Methyl prednisolone via a drip is manageable but necessary pain because of inflammation in the CNS.

Prednisolone is extremely painful through the eyes/back of the head.

I hate corticosteroids because of their addiction and stablisation effects through the weakening of the immune system so the corticosteroid will be accepted by the body.

Gabapentin and related drugs often have some benefit with less side effects than the steroids. As ever with this sort of complex issue there is apparently no one solution.

What are the differences between Amitriptyline, Gabapentin and Pregabalin?

I do not know what is available here. I'd never heard of those before until I looked up Gabapentin.

http://www.pbs.gov.au/medicine/item/4591P-8505P

This would only target allieviating the pain and not assist with an underlying condition?

As it has been previusly said, first you should get a good diagnosis or at least a hypothesis about the origin of pain. Sometimes treatment doesn't have to be drugs.

There are several drugs (and pharmacological groups) to treat neurological pain:

Antidepresants: Good for different kinds of pain the rise the threshold of pain.

Mainly tricyclic antidepresants like amytriptiline. Very usefull with many different kinds of pain, doses much lower than the ones for depression

Dual antidepresans: Venlafaxine, duloxetine. They don´t have memory and focusing side effects like amytriptiline but a lot of GI

Other antidepressants: weaker evidence but you can use SSRI or tetracyclics

Antiepileptics: not for every pain, but very powerful when the problem is about nerve depolarization like neuropathies.

Gabapentine and pregabaline: quite similar in tolerance and side effects

Carbamazepine (and OXZ, ESL): block Na+ chanels

Other antiepileptics can be used but are not as good (Valproic, Phenitoine)

NSAIDs can help but not much

Opioids are not a good idea except if is an accute situation or bad life prognosis.

You often need to convine drugs, but they should have different mechanism of action (eg you can use gabapentine+ carbamazepine+amytriptiline, but you shouldn't use venlafaxine+amitriptiline or carbamazepine+oxcarbazepine)

demylineating lesions are the primary source of the pain

i recall carbamazepine but didn't take it cos drip treatment almost concluded and no longer any significant inflammation thus docs said (half a year later) it was correct I didn't take it.

no new lesions

neurologist deduced stress as the primary cause of the neurological pain, some via CNS in spine and brain (but pain where there is already brain deterioration, that is it is already scarred/ deteriorated/ damage

Thanks for that Anthony!! Did you mean physical resources we can mobilise? That is correct if the brain can send the nerve signals to operate the equipment prior to whatever consequence for failing to operate the equipment e.g. making impact with ashphalt i.e. falling to the ground or falling down the stairs rather than holding the walking stick or balustrade.

Agree with Anthony for chronic pain patients in general. That said, Amitriptyline and other TCA's such as nortriptyline as well certain SNRI's (especially duloxetine) can be effective for some types of neuropathic pain. There is some evidence for combining one of these with either pregabalin or gabapentin. In addition, opioids can be helpful in severe cases; I will sometimes combine an SR opioid with a TCA (or dulox) AND either gabapentin or pregabalin.

In addition, if they are sensitive to touch, definitely try a topical anaesthetic such as lidoderm; but use caution on pressure areas.

In acute neuropathy, steroids can be considered as well.

Disclaimer: my focus is Palliative medicine, not primarily chronic pain.

Please explain your acronyms

TCA =

SR opioid =

In Australia, they are primarily corticosteroids

Thanks Anthony and thank you Andrew.

How can we settle intermittent neurological pain?

It is 'minor' as such but how can it be settled or is the best bet to endure whatever pain?

The previous answer is not strictly correct. Tricyclic antidepressants, and SNRIs are not "addictive" in the sense that no one seeks to acquire them because of the euphoria causing properties (they don't have any). Both gabapentin and pregabalin do have some slight abuse potential - but studies indicate it's low. Opioids, of course, have a huge abuse issue and can be highly addictive. Marijuana does work well in some types of chronic neurological pain - but it's efficacy (just like that of any other drug) is not universal - it's certainly worth a try if nothing else works. However, it does have CNS effects that, while many people find them pleasant, some do not. And, contrary to your implication cannabis isn't addictive, some individuals do indeed become addicted to it. The addiction includes chronic use in the absence of a medical indication, a desire to acquire more if the supply is becoming low, interference with life's other duties and a withdrawal syndrome (although it's certainly no where near as severe as what is seen with opioids or alcohol). And....for the record my salary is not paid by pharma - big or otherwise.

Recent work is being done on the application of tDCS for neuropatic pain. Let me recommend you some papers

http://www.sciencedirect.com/science/article/pii/S1474442207700327

http://brain.oxfordjournals.org/content/133/9/2565.full.pdf

http://www.sciencedirect.com/science/article/pii/S030439590600114X

The answer to this question is to relax, not stress, and enjoy life.

Here is an attachement of one of my patient monographs that may be helpful to the subject at hand.

Rather than heading more patients in the direction of potentially dangerous psychotropics and neuroleptics I suggest getting to the cause of the problem. There are only a handful, really, but seems they are ignored almost entirely in the allopathic approach we see in the US.

If you are looking for technique, then stretching exercise with the right count would be best.

how is this conducted? are you talkin about physically exercise on RHS?

I am sorry Christine. ..body exercise may help brain. We may don't understand completely how this happened but strengthening muscles help you to maintain balance. This could trigger the brain by proprioception techniques. 

There are many pharmacological management available for the pain management, with the advent of the modern medicine it has become handy to the clinicians for the management of neurological pain including the diabetic neuropathy. The recent medications with considerably less addictive and low side effects are the Lyrica-Pregablin  and Neurontin -Gabapentin , comes in 75 milligram ,150 milligram ,300-400 milligram respectively. These medications are relatively safe and effective in ameliorating pain caused by the neurological disorders.There are other options available in the complimentary medicine with less evidence based on its mechanisms.

I hope added few points to the avid cohort. 

Managing chronic pain becomes a simple matter if we take the time to ascertain what is causing the pain and resolve that. But today in the US pain management is generally dangerous to the patient--getting hooked on opiates, for instance, is a far worse fate than chronic pain--or succumbing to the marijuana siren--or, worse still, surgery that only makes matters worse. Pain is the messenger that something is wrong. When we simply shoot the messenger we have broken our Hippocratic pledge to First, Do No Harm. Instead, we should take Hippocrates up on his other admonitions--which are as true today as they were in his day: Let food be thy medicine and thy medicine be thy food. For this and other good advice he spent 20 years in prison. I would suspect he might suffer the same fate or at least banishment from medicine in the US--for he would be shocked that we are making hundreds of billions out of keeping the population, telling them we don't know what causes the problem and that there is no cure. Get the patient healthy, addressing the handful of known underlying causes, and watch pain become its useful, healing messenger instead of the Public Enemy #1 it has become today.