Most Effective Treatments for Neuropathy (2024)

The most effective treatment for neuropathy varies from person to person. Treatment often depends on the underlying cause of the neuropathy, such as vitamin B12 deficiency or diabetes. While neuropathy cannot be cured or reversed, several medical approaches can help stop it from getting worse. There are also effective ways to alleviate neuropathy symptoms.

This article discusses the most effective treatment options for neuropathy depending on the underlying cause. It explains how to manage neuropathic pain, weakness, and sensory loss, and ways neuropathy may be prevented.

Most Effective Treatments for Neuropathy (1)

What Is the Most Effective Treatment for Neuropathy?

Neuropathy is usually considered a symptom or complication of another underlying condition. Thus, the most effective treatment is the one that targets the underlying cause.

It's important to note that once neuropathy develops, it cannot be reversed or cured. However, effectively treating the underlying cause of the neuropathy can prevent it from getting worse. It can also help manage neuropathy symptoms, including weakness, numbness, and pain.

Treatment options for the most common causes of neuropathy are as follows.

Vitamin B12 Deficiency

Untreated vitamin B12 deficiency can lead to irreversible nerve damage and, as a result, neuropathy.

This nutritional deficiency is common among:

Critical Illness Neuropathy

Critical illness neuropathy develops as a complication of a severe, acute illness. It is the most common cause of nerve-related muscle weakness in hospital intensive care units.

The exact process by which critical illness neuropathy develops is not always clear. But it is often believed to be caused by a number of factors, including:

Infections
Inflammation
Fluid and electrolyte imbalances
Immobility (lack of physical movements)

How it's treated: Critical illness neuropathy often improves over time once the underlying illness that caused it has resolved. Treatment is therefore case-by-case and may involve managing infections, restoring fluid and electrolyte balances, and physical therapy. In cases of severe neuropathy, recovery may be limited or may not improve at all.

Guillain-Barré Syndrome (GBS)

Guillain-Barré syndrome (GBS) is a rare, autoimmune disorder in which the immune system attacks the nerves, resulting in neuropathy. The disorder often develops after a viral respiratory or gastrointestinal infection.

This progressive and aggressive type of neuropathy often begins in the feet and gradually travels up the body, eventually weakening the muscles that control breathing. The onset of GBS requires immediate hospitalization.

How it's treated: There is no known cure for GBS, although treatment can shorten its duration and help prevent severe complications. For most people, the disorder eventually resolves within a year of its onset. Treatment may involve:

Diabetic Neuropathy

Diabetic neuropathy is the most common type of neuropathy in adults, affecting up to 29% of adults with type 1 diabetes and 51% of adults with type 2 diabetes. Diabetic neuropathy is caused by chronic high blood sugar levels, which damage nerves in the leg and feet.

How it's treated: Diabetic neuropathy is best managed by getting blood sugar levels under control. This is typically done by monitoring blood sugar closely, administering insulin on time, and taking diabetes medications as prescribed. While blood sugar control will not cure neuropathy, it will prevent it from getting worse.

For diabetic neuropathy pain, anticonvulsant (anti-seizure) drugs, and certain antidepressants, including tricyclic antidepressants and amitriptyline, may be helpful.

Alcoholic Neuropathy

Long-term, excessive alcohol consumption can damage nerves and result in alcoholic neuropathy. Up to one-half of all long-term excessive alcohol drinkers will eventually develop alcoholic neuropathy.

How it's treated: The best treatment for alcoholic neuropathy is discontinuing alcohol consumption. Again, this will not cure the neuropathy, but it will prevent it from getting worse and allow symptoms to improve.

Often, nutritional deficits associated with heavy alcohol use can contribute to alcoholic neuropathy, and correcting these nutritional deficits may help the neuropathy as well.

