Treatment for peripheral neuropathy will depend on the underlying cause, but in most cases, treatment will consist of antidepressants such as amitriptyline, anticonvulsants, pain relievers such as oxycodone, anti-seizure medications, pain-relieving creams, physical therapy, surgery, or corticosteroid injections for. Certain tricyclic antidepressants, such as amitriptyline, doxepin (Silenor, Zonalon), and nortriptyline (Pamelor), have been found to help relieve pain by interfering with chemical processes in the brain and spinal cord that cause you to feel pain. The serotonin-norepinephrine reuptake inhibitor duloxetine (Cymbalta, Drizalma Sprinkle) and the extended-release antidepressants venlafaxine (Effexor XR) and desvenlafaxine (Pristiq) may also relieve the pain of peripheral neuropathy caused by diabetes. Side effects of antidepressants may include dry mouth, nausea, drowsiness, dizziness, changes in appetite, weight gain, and constipation.
Surgical treatment may be recommended for people with nerve damage due to nerve injury or compression. Mobility aids, such as a cane, walker, or wheelchair, may be helpful. For pain, the doctor may prescribe painkillers. SNRIs inhibit serotonin and norepinephrine reuptake at the synaptic level.
Duloxetine is the most effective in reducing neuropathic pain. Duloxetine and venlafaxine are associated with increased blood pressure and cardiac conduction disturbances and should therefore be used with caution in patients with heart disease. Opioids are widely used for the treatment of pain and inhibit nociceptive transmission through μ-presynaptic and postsynaptic opioid receptors. Tramadol is a µ opioid agonist, but it also has effects that may contribute to its analgesic properties in neuropathic pain, including inhibition of serotonin and norepinephrine reuptake.
Tapentadol is the only FDA-approved opioid for the treatment of neuropathic pain associated with diabetic peripheral neuropathy, 7 ACTs were found to be effective in the treatment of painful neuropathy, nerve injury pain, postherpetic neuralgia, central postpartum pain and in the treatment of pain posterior SCI. Talk to your doctor before trying these treatments if they might interfere with your ongoing treatment. Pregabalin (Lyrica), gabapentin (Neurontin), amitriptyline (except in older adults) or duloxetine (Cymbalta) should be used as a first-line treatment for painful diabetic peripheral neuropathy. They have investigated the analgesic effects of gastrodin, a bioactive constituent of traditional Chinese herbal medicine, on peripheral neuropathy induced by antitumor treatment with vincristine, a chemotherapy drug administered in the rat model of breast cancer.
The effective prognosis and treatment of peripheral neuropathy largely depends on the cause of nerve damage. Just as neuropathy (also called peripheral neuropathy) is not just a condition, nor is there a single treatment option that is best for all forms of this group of health problems. Physicians should carefully consider the patient's goals and functional status and possible adverse effects of medication when choosing a treatment for painful diabetic peripheral neuropathy. Early diagnosis and treatment of peripheral neuropathy is important, because peripheral nerves have a limited ability to regenerate and treatment can only stop progression, not reverse damage.
It is important to identify the type of pain reliever that works best to control the painful symptoms of peripheral neuropathy, that also works with your body chemistry, and complements other treatments. The study conducted by Kandhare AD and his colleagues showed the possible involvement of Azadirachta indica (IA), a tree of the Meliaceae family, in the treatment of PSNL-induced peripheral neuropathy. Ultimately, your treatment will be determined by the cause of the nerve damage, as well as the symptoms of neuropathy you develop. SCS can be considered a valid, effective and safe treatment option for patients suffering from neuropathic pain and resistant to drug treatment.