The goal of treatment is to manage the underlying condition causing your
neuropathy and to repair damage, as well as provide symptom relief. If
your doctor hasn't been able to determine the cause of your neuropathy,
he or she may try a variety of medications to see which help ease your
Controlling a chronic condition may not eliminate your neuropathy, but
it can play a key role in managing it. Here's what your doctor may
recommend for treating various underlying conditions:
If you have diabetes, you and your doctor can work together to keep
your blood sugar level as close to normal as possible. Maintaining
normal blood sugar levels helps protect your nerves.
If your neuropathy is the result of a vitamin deficiency, it's
likely your symptoms will improve once the deficiency is corrected.
Your doctor may recommend injections of vitamin B-12 daily for a few
days, then once a month. If you have pernicious anemia, you'll need
regular injections for the rest of your life, and possibly
additional vitamin supplements. You'll also need to eat a healthy
If your neuropathy is caused by an inflammatory or autoimmune
process, treatment will be aimed at modulating your immune response.
In cases where neuropathy is the result of pressure on a nerve,
treatment will likely focus first on eliminating the source of the
pressure. That might mean adding ergonomic chairs, desks or
keyboards to your home or office, changing the way you hold tools or
instruments, or taking a break from certain hobbies or sports. In
some cases of nerve compression, you may need surgery to correct the
substances or medications.
If toxins or medications are responsible for the neuropathy, it's
critical that you stop taking the medication or avoid further
exposure to the toxin to prevent the neuropathy from progressing
Medications can ease pain symptoms, but most have side effects,
especially if you take them for long periods of time. If you take pain
medication regularly, including over-the-counter (OTC) products, discuss
the benefits and side effects with your doctor. Medications that may
help provide pain relief for neuropathy include:
OTC pain relievers, such as acetaminophen (Tylenol, others), and
nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and
ibuprofen (Advil, Motrin, others), usually help mild symptoms. For
more severe symptoms, your doctor may recommend prescription NSAIDs.
If you take NSAIDs for long periods of time or in large doses, you
may develop nausea, stomach pain, bleeding, or even ulcers.
Drugs such as gabapentin (Neurontin), carbamazepine (Tegretol) and
phenytoin (Dilantin) were originally developed to treat seizure
disorders (epilepsy). However, doctors often also prescribe them for
jabbing pain. Side effects may include drowsiness and confusion.
This patch contains the topical anesthetic lidocaine. You apply it
to the area where your pain is most severe, and you can use up to
three patches a day to relieve pain. This treatment has almost no
side effects except, for some people, a rash at the site of the
Antidepressant medications, such as amitriptyline (Elavil),
nortriptyline (Pamelor), desipramine (Norpramin) and imipramine (Tofranil),
may provide relief for mild to moderate symptoms by interfering with
chemical processes in your brain that cause you to feel pain. Common
side effects of these medications may include balance problems, dry
mouth, nausea, tiredness or weakness, constipation, and weight gain.
To help reduce these side effects, your doctor will likely start you
off at a low dose and slowly increase the amount of drug you take.
If you're bothered by insomnia, your doctor may also recommend an
antidepressant or a sleeping medication.
Opioid analgesics, such as codeine or oxycodone (OxyContin) may be
used to relieve pain. However, this class of medications produces
numerous side effects, including addiction, that make long-term use
of these drugs undesirable. Mexiletine (Mexitil), a drug ordinarily
used to treat irregular heart rhythms, sometimes helps relieve
burning pain. The topical ointment capsaicin (Capzasin, Zostrix) may
help ease the pain of diabetic neuropathy, and aside from a mild
tingling, burning or slight skin irritation where you apply the
ointment, it has few side effects.
Research aimed at finding more effective treatments for peripheral
neuropathy is ongoing. For example, researchers are looking at
developing nerve growth factors to reproduce the chemicals that signal
your body to repair small nerve fibers. Other scientists are studying
the use of the antioxidant alpha lipoic acid (thioctic acid) to treat
diabetic neuropathy. Unfortunately, no medications can repair nerve
damage yet, but the body can regenerate nerves if the offending
substance is removed.
Several drug-free therapies and techniques may also help with pain
relief. Doctors frequently use them in conjunction with medications, but
some may be effective on their own. They include:
electrical nerve stimulation (TENS).
Your doctor may prescribe this therapy, which may help prevent pain
signals from reaching your brain. TENS delivers tiny electrical
impulses to specific nerve pathways through small electrodes placed
on your skin. Although safe and painless, TENS doesn't work for
everyone or for all types of pain. It's generally more effective for
acute pain than for chronic pain and is often used in conjunction
with other therapies.
This therapy uses a special machine to teach you how to control
certain body responses that reduce pain. You then learn how to
control these same responses yourself. Biofeedback techniques are
often taught in medical centers and hospitals.
The National Institutes of Health has found that acupuncture can be
an effective treatment for chronic pain, possibly including the pain
of neuropathy. Keep in mind that you may not get immediate relief
with acupuncture and may require more than one session.
Many adults can be hypnotized by a trained professional, but for
hypnosis to be most effective, you also have to be a willing and
motivated participant. During hypnosis you'll typically receive
suggestions intended to decrease your perception of pain.
Designed to help reduce the muscle tension that makes pain worse,
relaxation techniques range from deep-breathing exercises to
visualization (imagining yourself floating in a tropical ocean, for
example), yoga and meditation. You might want to take classes in one
or more of these techniques, or you can learn them yourself using
books or tapes.
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