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Treatment of peripheral neuropathy
The treatment of peripheral neuropathy depends entirely on the cause. The condition can be reversible or irreversible, but even in irreversible cases, it is a must to control the original condition to prevent the progression of the disease. Another essential part of treatment is regular checkups and recording the progression or regression of the disease.
Managing bothersome manifestations of peripheral neuropathy is also a priority, and your doctor can prescribe some ointments or oral medications to help decrease the pain, burning or persistent numbness you may be feeling. Muscle cramps can also be controlled by muscle relaxants. One of the most successful medications in controlling sensory symptoms is gabapentin, which acts specifically on nerves rather than being a general analgesic.
Regarding common conditions causing peripheral neuropathy, the following should be done regarding them:
- Diabetes mellitus: The single most important measure that should be done in diabetes is controlling blood glucose levels. Uncontrolled blood glucose directly damages the nerves and causes progression.
- Kidney disease: In advanced renal failure, dialysis may be needed and is shown to improve peripheral neuropathy.
- Vitamin deficiencies: Administering vitamin B12 and folic acid can completely reverse the condition if deficiency is the cause.
- Inflammatory and autoimmune conditions: Anti-inflammatory medications such as steroids or even immunosuppressive medications can improve peripheral neuropathy resulting from autoimmune and inflammatory conditions.
- Managing a tumor regardless of the method has been shown to decrease the manifestations of paraneoplastic syndrome as well.
Surgical options are limited in peripheral polyneuropathy (which affects multiple nerves). It is of great benefit in many mononeuropathies, however, and many conditions such as carpal and tarsal tunnel syndromes can benefit from it. Carpal tunnel syndrome, for instance, occurs when excessive adhesions that may occur with overuse of the wrists, and such adhesions have to be cut to relieve pressure on the median nerve.
Surgical options can also be useful in cases of disc herniation, which is a common condition where the cartilaginous disc in between vertebrae becomes compressed or degenerated that it compresses the nerves while they are getting out of the spinal cord. Surgically, such disc can be removed either partially or totally and then the vertebrae may be fixed in position to avoid additional pain.
Managing autonomic neuropathy is a bit more complex. Patients suffering from gastrointestinal or heart related problems can benefit from special medications. Diabetic patients can have gastroparesis, which is the partial or complete paralysis of the muscles of the stomach. This condition can cause severe indigestion and affect diet. It can be treated by medications such as MiraLax. Orthostatic hypotension can also benefit from medications such as ephidrene which increases the pressure within blood vessels and therefore prevents the momentary decreased blood flow to the brain.
