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How is peripheral neuropathy treated?

No medical treatments now exist that can cure inherited peripheral neuropathy. However, there are therapies for many other forms. Any underlying condition is treated first, followed by symptomatic treatment. Peripheral nerves 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 can often prevent new damage.

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. Immunosuppressive drugs such as prednisone, cyclosporine, or azathioprine may be beneficial. 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 suppresses immune system activity. High doses of immunoglobulins, proteins that function as antibodies, can also suppress abnormal immune system activity.

Surgical intervention can often 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. The removal of benign or malignant tumors can also alleviate damaging pressure on nerves. Nerve entrapment can often be corrected by the surgical release of ligaments or tendons.

This answer is based on source information from the National Institute of Neurological Disorders and Stroke.

The treatment for peripheral neuropathy depends on the cause. If it is related to nutritional deficiencies, supplements may help. If the neuropathy is related to a medical condition, such as diabetes or thyroid dysfunction, treating the condition can sometimes reverse the neuropathic symptoms.

For neuropathy related to chemotherapy, most treatments are supportive and designed to improve symptoms and function. If problems develop during treatment and you continue to receive chemotherapy, the neuropathy can get worse. Clinical trials research shows promise in some treatments with medications that help peripheral nerves to heal and prevent the neuropathy associated with chemotherapy from occurring or being as severe.

Recovery may be helped by:

  • Good nutrition including foods rich in thiamine, protein, and antioxidants
  • Controlling and correcting contributing conditions such as diabetes or hypothyroidism
  • Appropriate pain medications
  • Physical and occupational therapy
Christopher Chiodo, MD
Orthopedic Surgery
Because there are many causes of peripheral neuropathy, treatment varies according to the primary problem. If the cause is diabetes, treatment aims at better control of high blood sugar levels, which can damage blood vessels that nourish the nerves and interfere with a nerve's ability to transmit signals. If the problem is compression by a tumor or some underlying structural problem, surgery may be in order. Vitamin deficiency is corrected with regular injections of B vitamins.

Your recovery will depend on the amount of damage that occurred before the problem was corrected. In very rare cases, the nerve will return to normal slowly, and you won't have any lasting effects. Most of the time, however, lingering sensory or motor abnormalities will remain, and the goal of treatment will be to prevent further damage. Nerve pain medications, such as duloxetine (Cymbalta) -- an antidepressant medication approved by the Food and Drug Administration (FDA) in 2004 to manage nerve pain associated with diabetes -- may also offer some relief. Metanx, a prescription medication used to treat diabetic neuropathy, may also help. Metanx contains active forms of folate, vitamin B6, and B12. According to its manufacturer, Metanx works by increasing the body's natural production of nitric acid, which in turn helps dilate blood vessels, increasing blood flow to the peripheral vessels and nerves.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.