Neuropathy is a condition in which the peripheral nerves are damaged and not functioning adequately. The most common causes of neuropathy in the western world are diabetes, vitamin/nutritional deficiencies, alcohol abuse, lumbosacral radiculopathy, drug induced and idiopathic diseases. Diabetes however is the number one cause.
Poor glycemic control causes glycation and degeneration of the nerves. These damaged nerves ‘misfire’ and cause the common symptoms of burning, tingling, pins and needle type sensation and eventually numbness. The damage caused by diabetes to these nerves is often irreversible but glycemic control can slow the progression of this condition. Damage to the nerves can be due to many reasons as mentioned above but the symptoms usually overlap.
When the diagnosis is made, treatment is usually based on the cause. Reversible causes are dealt with accordingly and usually a multi-specialty based approach is required to properly treat the patient.
Regular inspection of the feet is of paramount importance to prevent long term complications. Due to the numbness and loss of protective sensation, patients might notice infections and injuries of the foot. This can result in serious infections, amputations and even death. Good glycemic control is the mainstay of treatment in patients with diabetic neuropathy. Protective shoe gear which are custom made for the patient are utilized as well. Medications such as gabapentin and lyrica are often prescribed by your PCP which can help decrease the symptoms.
Nutritional supplements can also be very useful in managing symptoms. Many diabetics also have concurrent nutritional deficiencies that should be addressed. Topical treatments are also utilized which can be very effective in recalcitrant cases. These creams are compounded by specialty pharmacies and are a mixture of different medications that all work differently to soothe the nerves. Surgical intervention is required in nerve entrapment cases. The impinged nerve is released surgically to restore its function and to provide relief.
Alternative treatments that do provide short term pain treatment include topical options that do not have side effects and are a better option then OTC options.
If you are suffering for nerve pain and looking for several treatment options that can help please schedule a virtual or in person visit with one of our doctor.