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Qutenza for nerve pain - by the condition it treats.

Post-herpetic neuralgia, painful diabetic feet, HIV-related neuropathy, post-surgical nerve pain and CIPN - where Qutenza actually helps, how much, and where it belongs inside your wider neuropathic pain plan.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What Qutenza for nerve pain costs in the UK, by indication.

Cost depends on the treated area more than the diagnosis itself.

In short

Qutenza for painful diabetic peripheral neuropathy of both feet: £1,600–£2,400, in-clinic time around 2.5 hours.

IndicationIndicative range
Qutenza for post-herpetic neuralgia (typical thoracic area) £1,400–£2,100
Qutenza for painful diabetic peripheral neuropathy (both feet) £1,600–£2,400
Qutenza for post-surgical neuropathic pain (chest wall, groin) £1,400–£2,300
Qutenza for HIV-associated distal sensory polyneuropathy £1,600–£2,400
Qutenza for chemotherapy-induced peripheral neuropathy (both feet) £1,700–£2,600
Repeat cycle at 90 days £1,400–£2,600
Pain physician consultation only £250–£450

Ranges reflect body area treated and patch count. Repeat cycles at 90 days sit in the same bands.

The problem

Nerve pain deserves nerve pain treatments - not repurposed painkillers.

Most UK nerve pain patients spend years cycling through opioids, gabapentinoids at sub-therapeutic doses and physiotherapy for the wrong problem. A neuropathic plan built around the diagnosis changes everything.

  • Name the pattern first

    Post-herpetic neuralgia, painful DPN, CIPN and post-surgical nerve pain each have distinct patient profiles - treat them accordingly.

  • Ditch the opioids

    Long-term opioids do very little for neuropathic pain and create dependence. UK guidance is clear on this.

  • Set the outcome, then choose the tool

    Better sleep, less allodynia, fewer rescue analgesics - decide what "working" means before the first treatment.

The journey

From diagnosis to durable relief - what happens, in order.

One team from confirming the diagnosis through Qutenza, drug optimisation, structured review and planned repeat cycles.

  1. 01

    Before

    A short, confidential form. Symptom character (burning, shooting, allodynia), distribution, sleep impact, medication ladder tried and any relevant imaging.

  2. 02

    Before

  3. 03

    Before

    Confirming the neuropathic diagnosis

    Where needed, a specialist nerve pain assessment (DN4 questionnaire, quantitative sensory testing, or skin biopsy for small-fibre neuropathy) confirms the target before treatment.

  4. 04

    Before

    Aligning drug therapy first

    Optimise or wean underperforming neuropathic drugs before Qutenza so the response is clear. A pain plan is worked out before the patch, not after.

  5. 05

    On the day

    Treatment day at the clinic

    Application to the painful skin area, monitored for the licensed contact time. Standard aftercare and cool packs to take home.

  6. 06

    After

    The first fortnight

    Neuropathic pain often flares in the first few days before it eases. Diary the pattern - the true response emerges by week 2 to 4.

  7. 07

    After

    Response review and next steps

    A 4 to 6 week telephone or clinic review with a validated pain score. If response is meaningful, plan a repeat at 90 days. If not, we step-up to a different neuropathic strategy.

Typical end-to-end: 2–3 weeks from first appointment to treatment. First response signal: by week 2.

When it helps

The nerve pain patterns Qutenza actually helps.

The patient stories we recognise - plus the red flag that means a completely different pathway.

  • Burning after shingles (PHN)

    Persistent burning, stabbing or allodynic pain in a dermatome affected by shingles at least three months earlier - the classic Qutenza indication.

  • Painful feet in type 2 diabetes

    Symmetrical burning, tingling or shooting pain in the feet, worse at night, with confirmed diabetic peripheral neuropathy - Qutenza is licensed here since 2020.

  • Numb yet painful feet on ART

    HIV-associated distal sensory polyneuropathy - feet feel both numb and painful, especially in patients on older ART regimens.

  • Chest wall pain after thoracotomy

    Post-thoracotomy neuropathic pain along the intercostal distribution - a well-recognised off-label use with good evidence.

