What Is the Treatment for Peripheral Neuropathy?

  • Medical Author:
    Standiford Helm II, MD

    Dr. Helm has been practicing interventional pain management since 1982. Dr. Helm is a diplomate of the American Board of Anesthesiology with subspecialty certification in Pain Medicine and of the American Board of Pain Medicine. Dr. Helm is a Fellow of Interventional Pain Practice (FIPP), the only certifying agency which tests the ability to perform interventional pain procedures. Dr. Helm is also an examiner for FIPP.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What kind of relief or treatment is there for peripheral neuropathy?

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Peripheral neuropathy is when the peripheral nerves (as compared to the spinal cord or brain) become the source of pain. One way to look at pain is whether it is in response to an appropriate stimulus, such as someone stepping on your toe, or whether the pain occurs for no obvious reason; malfunctioning of the nerves themselves becomes the source of the pain. Peripheral neuropathy can occur for many reasons, including as a consequence of diabetes, following trauma, toxins, and in alcoholism, to name a few causes. Peripheral neuropathy can also occur for no obvious reason.

Treatment depends in part upon the cause of the neuropathy. In general, physicians prescribe drugs that alter the processing of pain information in the spinal cord. Examples would include antidepressants, anti-epilepsy drugs, certain alpha-2 agonists, and opioids. Capsaicin cream (containing the substance found in hot peppers) and lidocaine patches have also been used for some patients.

Peripheral neuropathies can be frustrating to treat. As a general rule, the drugs used have a number needed to treat of about three, meaning that you have to treat three people to get one who has a 50% reduction of pain. Much of this treatment is off label, meaning that the drugs are prescribed for a different use than one of their FDA-approved indications. However, two new medications which have received specific FDA approval for diabetic peripheral neuropathy are pregabalin (Lyrica) and duloxetine (Cymbalta).

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care


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Reviewed on 8/4/2017