Peripheral neuropathy
Peripheral neuropathy is a disorder involving the peripheral nervous system (PNS). The central nervous system (CNS) includes your brain and spinal cord, and the PNS includes all of the nerves that come from your spinal cord and innervate the rest of your body. Peripheral neuropathy can be caused by many conditions including vitamin deficiencies, alcoholism, autoimmune diseases, certain medications, unknown causes, and diabetes. When your peripheral nerves become damaged, they do not function properly and can eventually produce symptoms such as pain, tingling, or numbness.
Pharmacologic Therapy
Membrane-stabilizing medications are typically the drug of choice used to treat painful neuropathies. These medications typically calm down irritated nerves, but can have a high rate of side effects that may limit their use. Some of the medications that are particularly effective at treating nerve pain include Cymbalta, Elavil, Lyrica, Tramadol, and Neurontin. These medications may relieve pain but do not help to prevent the progression of the disease.
Pain relievers, such as NSAIDs and opiates, may offer some pain relief, but there is a concern of overuse and dependence that may develop along with other side effects. Opioids are usually not the drug of choice when treating nerve pain.
Alternative Therapies
Some alternative therapies that are used to treat diabetic peripheral neuropathy include:
- Acupuncture: Harvard Medical conducted a study that stated that traditional Chinese acupuncture improved nerve sensation in diabetic peripheral neuropathy (Ahn 2007). Another study involving acupuncture in the treatment of peripheral neuropathy showed 77% of patients noted significant improvement in their symptoms, and 21% noted that their symptoms cleared completely. The study concluded that acupuncture is a safe and effective therapy for the long-term management of painful diabetic neuropathy (Abuaisha 1998).
- Biofeedback: Studies on the psychological assessment and treatment of neuropathic pain conditions, including diabetic peripheral neuropathy, showed that cognitive-behavioral interventions will improve the quality of life in these patients (Haythornthwaite 2001).
- Nutrient and vitamin supplements: Certain nutritional supplements have been implicated in helping to treat and prevent neuropathies. Working closely with a nutritionist or physician, you can come up with a diet or supplements that may benefit your neuropathy. Alpha-lipoic acid, acetyl-L-carnitine, benfotiamine, methylcobalamin, and topical capsaicin are among the well-researched alternative options for the treatment of peripheral neuropathy. Other potential therapies include vitamin E, glutathione, folate, pyridoxine, biotin, omega-3 and -6 fatty acids, L-arginine, L-glutamine, taurine, N-acetylcysteine, zinc, magnesium, chromium, and St. John’s wort (Head 2006).
Advanced Interventional Therapies
At LA Pain Doctor, we have successfully treated patients with painful peripheral neuropathy with a modality called spinal cord stimulation (SCS). Spinal cord stimulation is often thought of as a pacemaker for pain management and can be a very effective long-term treatment modality for neuropathies and other difficult-to-treat pain syndromes.