  • Pain after mastectomy or breast surgery

    Chronic post-surgical pain in the anterior chest wall or axilla, often with allodynia - Qutenza fits when other options have plateaued.

  • Nerve pain after hernia repair

    Chronic groin, thigh or scrotal neuropathic pain after inguinal hernia surgery - an off-label but well-established indication.

  • CIPN - chemotherapy-induced neuropathy

    Burning and tingling in the feet or hands after taxane, platinum or vinca chemotherapy - a growing evidence base for Qutenza.

  • Red flag: new weakness, saddle numbness or bladder change

    A neuropathic pain plan changes completely if there is a new motor deficit, saddle anaesthesia or bladder change - that is A&E, not a Qutenza appointment.

By condition

Where Qutenza fits in each neuropathic pain condition.

What the evidence looks like by indication, and where Qutenza should not be your first move.

  • Post-herpetic neuralgia (PHN)

    Persistent pain in a healed shingles dermatome at three months. Around 45 to 55 percent of Qutenza-treated PHN patients achieve a 30 percent or greater pain reduction lasting 8 to 12 weeks per cycle.

  • Painful diabetic peripheral neuropathy (DPN)

    Feet symmetrical burning pain in confirmed DPN. STEP trial data supports meaningful analgesia - Qutenza is a licensed second-line option in the UK for DPN of the feet.

  • Chronic post-surgical neuropathic pain

    Localised nerve pain after thoracotomy, mastectomy, hernia repair or amputation. Off-label but with growing UK-specialist adoption for allodynia-dominant patterns.

  • HIV-associated distal sensory polyneuropathy

    Feet-dominant burning in ART-treated HIV. Case-series and RCT data show useful analgesia in a group that tolerates systemic drugs poorly.

  • Chemotherapy-induced peripheral neuropathy (CIPN)

    Taxane, platinum and vinca-related feet or hand pain. Emerging evidence for Qutenza in CIPN of the feet, particularly in patients where duloxetine has failed or is contraindicated.

  • Small-fibre neuropathy (idiopathic)

    A stubborn diagnosis - where skin biopsy confirms reduced intraepidermal nerve fibre density, Qutenza is a reasonable off-label option worth considering.

  • Complex regional pain syndrome (localised)

    Selected CRPS where a cutaneous component dominates the picture. Not a first-line CRPS treatment - best considered in a multidisciplinary CRPS clinic.

  • What Qutenza will not fix

    Central pain from spinal cord injury, deep somatic pain, or musculoskeletal pain without a neuropathic component. Correct diagnosis matters more than the medicine.

Reading the response

How to tell if Qutenza is actually working for your nerve pain.

The metrics that matter, the honest response window, and the signals that mean it is time to change strategy.

  • Neuropathic pain often flares first

    Unlike ordinary skin irritation, allodynic nerve pain can spike for 24 to 72 hours before improving. Plan pain relief for that window in advance.

  • Sleep impact matters most

    Sleep quality tracks Qutenza response better than daytime pain scores. If you sleep better by week 2 to 3, the treatment is working.

  • Set a benchmark before treatment

    A pre-treatment NRS score and DN4 or painDETECT questionnaire gives you and your clinician an honest reference point at review.

  • Not a standalone therapy

    Best results come when Qutenza sits alongside optimised neuropathic drugs, sleep hygiene, gentle exercise and, sometimes, targeted physiotherapy.

  • Watch for drug interactions and dose changes

    If Qutenza reduces pain, gabapentinoids and TCAs can often be tapered. Do not do this without your pain physician - sudden withdrawal has its own problems.

  • Effect size - the honest numbers

    A 30 to 50 percent pain reduction is a good response. A pain-free result is uncommon. Framing this properly protects you from unrealistic expectations.

  • Repeat cycles do not lose effect

    Long-term studies show sustained response through repeated cycles. Some patients get progressively longer intervals between cycles as central sensitisation calms.

  • When to stop trying Qutenza

    No meaningful response after two properly delivered cycles is a signal to change strategy - pulsed radiofrequency, spinal cord stimulation or a different drug direction.

