Treatment for the Underlying Illness or Exposure

Treating the underlying illness can decrease or eliminate symptoms. For instance, if it is caused by diabetes, controlling blood sugar levels may help. In some cases, neuropathy caused by medications or toxins is completely reversed when these substances are stopped or avoided. Correction of vitamin B12 deficiency often improves symptoms.

Physical Therapy

Certain exercises may help stretch shortened or contracted muscles and increase joint flexibility. In long-standing cases, splinting the joint may be required to protect and rest it, while maintaining proper alignment.

Orthotics (supports and braces) may help with:

• Deformities
• Balance issues
• Muscle weakness

Maintaining physical activity is also key.

Medications

Prescription and over-the-counter (OTC) pain medications are often used to ease discomfort.

Drugs to treat depression and prevent convulsions sometimes relieve neuropathy symptoms. These medications are often given at lower dosages. Commonly used antidepressants include:

• Amitriptyline (Elavil)
• Nortriptyline (Pamelor)
• Desipramine (Norpramin)
• Imipramine (Tofranil)
• Duloxetine (Cymbalta)

Commonly used anticonvulsants may include:

• Gabapentin (Neurontin)
• Carbamazepine (Tegretol)
  • According to the Food and Drug Administration (FDA), patients of Asian ancestry who have a certain gene, called HLA-B*1502, and take carbamazepine are at risk for dangerous or even fatal skin reactions. If you are of Asian descent, the FDA recommends that you get tested for this gene before taking carbamazepine. If you have been taking this medication for a few months with no skin reactions, then you are at low risk of developing these reactions. Talk to your doctor before stopping this medication. *
• Pregabalin (Lyrica)—recently approved for peripheral neuropathy

For severe and potentially life-threatening cases (such as Guillain-Barre syndrome ), treatment includes:

• Steroids (such as prednisone )
• Intravenous immunoglobulins

Other Therapies

These therapies are aimed at reducing symptoms and may include:

• Relaxation training
• Biofeedback
• Walking
• Exercise
• Yoga
• Warm baths
• Massage
• Acupuncture
• Transcutaneous electronic nerve stimulation

Surgery

Surgery can relieve the pressure on nerves. For example, surgeons commonly release fibrous bands in the wrist to treat carpal tunnel syndrome .