Neuropathy is a condition that is characterized by the dysfunction of the nervous system. Most often, it is due to damage to peripheral nerves leading to neuropathic symptoms, hence the term – peripheral neuropathy.
Neuropathy may manifest differently based on the type of nerve fibers damaged and can range from numbness, weakness to stabbing or burning pain. There may also be tingling, numbness, or paresthesia. Sometimes, there is damage to motor nerves and can lead to lack of coordination, weakness, or cramping.
In many cases, neuropathy leads to chronic pain. While it can be very longlasting, there are ways to control it.
Neuropathic pain occurs due to a nerve injury which can be triggered by a specific incident (accident, stroke or amputation) or a disease (diabetes, viral infection or neurodegenerative condition). It may be a CNS or a peripheral nervous system problem.
Neuropathic pain in the feet is not uncommon in diabetics (diabetic neuropathy). The pain may be described as stabbing, burning, electric shock, or a freezing sensation, and it may worsen at night. There might be temporary numbness, tingling, and pricking sensations, sensitivity to touch, etc.
It is a chronic condition that can be extremely debilitating. The good news is that there is a way to manage the pain through a number of treatment options.
First, the underlying cause or medical problem needs to be diagnosed and treated, in an attempt to prevent further nerve damage.
Over-the-counter NSAIDs cannot help with neuropathic pain. Anticonvulsant or antidepressant medications may be needed to help reduce nerve pain. In some cases, pain creams, patches or even injections may relieve some types of nerve pain. Opioids, such as tramadol or oxycodone lead to dependence and addiction and should be avoided unless other medications fail to improve pain. Anti-seizure medications, gabapentin, and pregabalin may relieve nerve pain.
Antidepressants, such as amitriptyline, doxepin, and nortriptyline have been found to help relieve pain by interfering with neurotransmission in the brain and spinal cord implicated in this pain syndrome. The serotonin and norepinephrine reuptake inhibitor duloxetine and the extended-release antidepressant venlafaxine may have some efficacy in controlling diabetic neuropathic pain.
Topical treatments, such as Capsaicin cream has been shown to cause mild improvements in peripheral neuropathy symptoms. Lidocaine patches may also provide pain relief in these patients.
If medications are ineffective or intolerable, neuromodulation therapy using spinal cord stimulation (SCS) or peripheral nerve stimulation might be the remaining viable option.
A non-invasive type of peripheral nerve stimulation that is delivered through the skin, transcutaneous electrical nerve stimulation (TENS) may also be considered to improve symptoms of diabetic peripheral neuropathy & neuropathic pain.
Thus, there are many ways to try and tackle this notoriously stubborn and prolonged pain syndrome. It is important to detect it early and respond immediately in order to minimize further nerve damage.