Non-Opioid Options for Neuropathic Pain Management 

Updated on April 12, 2024
Closeup of female holding her painful wrist caused by prolonged work on the computer or housewife, Carpal tunnel syndrome, arthritis. Neurological disease concept.

Neuropathic pain can not only be debilitating, but also downright frightening. From shocks to burning sensations to tingling and numbness, neuropathic pain can take many forms. Managing this type of pain can be a challenge for both patients and their healthcare providers. While many people who suffer from neuropathy might be tempted to turn to opioids for relief, these types of medications come with devastating side effects.

Fortunately, new research is discovering alternative methods of managing neuropathic pain that don’t involve opioids. These options include innovative molecules and medications, like FEM-1689, and electrical stimulation techniques, such as transcutaneous electrical nerve stimulation (TENS). Even newer therapies like scrambler therapy are quickly gaining popularity as a non-invasive and effective way to manage neuropathic pain.


Pain is as psychological as it is physical. In fact, the way pain works is through opioid receptors, which release neurotransmitters that reduce the perception of pain, rather than treating its root cause. This is why opioid medications are so effective in relieving pain, but often don’t do much to tackle its underlying cause or provide long-lasting relief.

In short, opioids can do more harm than good, which is why researchers have been searching for new molecules that don’t need to activate these opioid receptors to alleviate pain. Enter FEM-1689.

Researchers at the University of Texas at Austin discovered that FEM-1689 works by binding to a sigma 2 receptor. This is a type of protein that, when binded with FEM-1689, produces pain-relieving effects against neuropathy.

How it Works

In addition, FEM-1689 does not interact with the opioid receptors, but rather, it works by inhibiting the integrated stress response, or ISR. The ISR is an evolutionary cellular mechanism that contributes to neuropathy development, aging, and even cell death.

While the molecule itself was already known, this new FEM-1689 breakthrough lets scientists know exactly how FEM-1689 works. This new knowledge can, therefore, be used to create future medications that alleviate pain without impacting the opioid receptors. This type of medication would provide pain relief without the addiction!

Transcutaneous Electric Nerve Stimulation (TENS) 

Transcutaneous electric nerve stimulation (TENS) is another non-opioid treatment option for managing neuropathic pain. TENS works by delivering small electrical currents through the skin to stimulate the nerves and reduce pain signals sent to the brain.

How it Works

Remember that pain is a process that involves nerves sending signals to the brain. By altering these signals, TENS can provide temporary pain relief.

TENS machines can be easily purchased online or at local pharmacies, making it a convenient and accessible option for those experiencing neuropathic pain. There are even newer models that are wireless and controlled with a mobile app to deliver electrical signals at the touch of a button.

However, it’s important to consult with a healthcare professional before using TENS. Certain people, such as those with pacemakers or epilepsy, might not be able to use TENS. In addition, a recent study that showed TENS helped neuropathic pain in cancer patients mentioned that patients only used TENS for a maximum of 5 hours a day.

While pain relief is only temporary while the machine is in use, TENS can be a great way for cancer patients or those suffering from other types of neuropathic pain to get just a little bit more relief during the day. For people with cancer, TENS is a better alternative than adding more medications to their already long list of treatments.

Scrambler Therapy

Scrambler therapy takes TENS to the next level by using a machine that transmits electrical pulses through electrodes placed above and below areas where chronic pain is felt. However, unlike TENS, which uses an electrical signal to reduce pain signals, scrambler therapy works differently. It aims to capture healthy nerve signals (free of pain) and mix them with nerve signals that experience pain. This helps to “scramble” the brain’s perception of pain and can provide long-lasting relief even after the treatment is over.

The treatment is non-invasive and does not involve the use of drugs or needles. Sessions typically last for about 30 minutes, but the number of sessions required varies depending on the individual’s level of pain and response to the therapy.

While scrambler therapy is still a relatively new treatment for neuropathic pain, studies have shown that it can significantly reduce pain levels with as little as 12 half-hour treatments. Scrambler therapy was also approved by the U.S. Food and Drug Administration in 2009, showing just how far this technology has come in the field of pain management.

Choosing the Right Treatment

In some cases, traditional methods like TENS might be enough to provide temporary, but much-needed relief. Whether you choose to explore alternative treatments like scrambler therapy or stick to traditional methods, the key is finding what works best for you and your neuropathic pain. As more research is conducted and technology advances, there may be even more options to help you manage and alleviate your neuropathic pain.

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