What are possible neuropathy treatments?

by Waden E. Emery III MD FAAN, – Neuromuscular Neurologist
Board Certified in Neurology, Asst Clinical Professor in Neurology
Miller School of Medicine University of Miami

 
Diagnosing Neuropathy

The treatment for a neuropathy depends both on the type and the possible cause.  If the cause is identified, then treating the cause is the obvious answer.  If the cause is not identified, then identification of the type will help in determining any possible treatments.

For the immune mediated neuropathies, the use of immune globulin or IVIg is a proven treatment.

Other treatments would include short term corticosteroids or plasmapheresis, which have been shown effective in preventing further damage and helping the damaged nerves to work to some degree depending upon the extent of damage.

Chemotherapy agents, if standard treatments are ineffective or cannot be tolerated and in rare cases immunomodulatory drugs or bone marrow ablation have been used when there are no other options.

Learning to live with the symptoms, while working on diagnosing the cause and getting the proper treatment(s), is a must in order for a neuropathy patient to live their life as normal as possible. Mims Cushing has an excellent book entitled “You Can Cope With Peripheral Neuropathy: 365 Tips for Living a Full Life available on Amazon.

A good balanced diet designed by a nutritionist based on your medical needs and constraints is always a good idea.

Proper exercise or physical therapy when it follows the principles of Matt Hansen DPT (Ref: 4) is great to maintain muscle strength and flexibility.  However, the wrong type or intensity of an exercise forcing damaged nerves to work, will increase neuropathic pain and cause more damage!

In some instances, orthotics and bracing may be needed, or surgery to correct foot deformities or nerve entrapments.

Proper shoes with soft inserts and no high heels with socks (diabetic socks recommended for all neuropathy patients) whose feet are affected.

Vitamin supplements when a deficiency is identified by testing or subliminal vitamins (melt in your mouth to bypass stomach) or even shots of vitamins are used if malabsorbtion is an issue.

Alpha Lipoic Acid is recommended and proven in many studies to reduce neuropathic pain especially in diabetic neuropathy and other patients report that it helps even in other types of neuropathies.

The use of a wheelchair, walker, or cane may be used to prevent falls.

Making the home accessible or removing possible items that may cause tripping or falls may be important.