Your nerves turn information from the outside world into signals that travel to your brain. This allows you to sense your surroundings and control movement.
Medications can reduce the pain of neuropathy by blocking certain pain messages or changing the way the body sends them. Acupuncture might also help.
The serotonin and norepinephrine reuptake inhibitors duloxetine (Cymbalta) and venlafaxine XR (Effexor XR) may relieve numbness, tingling and pain associated with diabetic neuropathy.
Medications
The underlying medical condition often determines what treatments are effective. Your NYU Langone health care professional will take a full medical history to detect vitamin deficiencies, low blood sugar levels, exposure to toxins, and family genetics. He or she may also check tendon reflexes, limb strength and tone, and balance and coordination. A neurological exam might reveal signs of nerve damage, such as numbness and weakness. Imaging tests can help your doctor find herniated disks, compressed nerves, and other problems that might cause neuropathy.
Your NYU Langone healthcare provider will prescribe medications to treat the symptoms of peripheral neuropathy. Topical creams, such as capsaicin (derived from the chile pepper), can relieve pain and itching. Medications, such as antidepressants, anti-epileptics, and opioids, can decrease pain signals from the damaged nerves. If neuropathic pain is severe, your doctor may consider spinal cord stimulation or immunosuppressive therapies, such as plasma exchange and steroids.
It’s important to tell your doctor about any changes in symptoms or side effects of your treatment.
Physical Therapy
A physical therapist can help with balance and coordination, which often are affected by peripheral neuropathy. They can recommend exercises that will keep muscles strong and improve the way your body moves. They can teach you techniques to reduce pain, like using cold or hot packs on your skin or doing low-impact aerobic exercises.
Medications can help relieve nerve pain in people with some types of neuropathies. NYU Langone neurologists might prescribe medications such as acetaminophen, ibuprofen, duloxetine, tricyclic antidepressants, or membrane stabilizers and anti-epileptic drugs. Topical creams containing lidocaine, which blocks nerve signals to the brain, may also be helpful for many people.
A neurologist can check your medical history and do a neurological exam to look for problems like muscle weakness, changes in your tendon reflexes, and balance issues. They might do blood tests to check for diabetes, vitamin deficiencies, inflammation and other problems that can cause neuropathy. They might do imaging tests, such as CT or MRI, to look for herniated disks, enlarged spinal cord and other conditions that can compress the nerves.
Electrotherapy
Your peripheral nerves convert information from your senses into signals that travel to your brain. Your brain then interprets those signals to determine what you see, hear, feel and move. Peripheral neuropathy therapy can disrupt the normal flow of these nerve signals or send out inappropriate or distorted ones.
Those damaged nerves leak electricity, which then pools in surrounding tissue and may produce pain and inflammation. Electrical stimulation, such as TENS therapy, can be used to block this electricity or change the way the nerves perceive pain.
Acupuncture is another type of electrotherapy that involves inserting needles at precise points in the body to help relieve pain and other symptoms of neuropathy. It also boosts circulation to speed up the healing process. EMS, or electrical muscle stimulation, is another form of electrotherapy that stimulates your motor neurons to cause your muscles to contract and tighten up, which can prevent atrophy and help manage pain. This is also a common treatment option for musculoskeletal conditions like tendon injuries, such as tennis elbow.
Surgery
The first step in determining the cause and extent of nerve damage is to do physical and neurological exams. These include tests that check your tendon reflexes, your ability to feel certain sensations, your balance and coordination, and your muscle strength. Blood tests may look for signs of diabetes, kidney or liver problems, vitamin deficiencies and autoimmune disorders. Other tests are used to look for herniated disks, nerve compression, vascular conditions, and growths that can affect the nerves.
For some people with neuropathic pain, treating the underlying condition will eliminate or significantly reduce symptoms. For example, controlling blood sugar levels can relieve symptoms of diabetic neuropathy. Correcting vitamin deficiencies and avoiding toxic exposures can help other patients. For some, a surgical procedure called decompression surgery can improve their numbness and pain by relieving the pressure on compressed nerves. This procedure is typically performed under general anesthesia. It’s an important option to consider if other treatments aren’t helping your symptoms.
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