The nervous system enables communication between your brain and all the other parts of your body. Neuropathy treatment can help you manage pain and improve your quality of life.
Your doctor will review your medical history and do a physical exam. Tests may include blood work to detect diabetes, low levels of vitamins and other health issues that can cause nerve damage.
Physical Therapy
A physical exam and blood tests can help your doctor find the cause of your neuropathy. Your neurologist will check for signs of diabetes, vitamin deficiencies, liver or kidney disease and other conditions that can affect nerve function. You might also have a skin biopsy to identify the type of neuropathy and its cause. Other tests include electromyography (EMG), nerve conduction velocity (NCV) and lumbar puncture, in which a needle is used to get a sample of spinal fluid.
The nervous system carries messages from the brain to the rest of your body and controls involuntary actions such as breathing, heartbeat and digestion. When the peripheral nerves become damaged, they can’t send those messages, which leads to numbness, tingling and weakness in your feet and legs.
If your neurologist can identify the condition causing your pain, it may be treated to reduce symptoms and prevent further damage. Some doctors might recommend a combination of treatments, including pain relievers, physical and psychological therapies and complementary and alternative approaches.
Medication
Peripheral nerves carry information about the outside world to your brain, and your sense of balance and coordination depend on their messages. If the nerves lose their connection, you might have muscle weakness and clumsiness in your feet or hands.
Your doctor will ask you about your symptoms and do a physical and neurological exam. He or she might also order blood and urine tests to check your levels of vitamins, minerals, glucose, liver or kidney function and to identify conditions that can cause neuropathy, such as diabetes, high blood pressure and autoimmune disorders.
Electromyography (EMG) and nerve conduction velocity (NCV) tests can help your doctor pinpoint which nerves are damaged. A lumbar puncture — a spinal tap — might also be needed to diagnose infection or inflammation that could be causing the neuropathy. A lumbar puncture can also help find out if you have hereditary neuropathies such as familial amyloidosis and Fabry disease. Nerve biopsies may also be used to determine the type of neuropathy.
Acupuncture
Peripheral neuropathy causes pain, numbness and imbalance. Symptoms usually start in your feet and lower legs and move up to your arms. They can be mild or severe, burning or stabbing. Most often, your doctor diagnoses the condition by talking with you and doing a physical exam.
Other tests might include blood and urine tests for diabetes, vitamin or mineral deficiencies and underlying disease or cancer that could affect nerve function. You may also need a spinal tap to see how well the nerves in your spine are working, an EMG (electromyography) to test muscle electrical activity, and a nerve biopsy to examine actual damaged nerve tissue.
Some types of peripheral neuropathy therapy are caused by damage to one nerve in a specific area (mononeuropathy). Others are caused by more scattered nerve injury across your body, which is called polyneuropathy. Treatment focuses on treating the underlying cause of the condition, if possible. This might include avoiding alcohol, addressing diet and nutrition issues, correcting vitamin deficiencies, getting enough exercise and reducing exposure to toxins.
Complementary & Alternative Therapies
As the name implies, complementary therapies are used in addition to conventional treatments and often involve mind/body practices such as yoga, tai chi, massage therapy and meditation. Some of these techniques help reduce pain and stress. Others may ease autonomic symptoms, such as orthostatic hypotension (a sudden drop in blood pressure when standing up).
Unlike standard medicines, many complementary therapies haven’t been thoroughly tested and some can cause serious side effects. Some herbal remedies, for example, may interfere with certain medications, so you should always tell your doctor what other treatments and supplements you’re using.
Research is continuing into both the causes and the treatment of neuropathies. The NINDS is funding a variety of studies, from clinical trials of new ways to prevent hereditary neuropathies to basic science investigations of the nerves that generate sensory and autonomic symptoms. The shingles vaccine prevents most cases of hereditary neuropathies, and drugs like the serotonin and norepinephrine reuptake inhibitor duloxetine (Cymbalta) and venlafaxine extended-release (Effexor XR or Pristiq) might help control pain caused by diabetes.
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