Peripheral neuropathy is a condition in which damage occurs to the nerves of the peripheral nervous system, producing numbness, tingling, and pain.

Peripheral neuropathy can be caused by a large number of medical and environmental conditions: these include metabolic diseases such as diabetes; autoimmune diseases such as rheumatoid arthritis and lupus; cancerous growths that put pressure on surrounding nerve tissue; viral or bacterial infections such as shingles; medication toxicity induced by chemotherapeutic agents or other medications; exposure to environmental toxins such as pesticides; physical trauma resulting in nerve damage; repetitive motion disorders that compress surrounding nerves such as carpal tunnel syndrome; and excessive alcohol consumption.

Treatments for peripheral neuropathy can target either the underlying cause of the nerve damage or the associated pain symptoms. Treatments include a variety of medications and therapies.

Medications

The pain associated with peripheral neuropathy, which can affect a patient’s emotional and physical well-being, can be managed through a number of medications.  In the earliest stages, patients may take non-steroidal anti-inflammatory drugs (NSAIDs) or other over-the-counter analgesics.  However, these medications are typically not effective for more severe pain.  In such cases, patients often find relief with anti-depressant or anti-epileptic medications, which interfere with pain detection mechanisms in the brain.

Patients suffering from peripheral neuropathy may also be given opioid-containing pain medications, but this is typically a medication of last resort due to the high incidence of abuse and dependence associated with opioids.

A topical cream containing capsaicin is also available to alleviate pain symptoms.  Capsaicin is a naturally occurring substance found in chili peppers that blocks the sensation of pain and provides additional relief to localized regions of the body.

For patients suffering from autoimmune-induced neuropathy, immunosuppressive drugs such as prednisone can limit additional damage to nerves.

Therapies

It is important to address the underlying cause of peripheral nerve damage when treating neuropathy. For example, the uncontrolled blood glucose levels found in patients with diabetes can damage the blood vessels that supply the peripheral nerves, resulting in diabetic neuropathy.

Diabetes is one of the most common causes of neuropathy, and proper management of glucose levels is imperative for patients with this condition in order to prevent further damage.

Similarly, patients with autoimmune disorders may undergo plasmapheresis, a therapy in which blood is removed from the body, filtered to remove antibodies and cells that trigger immune reactions, and returned to the body.

A variety of medical therapies are used to treat neuropathic symptoms. Transcutaneous electrical nerve stimulation (TENS) is a therapy used to alleviate pain symptoms.

TENS therapy uses electrodes and gentle electrical current to stimulate nerve endings in areas where pain occurs, blocking pain sensations from reaching the brain.

TENS is often used in combination with medications or other therapy. Physical therapy is often used to help patients with muscle weakness to regain strength and balance. Surgical therapy to relive nerve compression can be beneficial in some cases where localized damage occurs due to repetitive motion or injury.

There are also a number of lifestyle changes a patient can make to reduce existing symptoms or the potential for additional nerve damage. These include eating a healthy diet, stopping smoking, limiting alcohol consumption, and exercising regularly.

Exercise can strengthen muscles that have been weakened by motor neuropathy and increase balance and coordination.

Smoking negatively affects the blood circulation supplying the nerves and consuming alcohol exacerbates nerve damage. Frequent visual checks on the feet and hands can identify infections or abrasions that may go undetected due to lack of sensation.