Millions of people live with chronic nerve pain, which can continue for months or even years and can be difficult to control.
Scientists at Weill Cornell Medicine and the Burke Neurological Institute are studying an experimental drug that may eventually offer relief without the addiction risks of opioid painkillers.
Chronic nerve pain, also known as neuropathic pain, happens when nerves become injured or start sending abnormal signals. Instead of warning the body about a new injury, damaged nerves may continue sending pain messages even when there is no immediate danger.
People with nerve pain often describe burning, tingling, stabbing, or electric-shock sensations. The condition can develop because of diabetes, injuries, infections, surgery, cancer treatments, and other health problems.
Treating this type of pain is challenging because ordinary painkillers may not work very well. Doctors often use medicines such as gabapentin, originally developed for seizures, or duloxetine, an antidepressant that can also reduce some forms of nerve pain.
These medicines can be useful, but they do not help everyone. They may also cause side effects such as sleepiness, dizziness, tiredness, or mood changes.
Opioid medicines are another option in some situations, but they can create additional problems. Long-term opioid use can lead to dependence and addiction, while taking too much can slow breathing and cause a fatal overdose.
The new research focuses on tiny proteins called HCN ion channels. These proteins help control the electrical signals that allow nerve cells to communicate.
After nerve damage, some nerve cells can become unusually active. Changes involving HCN channels may contribute to this activity, causing the nerves to repeatedly send pain messages to the brain.
Simply blocking these channels throughout the body would not be ideal. HCN channels also perform important jobs in the brain and heart, so a drug that affects them everywhere could cause sleepiness, heart problems, or other unwanted effects.
Dr. Gareth Tibbs and his team developed an experimental compound called BP4L-18:1:1 to address this problem. Their aim was to calm pain-producing nerves outside the brain while avoiding strong effects on the brain and heart.
The scientists started with propofol, an anesthetic commonly used to make patients unconscious during medical procedures. They changed its chemical structure by adding a special feature designed to make it difficult for the new compound to enter the brain.
The researchers compare the idea to anchoring a boat. An anchor limits where the boat can move, and the added chemical feature similarly helps keep the drug in parts of the body where it may act on damaged nerves.
When the researchers tested BP4L-18:1:1 in rats, giving the drug by mouth reduced signs of nerve pain. Importantly, the animals did not show obvious harmful effects associated with strong activity in the brain or heart.
These early results are encouraging, but animal studies cannot show whether a treatment will be safe or effective in people. Many experimental medicines that work in animals do not ultimately become approved human treatments.
The team is therefore working toward human clinical trials. Akelos, a company involved in developing the drug, is helping advance the treatment, while the research has also received support from the Daedalus Fund for Innovation.
If human studies confirm the early findings, the approach could provide a new way to treat chronic nerve pain. Rather than broadly reducing activity throughout the nervous system, future medicines may be able to target the abnormal nerves causing pain while limiting effects elsewhere in the body.
Copyright © 2026 Knowridge Science Report. All rights reserved.