Chemotherapeutic and Medication-Induced Neuropathy

Several medications are associated with neuropathy, particularly some chemotherapeutic medications. It is not possible to completely avoid medications that cause neuropathy, because many of them provide important medical benefits, and they do not always cause neuropathy for everyone who takes them.

How it's treated: Depending on the severity of the neuropathy, discontinuing the medication can help prevent the neuropathy from worsening. When the medication responsible is medically necessary, such as chemotherapy, other treatment options that may relieve symptoms include:

Exercise therapy
Acupuncture
Anti-seizure drugs like gabapentin
Tricyclic antidepressants
Scrambler therapy, in which nerves are electrically stimulated via electrodes placed on the skin. The therapy works by "scrambling" pain signals and replacing them with "non-pain" signals.

Effective Treatments for Neuropathic Pain

There are several different treatments for neuropathic pain. The most effective treatment is not always the same for everyone, as you may not experience the exact same outcome and side effects as everyone else. This means that you and your healthcare providers may need to spend some time trying a few different options before discovering which is right for you.

The most common medications used for relieving neuropathic pain include:

Over-the-counter pain meds
Creams with anti-pain components
Prescription pain meds
Anti-seizure medications (anti-convulsants): While these medications are not specifically approved for the treatment of neuropathic pain, they do provide relief for many people. Therefore, healthcare providers frequently prescribe them for this problem.
Antidepressants: As with anticonvulsants, these medications may not be formally indicated for neuropathic pain. However, many people experience relief of neuropathic pain by taking them.

Treatments for Neuropathic Muscle Weakness

There are no effective medications to heal or regrow nerves damaged by neuropathy. But there are a few instances in which specific neuropathic muscle weakness can be managed:

Physical therapy: Often, physical therapy is the most effective way to gain better control of nerves that are not affected by neuropathy, which can help compensate for the weakness caused by nearby damaged nerves.
Incontinence: Neuropathy may affect bladder control, and sometimes medications used to control the bladder muscles can help regain better bladder control. Although these medications do not cure damaged nerves, they can help through their effect on nearby nerves and muscles that contribute to bladder control.
Erectile dysfunction: This is often one of the consequences of neuropathy, and medications that are used for the treatment of erectile dysfunction may help alleviate this issue.

Treatments for Sensory Loss

As with muscle weakness, it is not possible to repair the damaged nerves that control sensation. However, it is vital not to ignore this problem, as the sensory loss of neuropathy can lead to severe injuries and infections:

Wound care: If you have neuropathy, your injuries and wounds may not be as painful as they normally would. This lack of pain is a real problem, as you may not notice a wound becoming larger or infected. Whenever you have a wound or an injury, be sure to keep it clean and watch for signs of infection, even if you cannot feel the pain.
Physical therapy for balance: Sensory loss interferes with balance, and physical therapy can help you learn how to maximize your abilities and compensate for your deficits so that you can maintain better balance.
Scrambler therapy: The therapy of electrically stimulating muscles may be helpful in reducing the sensory loss of neuropathy, and some research studies point to benefits of this method.

Preventing Neuropathy

Because neuropathy is a condition that does not generally heal, prevention is particularly important. There is little you can do to prevent some of the common types of neuropathy, but you should get medical attention if you notice the early symptoms of neuropathy, which typically include tingling, numbness, and a burning sensation.

If you have early signs of alcoholic neuropathy, diabetic neuropathy, or medication-induced neuropathy, there are steps you can take to prevent the condition from becoming worse. Furthermore, if you have diabetes or if you are a heavy drinker, you can prevent neuropathy by managing these issues even before neuropathy starts.

Summary

Neuropathy is generally considered a symptom or complication of another underlying condition, such as diabetes or some severe infections. It cannot be cured or reversed. However, treating the underlying cause of neuropathy can prevent it from getting worse and may improve symptoms.

Treatment for neuropathy symptoms might include tricyclic antidepressants, anti-seizure medications, or electrical stimulation. Physical therapy can also help with managing neuropathy and improving mobility.