Treatment for Peripheral Neuropathy
No medical treatments now exist that can cure inherited peripheral neuropathy. However, there are therapies for many other forms. Here are the key points for peripheral neuropathy treatment.
- Any underlying condition is usually treated first, followed by symptomatic treatment.
- Peripheral nerves do have the ability to regenerate, as long as the nerve cell itself has not been killed.
- Symptoms often can be controlled, and eliminating the causes of specific forms of neuropathy often can prevent new damage.
- Positive changes and healthy habits often create conditions that encourage nerve regeneration.
- Timely treatment of injuries can help prevent permanent damage.
In general, treatment of peripheral neuropathy involves adopting healthy habits to reduce the physical and emotional effects, such as:
- maintaining an optimal weight
- avoiding exposure to toxins
- following a physician-supervised exercise program
- eating a balanced diet
- correcting vitamin deficiencies
- limiting or avoiding alcohol consumption
Other treatments for peripheral neuropathy include:
- Exercise: active and passive forms of exercise can reduce cramps, improve muscle strength, and prevent muscle wasting in paralyzed limbs.
- Diet and Nutrition: various dietary strategies can improve gastrointestinal symptoms.
- Stop Smoking: quitting smoking is particularly important because smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathic symptoms.
- Self-care skills: self-care skills, such as meticulous foot care and careful wound treatment in people with diabetes and others who have an impaired ability to feel pain, can alleviate symptoms and improve quality of life.
- Guide to Foot Care / Common Foot Problems
Treatment of Systemic Diseases
Systemic diseases frequently require more complex treatments. Strict control of blood glucose levels has been shown to reduce neuropathic symptoms and help people with diabetic neuropathy avoid further nerve damage.
Inflammatory and autoimmune conditions leading to neuropathy can be controlled in several ways incuding Immunosuppressive drugs such as:
Plasmapheresis - a procedure in which blood is removed, cleansed of immune system cells and antibodies, and then returned to the body - can limit inflammation or suppress immune system activity. High doses of immunoglobulins, proteins that function as antibodies, also can suppress abnormal immune system activity.
Neuropathic pain is often difficult to control. Mild pain may sometimes be alleviated by analgesics sold over-the-counter.
Several classes of drugs have recently proved helpful to many patients suffering from more severe forms of chronic neuropathic pain. These include:
- mexiletine, a drug developed to correct irregular heart rhythms (sometimes associated with severe side effects)
- several antiepileptic drugs including Neurontin (gabapentin), Lyrica (pregabalin), phenytoin, and carbamazepine
- some classes of antidepressants including tricyclics such as amitriptyline (Elavil, Endep)
Injections of local anesthetics, such as lidocaine or topical patches containing lidocaine, may relieve more intractable pain.
In the most severe cases, doctors can surgically destroy nerves; however, the results are often temporary and the procedure can lead to complications.
Mechanical aids and other assistive devices can help reduce pain and lessen the impact of physical disability.
- Hand or foot braces can compensate for muscle weakness or alleviate nerve compression.
- Orthopedic shoes can improve gait disturbances and help prevent foot injuries in people with a loss of pain sensation.
- Mechanical ventilation can provide essential life support if breathing becomes severely impaired.
Surgical intervention often can provide immediate relief from mononeuropathies caused by compression or entrapment injuries.
- Repair of a slipped disk can reduce pressure on nerves where they emerge from the spinal cord
- Removal of benign or malignant tumors can also alleviate damaging pressure on nerves.
- Nerve entrapment often can be corrected by the surgical release of ligaments or tendons.
NIH Publication No. 04-4853