Managing the condition causing neuropathy therapy can improve or at least stop symptoms from getting worse. Taking painkillers, including acetaminophen and NSAIDs, or tramadol can lower painful symptoms.
Health care professionals check a patient’s medical history and do a physical and neurological exam. They may order blood tests to detect diabetes, vitamin deficiencies, inflammation or metabolic problems.
Anti-seizure drugs
The nervous system enables communication between all parts of your body and the brain. If you have neuropathy, your brain is sending inaccurate information to other parts of the body that can result in pain and numbness or weakness.
Over-the-counter medications can help relieve mild to moderate pain caused by neuropathy. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain, swelling and stiffness. These include ibuprofen, naproxen and others.
Other prescription medicines can also reduce pain by reducing the activity of nerve cells that send pain signals to your brain. These include medications first developed to treat depression such as duloxetine hydrochloride, nortriptyline and newer serotonin-norepinephrine reuptake inhibitors such as gabapentin and pregabalin. Medications used to treat epilepsy such as carbamazepine and oxcarbazepine also may be effective.
Other treatments may include TENS therapy, in which electrodes are placed on the skin and deliver a low level of electrical stimulation that blocks or changes your nerves’ perception of pain. Physical and occupational therapies can help you strengthen muscles that have weakened and improve your balance and coordination.
Nerve stimulation
The nervous system enables your brain to communicate with every other part of your body. Your nerves transform information about the outside world into signals that your senses send to your brain. Then your brain turns those signals into the things you can feel, such as pain, temperature and touch. Nerve damage can interrupt this communication and leave you with neuropathic pain and other symptoms.
If the cause is known, your health care professional might treat the underlying condition. For example, if your neuropathy is caused by diabetes, treatment may include controlling your blood sugar. If the cause is a herniated disc or tumor, therapy might include surgery to remove the growth or a procedure such as a spinal cord decompression.
Your doctor will want to know your family history of neuropathies and will conduct a physical and neurological exam. He or she might also order tests to detect diabetes, vitamin deficiencies, liver and kidney problems, metabolic disorders, infections, and autoimmune diseases. Tests can include muscle ultrasound and electromyography to evaluate for nerve function.
Nerve blocks
Nerve blocks use local anesthetic to block pain signals from a specific nerve. They usually begin to work within a few minutes and last a couple of hours, but some people require a series of nerve blocks over several months.
The injections are performed in an outpatient setting, meaning you don’t need to stay at the hospital. You’ll need to arrange for someone to drive you home afterward, as the affected area will be numb and weak. You shouldn’t place hot or cold items on the area and be careful not to bump or injure it.
The provider will use X-ray or ultrasound imaging guidance to locate the exact spot where they’ll inject the medication. The provider will clean the skin and may give you a mild sedative to help you relax before starting the procedure. A needle is used to insert a catheter that delivers the medication to the site. Occasionally, a small leak around the catheter entry will occur, but this is common and nothing to worry about.
Implants
A new implant that delivers a mild electrical current to nerves in the area where pain is felt shows promise as a treatment for peripheral neuropathy. The device, which is similar to a pacemaker, sends pulses to nerve fibers in the spinal cord and masks painful signals from reaching the brain. The technique may also reduce the need for pain medication.
This new technology is still being tested in laboratory animals, but researchers believe it could eventually replace larger and more invasive implants currently used to treat conditions like Parkinson’s disease, epilepsy, and chronic pain. The implant uses tiny wires to stimulate the peripheral nerves in the blood vessels surrounding them.
Peripheral neuropathy can be a life-threatening condition and is not always curable. However, there are many ways to manage the symptoms and prevent further damage. It is important to talk with your health care provider about any changes in your symptoms or side effects from your treatments.
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