Whether nerve damage can be reversed depends on its cause. Removing a tumor that was causing neuropathy, for example, might relieve someone of nerve pain entirely. But some nerve damage is permanent.
Treatments for neuropathy might include lifestyle changes, medications or alternative modalities, such as spinal cord stimulation, says Dr. Rajneesh. The overarching goal is to treat the underlying issue that caused nerves to stop functioning normally, he adds. Forms of neuropathy treatment may include:
Nutritional interventions. Certain nutritional interventions, such as controlling a persons hemoglobin and B12 absorption can help relieve symptoms. If neuropathy is stemming from diabetes, diet and exercise may help decrease a persons hemoglobin A1C (the average of someones blood sugar levels over three months) to a normal range, says Dr. Mayberry. If nutritional interventions are successful, the progression of neuropathy may stop.
Meanwhile, in the case of a person with a B12 deficiency experiencing neuropathy, doctors may administer an injection of B12 every six months, says Dr. Rajneesh, adding that if this deficiency is the cause of an individuals neuropathy, some or all of the nerve damage and symptoms can be reversed.
Physical therapy. Exercise and physical therapy can help retrain damaged nerves to make appropriate connections to muscles, says Dr. Mayberry. This includes use of electrical stimulation, braces, orthoses, compression and other modalities. Improving strength and balance can help increase stability so individuals with neuropathy can maintain balance during daily activities.
Medication. Several medications including anti-seizure medications (pregabalin and gabapentin), antidepressants (like amitriptyline), anxiety medications (like duloxetine) and dementia and Alzheimers medications (like memantine) can help stabilize nerves that are firing haphazardly to reduce pain, as well as prevent abnormal nerve sensations in people with neuropathy, says Dr. Rajneesh.
Certain antidepressants appear to be effective at treating neuropathic pain by helping to increase a persons mobility, adds Dr. Mayberry. If someone has a lot of pain in their feet, they wont be up and moving around, so its a vicious cycle from a symptom management perspective, says Dr. Mayberry. Some antidepressants and anti-epileptics can [enable patients to] exercise and help nerves regenerate.
In some cases if a nerve is irritated or inflamed, a steroid injection may help address this temporarily, as seen in carpal tunnel syndrome and radiculopathies.
Spinal Cord Stimulation. Research demonstrates that spinal cord stimulation can be an effective treatment to prevent pain sensations from reaching the brain, says Dr. Rajneesh. The treatment was approved for neuropathy by the Food and Drug Administration (FDA) in 2021 and involves attaching a stimulating electrode over the spinal cord that blocks pain signals from reaching the brain. A trial course of spinal cord stimulation usually lasts for about a week, and, if its helpful, a permanent stimulator may be surgically placed.
OTC Remedies. Individuals with neuropathy may find relief in supportive shoes and insoles that help with pain and balance issues. Orthopedic shoes and hand or foot braces may also help, as well as some creams containing lidocaine or capsaicin for the feet to help combat painful sensations, says Dr. Mayberry. In terms of diabetic neuropathy, theres some research that a supplement for diabetes, alpha lipoic acid, can improve neuropathy pain.
Transcutaneous Electrical Nerve Stimulation (TENS) Therapy. People who want to avoid taking medications for neuropathy may try TENS (transcutaneous electrical nerve stimulation) therapy, says Dr. Rajneesh. This form of therapy uses electrical impulses to stimulate nerve cells in certain areas and help reduce sensations of pain. TENS units may be more appropriate for focal pain rather than peripheral pain, as peripheral neuropathy might cause discomfort in too large of an area to stimulate with TENS therapy, adds Dr. Rajneesh.
Surgery. Surgery might be appropriate for certain types of neuropathies, such as if a single nerve is being compressed and causing pain or weakness. However, surgical intervention is unlikely to help neuropathy affecting more than one nerve, as is the case in diabetic neuropathy, according to research.
Lifestyle modifications, such as enhanced physical activity and a healthy diet can help prevent nerve damage, says Dr. Mayberry. The Foundation for Peripheral Neuropathy recommends a diet rich in colorful fruits and vegetables, lean protein, legumes and limited salt and alcohol consumption to maintain nerve health. Alcohol can affect nerves negatively and cause dysfunction. Dr. Mayberry also recommends people maintain regular primary care checkups, physical activity and a balanced diet.
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What Is Neuropathy? Symptoms, Causes, Diagnosis, Treatment And ... - Forbes