How is Neuropathy Pain Treated?

Pain associated with neuropathy is referred to as neuropathic pain. In most cases it is not pain per se, rather a very uncomfortable feeling-burning, numbness, pins and needles or electrical shocks sensation.
The goal of pain management is to improve quality-of -life, enabling individuals to work, attend school, or participate in other day-to-day activities.  There are a number of options when approaching and relieving neuropathic pain. These methods can be powerful and effective.  The following treatments are among the most common.

Topical creams, gels, solutions and patches. Many of these products contain menthol and menthol salicylate. These ingredients have a cooling and “numbing” effect that can dampen neuropathy symptoms. Some of the more effective topicals include, Nerve Health Relief Cream, Biofreeze and Sombra.   

Acetaminophen is the basic ingredient found in Tylenol and its many generic equivalents.  It is sold over the counter (OTC), in a prescription-strength preparation, and in combination with codeine (prescription).

Acupuncture dates back 2,500 years and involves the application of needles to precise points on the body.

Analgesic refers to the class of drugs that includes most painkillers, such as aspirin, acetaminophen, and ibuprofen.  The word analgesic means:  to reduce or stop pain.  OTC pain relievers are generally used for mild to moderate pain.  Prescription pain relievers are used for more moderate to severe pain.

Anticonvulsants are used for the treatment of seizure disorders but are also prescribed for pain.  Carbamazepine is used to treat a number of painful conditions, including trigeminal neuralgia.  Gabapentin (Neurontin) and pregabalin (Lyrica), is used for its pain-relieving properties as a treatment for neuropathic pain.

Antidepressants (psychotropic drugs) are sometimes used for the treatment of pain. A common drug in this category is Cymbalta is FDA approved for diabetic neuropathy.

Capsaicin is a chemical found in chili peppers that is also a primary ingredient in pain-relieving creams.
Cognitive-behavioral therapy involves a wide variety of coping skills and relaxation methods to help prepare for, and cope with pain.  

Electrical stimulation –including TENS including transcutaneous electrical stimulation (TENS), implanted electric nerve stimulation, and deep brain or spinal cord stimulation, is the nerves of muscles are subjected to a variety of stimuli, including heat or massage.  The following techniques each require specialized equipment and most require personnel trained in the specific procedure being used:

TENS uses tiny electrical pulses, delivered through the skin to nerve fibers, to cause changes in muscles, such as numbness or contractions.  This produces temporary pain relief.  There is also evidence that TENS can activate subsets of peripheral nerve fibers that can block pain transmission at the spinal cord level, in much the same way that shaking your hand can reduce pain.
Spinal cord stimulation uses electrodes surgically inserted within the epidural space of the spinal cord.  The patient is able to deliver a pulse of electricity to the spinal cord using a small box-like receiver and an antenna taped to the skin.
.

Light Therapy- Infrared and cold laser light therapy have been shown to be effective in some instances in relieving neuropathy discomfort. A popular home infrared device that is FDA cleared is the DPL Infrared Light Therapy.

Exercise has come to be a prescribed part of some doctors’ treatment regimes for patients with pain.  Because there is a known link between many types of chronic pain and tense, weak muscles, exercise—even light to moderate exercise such as walking or swimming—can contribute to an overall sense of well-being by improving blood and oxygen flow to muscles.  
Just as we know that stress contributes to pain, we also know that exercise, sleep, and relaxation can all help reduce stress, thereby helping to alleviate pain.  

Hypnosis continues to grow in popularity.  In general, hypnosis is used to control the amount of pain an individual can withstand.  How it works is not fully understood.  Hypnosis may deliver the patient into a trance-like state, the individual may simply better be able to concentrate and relax, may be more responsive to suggestion, or may result in relief of pain by acting on chemicals in the nervous system, slowing impulses.

 Nonsteroidal anti-inflammatory drugs (NSAIDs) (including aspirin and ibuprofen) are widely prescribed analgesics.  They work by reducing inflammatory responses in tissues.  Many irritate the stomach and are usually take with food.  Although acetaminophen may have some anti-inflammatory effects, it is generally distinguished from the traditional NSAIDs.

Opioids are derived from the poppy plant and are among the oldest drugs known to humankind. They include codeine and morphine.  Morphine can be administered in a variety of forms, including a pump for patient self-administered.