alcohol intake
  

Addressing these can materially improve nerve recovery.

4. Sleep, Mood, and Stress

Nerve pain frequently disrupts sleep and mood, and these factors feed back into the pain experience. Supporting stress regulation and sleep quality can make a meaningful difference. 

5. Medications

Some people benefit from neuropathic pain medications however evidence is limited often by a poor identification of neuropathic pain [5]. Medication should always be guided by an experienced doctor, as benefits vary and side effects can occur.

What About Recovery from Nerve Pain?

Nerves have an incredible ability to heal:

• Myelin (the nerve’s insulation) can regenerate in around 3 months
• Axons can regrow at approximately 1 mm per day
• Sensitization (over-protective signalling) can be retrained through movement, reassurance, and emotional safety - the brain can learn safety 

Even when nerve pain doesn’t disappear completely, many people experience major improvements in confidence, mobility, and quality of life.

Looking Ahead: The Future of Nerve Pain Treatment

Emerging research is shifting toward:

• How the immune system and nervous system interact [6]
  
• More personalised treatments
  
• Better ways to assess nerve pain and avoid misdiagnosis

Nerve pain is complex but it is not mysterious, hopeless, or untreatable. With clear information, supportive clinicians, and a structured plan, people can regain movement, confidence, and quality of life. Whether you're living with nerve pain or supporting others, understanding the nature of nerve pain is the first step toward meaningful improvement.

Support for Nerve Pain

If you would like to know more - we recently interviewed Professor Annnina Schmid - physiotherapist and Professor of Pain Neurosciences at the University of Oxford, specializing in neuropathic pain research for our More Good Chats series. Create an account to watch the full interview and explore our full range of resources.

An additional helpful resource is the Pain Storm podcast. 

If you’d like more information on whole-of-person pain management, reach out to us and learn more about our comprehensive pain programs. Break the cycle and accelerate your journey to recovery by learning more about our simple, science-based programs that help you manage your pain, feel better, and improve your mood - all from the comfort of your home. We’re here to support you in finding the best path forward for your pain management