  • Red flags at home

    Blistering, spreading rash, sustained BP over 180/110, chest pain or new neurology need same-day medical review - not a routine call.

Reading your nerve pain plan

Your neuropathic pain plan in four parts. Read the last one first.

Every good pain-clinic plan is more than a single Qutenza booking - it is a schedule, drug ladder and review structure.

A UK consultant pain physician reviewing a neuropathic pain plan and Qutenza cycle

A quiet reminder

Neuropathic pain language can read coldly - we translate it for you.

If you would like us to talk you through your plan and honest expectations, just ask.

  1. 01 Header

    Indication, distribution, baseline scores

    The neuropathic pain diagnosis, distribution treated, and pre-treatment NRS and painDETECT scores.

  2. 02 Technique

    Cycle plan and current cycle

    Number of cycles planned across the year, cycle number for this visit, and integration with drug therapy.

  3. 03 Findings

    Response markers and diary

    Any change in sleep quality, allodynia extent and reliance on rescue analgesia between cycles - the metrics that actually track response.

  4. 04 Impression

    Wider pain plan, review, escalation

    Read this first: your full neuropathic pain plan, review date and the criteria that would trigger a change of strategy.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for Qutenza in nerve pain varies by policy and indication. Licensed indications (PHN, painful DPN of the feet) are usually straightforward. Off-label uses may need prior authorisation.

Frequently asked

Everything we get asked about Qutenza for nerve pain.

Quick answers on diagnosis, indication, response, and how Qutenza sits alongside gabapentinoids and other treatments.

  • How do I know my pain is truly nerve pain and not just chronic pain?

    Nerve pain has a specific character - burning, stabbing, electric-shock, pins-and-needles - often with allodynia (light touch is painful) or thermal changes. Validated bedside tools like the DN4 and painDETECT scores flag it. A pain physician will use those alongside the story, examination and (sometimes) small-fibre nerve studies before recommending a neuropathic-specific treatment such as Qutenza.

  • Which nerve pain conditions does Qutenza help most?

    The strongest evidence sits in post-herpetic neuralgia and painful diabetic peripheral neuropathy of the feet - both licensed UK indications. Meaningful evidence also supports Qutenza in HIV-associated distal sensory polyneuropathy, chronic post-surgical neuropathic pain (thoracotomy, mastectomy, hernia repair) and increasingly in chemotherapy-induced peripheral neuropathy of the feet.

  • Where does Qutenza fit in the UK neuropathic pain ladder?

    NICE CG173 puts amitriptyline, duloxetine, gabapentin and pregabalin as first-line oral options in adult neuropathic pain. Topical treatments - capsaicin patches and lidocaine 5% - are recommended for localised neuropathic pain, particularly when systemic drugs are intolerable or ineffective. In practice most UK patients get Qutenza after a genuine trial of two oral neuropathic drugs, though it can be first-line in DPN of the feet for patients who cannot tolerate systemic therapy.

  • Will Qutenza replace my other pain medications?

    Sometimes, but usually not entirely. Many patients reduce gabapentinoid or TCA doses if Qutenza gives durable relief - which is a good outcome, because side-effect burden falls. Any taper should be gradual and pain-physician led. Ordinary rescue analgesia (paracetamol, NSAIDs where safe) remains available alongside Qutenza.

  • What does a realistic response actually look like?

    A 30 to 50 percent reduction in your average pain score, better sleep, a smaller allodynic area, and needing less rescue analgesia. Pain-free is unusual. If sleep improves and you can tolerate touch to the area for the first time in months, that is a genuine win - the point is to make life liveable, not to cure the neuropathy.

  • How much does private Qutenza for nerve pain cost in the UK?

    Roughly £1,400 to £2,100 for a typical post-herpetic thoracic distribution, £1,600 to £2,400 for both feet in DPN or HIV neuropathy, £1,400 to £2,300 for post-surgical chest wall or groin pain, and £1,700 to £2,600 for CIPN of the feet. Repeat cycles at 90 days sit in similar ranges.

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