Treatments and drugs

By Mayo Clinic Staff

Treatment goals are to manage the condition causing your neuropathy and to relieve symptoms. If your lab tests indicate no underlying condition, your doctor may recommend watchful waiting to see if your neuropathy improves. If exposure to toxins or alcohol is causing your conditions, your doctor will recommend avoiding those substances.

Medications

Medications used to relieve peripheral neuropathy pain include:

  • Pain relievers. Over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs, can relieve mild symptoms. For more-severe symptoms, your doctor may recommend prescription painkillers.

    Medications containing opioids, such as tramadol (Conzip, Ultram ER, others) or oxycodone (Oxycontin, Roxicodone, others), can lead to dependence and addiction, so these drugs generally are prescribed only when other treatments fail.

  • Anti-seizure medications. Medications such as gabapentin (Gralise, Neurontin) and pregabalin (Lyrica), developed to treat epilepsy, may relieve nerve pain. Side effects may include drowsiness and dizziness.
  • Capsaicin. A cream containing this substance found naturally in hot peppers can cause modest improvements in peripheral neuropathy symptoms. Doctors may suggest you use this cream with other treatments. Skin burning and irritation where you apply the cream may occur, but usually lessens over time. However, some people can't tolerate it.
  • Antidepressants. Certain tricyclic antidepressants, such as amitriptyline, doxepin and nortriptyline (Pamelor), have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain.

    The serotonin and norepinephrine reuptake inhibitor duloxetine (Cymbalta) and the extended-release antidepressant venlafaxine (Effexor XR) also may ease the pain of peripheral neuropathy caused by diabetes. Side effects may include dry mouth, nausea, drowsiness, dizziness, decreased appetite and constipation.

Your doctor also may prescribe medication to treat the underlying condition that's causing the neuropathy. For example, medications to reduce your immune system's reaction, such as prednisone, cyclosporine (Neoral, Sandimmune, others), mycophenolate mofetil (CellCept) and azathioprine (Azasan, Imuran), may help people with peripheral neuropathy associated with autoimmune conditions.

Intravenous immunoglobulin is a mainstay of treatment for chronic inflammatory demyelinating polyneuropathy and other inflammatory neuropathy.

Therapies

Various therapies and procedures may help ease the signs and symptoms of peripheral neuropathy.

  • Transcutaneous electrical nerve stimulation (TENS). Adhesive electrodes placed on the skin deliver a gentle electric current at varying frequencies. TENS should be applied for 30 minutes daily for about a month.
  • Plasma exchange and intravenous immune globulin. People with certain inflammatory conditions may benefit from these procedures, which help suppress immune system activity.

    Plasma exchange involves removing your blood, then removing antibodies and other proteins from the blood and returning the blood to your body. In immune globulin therapy, you receive high levels of proteins that work as antibodies (immunoglobulins).

  • Physical therapy. If you have muscle weakness, physical therapy can help improve your movements. You may also need hand or foot braces, a cane, a walker, or a wheelchair.
  • Surgery. If you have neuropathies caused by pressure on nerves, such as pressure from tumors, you may need surgery to reduce the pressure.
Dec. 02, 2014

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