How is Neuropathy Pain Treated?
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
The physical cause of neuropathic pain is damaged peripheral nerves and as one medical expert notes, may also be due to the attempt of damaged nerves to fire across damaged sections of the peripheral nerve.
Since there is no observable physical cause for the pain, patients are too often dismissed with the implication of a mental disorder, when the pain is real and often devastating emotionally and physically to the neuropathy patient.
Neuropathic pain does not respond to familiar pain medications.
Pain signals from an external stimulus like a cut or from an internal broken bone are treated with many well-known treatment options for pain.
Pain signals from damaged nerves which send real, but faulty signals to the brain must be treated with other options, which currently are limited until research provides more options at the clinical level.
One of the often overlooked aspects of treating your neuropathy pain or symptoms, is the cause or type of your neuropathy. Knowing the type can often point to a more effective treatment. Never settle for a diagnosis of idiopathic as it adds nothing but confusion.
Treating pain is to treat a symptom, but medical care must go beyond the symptoms in working with the neuropathy patient.
Drug Options for treating Neuropathic Pain
The majority of patients with neuropathy pain are currently treated with two classes of medication.
The anti-depressants and the anti-seizure medications either alone or in combination work for many patients to reduce such pain. Some of these options would include either Nortriptyline or Cymbalta in the first class and Lyrica in the second class. Speak to your doctor about the options, but recommend that you first consider the anti-depressants as these may have less side effects. Both the anti-depressants and anti-seizure medications reduce neuropathic pain, even if medicine is not totally sure why they work.
Most patients get about 85% relief and a few are lucky with 100% relief, but until there are better medications developed by research, we are fortunate to have these options.
Like all medications sometimes the side effects are worse than the symptoms. Each patient must decide if they are worth using if the pain is only at the nuisance level. The dosage and the combinations of these medications must be worked through by the patient with the doctor in a patient doctor partnership of trial and error. As of now, I know of no other way to find what works for you as every patient is unique.
Patients have been prescribed Lidocaine patches for burning pains and patients report that these help reduce the burning.
Many patients have found that the burning sensations respond best to compounded topical creams and not to the oral medications. Compounded topical creams are being prescribed more often by doctors and the benefit is the absorption into the blood is limited and it tends to stay concentrated to the area you need it the most. Some of the ingredients physicians use in these compounds includes Lidocaine, Ketamine, Gabapentin, and Amitriptyline, mixed by a compounding pharmacy in percentages as prescribed by the physician.
Neuropathy Journal Articles You May Find Helpful
Research Report Sites Possible Neuropathic Pain Relief for Diabetics In a follow up of a 2013 research report published in the Annals of Clinical and Translational Neurology and Science Daily, possible neuropathy pain relief for diabetics stating “two low dose rounds of non-viral gene therapy called VM 202 patients had significant improvement of their pain that lasted for months.”…READ MORE
What is Neuropathic Pain?The physical cause of neuropathic pain is damaged peripheral nerves and as one medical expert notes, may also be due to the attempt of damaged nerves to fire across damaged sections of the peripheral nerve. See: References #1 to #3 It is illegal to torture prisoners in our country. So…READ MORE
How is Neuropathic Pain Treated? Pain signals from an external stimulus like a cut or from an internal broken bone are treated with many well-known treatment options for pain. Pain signals from damaged nerves which send real, but faulty signals to the brain must be treated with other options which currently are limited until research provides more options at the clinical level…READ MORE
When Suffering from Neuropathic Pain Biofeedback May Be an Option When suffering from Neuropathic Pain biofeedback may be a possible option. Patients who are considering opiates, which can turn out to be more of a problem than the disease – should read Andy Griffiths’ story (of TV fame) who notes his success with Biofeedback …READ MORE