Peripheral neuropathy is a condition of numbness, tingling, weakness, and burning pain in the feet and hands that is caused by nerve damage. Persons with diabetes are most often affected by peripheral neuropathy (called diabetic neuropathy); other causes of the condition are injury, infections, exposure to toxins, and disorders associated with the kidneys, liver, and thyroid.
There are several types of Peripheral neuropathy, depending on what nerves are affected. Mononeuropathy is a variation where only one nerve is affected and so it only affects an isolated area. Carpal tunnel syndrome is an example of mononeuropathy. Mononeuritis multiplex, AKA, polyneuritis multiplex, is a variation where multiple individual and separate nerves are affected at the same time. This is the least common type.
Polyneuropathy, AKA, peripheral neuropathy is different from mononeuropathy, more serious and affecting more areas of the body. In this variation multiple nerve cells throughout the body are affected.
Autonomic neuropathy, a type of polyneuropathy, affects non-voluntary nerves, mostly associated with the internal organs. And finally, Neuritis is a general condition of inflammation of a nerve. At least twenty million people are affected by some form of Peripheral neuropathy.
What treatments are available for Peripheral neuropathy?
Treatment with over the counter (OTC) medications may provide some level of relief for some patients. NSAID (non-steroidal anti-inflammatory) medications such as Ibuprofen and Naproxen Sodium may help and are readily available without a prescription. In more severe cases your doctor may prescribe opioid analgesics such as hydrocodone or oxycodone.
Medications originally designed to treat epilepsy have proven to be quite effective for the treatment of Peripheral neuropathy. Drugs like topiramate (Topamax), gabapentin (Gralise, Neurontin), phenytoin (Dilantin, Phenytek), pregabalin (Lyrica), and carbamazepine (Carbatrol, Tegretol) are often prescribed to treat Peripheral neuropathy.
Immunosuppressive medications that are designed to reduce your immune system’s reaction have also been effective for the treatment of Peripheral neuropathy. These medications like azathioprine (Imuran, Azasan), prednisone, and cyclosporine (Sandimmune) are often prescribed.
Some topical medications are also useful for providing relief; creams containing capsaicin are effective as are Lidocaine patches and creams.
The antidepressants nortriptyline (Aventyl, Pamelor), and amitriptyline, doxepin are often used to relieve pain. These medications work by disrupting chemical processes in the brain and spinal cord that send pain signals to the brain. Serotonin and norepinephrine reuptake inhibitors like duloxetine (Cymbalta) and the extended-release antidepressant venlafaxine (Effexor XR) have proven to be useful when treating Peripheral neuropathy associated with diabetes.
Non-drug treatment with a TENS (transcutaneous electrical nerve stimulation) unit are helpful. This works by disrupting the electrical signals in the nerves. Plasma exchange and immune globulin therapy are other treatments that are available. In plasma exchange your blood is removed intravenously and a machine separates the red blood cells and plasma and then your blood is returned to your body. In immune globulin therapy, you are injected with immunoglobulins, (high levels of proteins that work as antibodies) to boost your immunity system.
In some cases of Peripheral neuropathy surgery may be required to alleviate pressure on a nerve. Diet and exercise are always important factors, especially for patients with diabetes.