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Peripheral Neuropathy: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Peripheral neuropathy is the disorder of peripheral nervous system that connects the nerves from the central nervous system (CNS) to the parts of your body such as arms, feet, mouth, legs, hands, face, mouth and internal organs. These nerves are responsible for delivering signals from these parts back to the CNS. These nerves get damaged due to some inherited disorder, or an injury, or a systemic illness or even due to an infection thereby disrupting the normal functioning of the nerves. Treatments for peripheral neuropathy can prove to be pretty helpful. It mainly deals with managing the conditions causing the neuropathy therefore alleviating the symptoms. So, the first step in treating peripheral neuropathy is to find out the cause. Treatments can involve physical therapy, surgery or injections to correct nerve entrapment, improvement of autoimmune diseases, correction of vitamin deficiencies, controlling Diabetes mellitus, minimizing progressing of shingles to postherpetic neuralgia by speedy treatment. So, treatments include medications that use topical treatments, antidepressants, anti-seizure medications and pain relievers. Therapies involve surgery, plasma exchange and intravenous immune globulin, physical therapy and transcutaneous electrical nerve stimulation (TENS). Peripheral neuropathy patients can also manage their symptoms using home remedies and modifications in lifestyle. These habits would include quitting smoking, avoiding excessive alcohol, exercising regularly, taking care of your feet if you suffer from diabetes, eating healthy meals and routine monitoring of blood glucose levels. For treating peripheral neuropathy some people may also like to go for some alternative treatments which may not have been proven by researchers but are found effective on many. Some of such treatments are with alpha-lipoic acid having its roots in Europe, acupuncture, amino acids and certain herbs

How is the treatment done?

There are several treatments available that alleviate the symptoms of peripheral neuropathy. Medications used for treating as well as relieving peripheral neuropathy symptoms embrace certain antidepressants like nortriptyline, amitriptyline and doxepin. These drugs lessen pain by obstructing the chemical processes in your Central Nervous System. Your doctor can also treat you with other extended-release antidepressants like venlafaxine (Effexor XR) to relieve your diabetes induced peripheral neuropathy pain. Pregabalin (Lyrica), gabapentin (Neurontin) and carbamazepine (Tegretol) medications used for treating epilepsy are anti-seizure drugs that help in alleviating nerve pain. Your physician might prescribe you over-the-counter medications like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs such as ibuprofen and aspirin for controlling moderate pain.Oxycodon (Oxytonin, Roxicodon), opoids or tramadol (Ultram) too are used for controlling peripheral neuropathy related pain in case failure of other treatments. Capsaicin is an over-the-counter cream used to ease peripheral neuropathy pain and 8% of it can also be used to treat postherpetic neuralgia. For the treatment of diabetic peripheral neuropathy, the drug duloxetine (Cymbalta) is very effective. The therapies that help ease the symptoms and signs of the disease are surgery which can be carried out in case there is any pressure on your nerves like that due to tumours. People suffering with inflammatory conditions can be treated by suppressing their immune system with the help of plasma exchange and intravenous immune globulin procedures. Transcutaneous electrical nerve stimulation (TENS) is another procedure wherein electrodes are placed on your skin to send small vibrations of electricity into the same to mess up the transmission of pain signals from nerves to the CNS. Physical therapy helps in all kinds of movement if there is muscle weakness. Other treatments like use of certain herbs and amino acids along with regular exercise and healthy lifestyle can reduce neuropathy pain.

Who is eligible for the treatment? (When is the treatment done?)

When you start feeling weakness and pain in your muscles or limbs and notice a peculiar tingling you must go in for a check-up for peripheral neuropathy. People with autoimmune diseases like rheumatoid arthritis, lupus, Guillain-Barre syndrome, necrotising vasculitis and Sjogren’s syndrome etc. are also prone to peripheral neuropathy. Pressure on nerves due to tumour or accidents, injuries or even by repeated activity of typing on your type-writer or computer can cause this severe disease. People with diabetes mellitus, hepatitis C, diphtheria or HIV infections, alcoholism or hereditary diseases like Charcot-Marie-Tooth are also likely to pick up peripheral neuropathy

Who is not eligible for the treatment?

People who are not affected by diseases like diabetes mellitus or the autoimmune diseases, or severe infections like HIV and leprosy, tumour affecting the nerves, vitamin deficiencies. Hypothyroidism, bone cancer or lymphoma or genetic diseases, stay away from getting peripheral neuropathy. Also, if you keep your blood glucose level under control, abstain from alcoholism, take proper vitamin supplements, avoid or take precautions from toxic exposure and follow a healthy life style, you can keep peripheral neuropathy at bay.

Are there any side effects?

Medication using pain relievers can cause drug dependence and addiction which of course is worrisome for patients in long terms. Topical treatments cause irritation and skin burning on application of the cream, can also cause dizziness, numbness and drowsiness at the affected area. Side effects of antidepressants can be drowsiness, nausea, dizziness, dry mouth, constipation and diminished appetite. Treatment with some alternative medicines like alpha-lipoic acid can cause skin rash and upset stomach, some herbs are also prone to get reacted with certain medications hence, discussion with doctor is suggested and amino acids as alternative medicines can also bring on side effects like vomiting and nausea.

What are the post-treatment guidelines?

After you are done with your treatments it is important to take care that the disease does not recur. For that you need to follow a very healthy daily routine which would include regular exercise like yoga, a healthy diet including several vitamin supplements, fruits, green vegetables, lean protein and whole grains, regular monitoring of blood glucose levels, keeping body weight under check, also check for calluses, cuts or blisters. You can get vitamin B-12 from meats, eggs, fish, fortified cereals and low-fat dairy products. Avoiding toxicity exposure, alcoholism, smoking, cramped positions, repetitive motions, massage, chiropractic care, meditation, clean feet or other practising self-care habits can prevent you from peripheral neuropathy.

How long does it take to recover?

After the treatment, the symptoms often start resolving in 6-12 months and in some people they can extend for a longer time and may become permanent too.

What is the price of the treatment in India?

The drugs for neuropathy treatment in India are undoubtedly effective and safe but they are quite costly and hence, can be difficult for the poorer section to get treated. Consultation for peripheral neuropathy in India can cost you somewhere around Rs. 300 to Rs. 3000. There are other costs like physiotherapy, acupuncture and TENS may be around Rs. 400 to Rs. 1050. Then there are medications doxepin drugs that come in different quantities and their price may range from Rs.15 to Rs.50. 4 injections of therapeutic plasma exchange in India can cost about Rs 1.2 to Rs. 1.5 lakhs. Intravenous immunoglobulin in India can cost around Rs. 1.5 lakh for a five day regime.

Are the results of the treatment permanent?

The results of peripheral neuropathy treatment can be permanent but sometimes some disorder can relapse. The treatments for peripheral neuropathy are just for alleviation of the symptoms than their complete eradication.

What are the alternatives to the treatment?

There are alternative medicines used to treat peripheral neuropathy which, though have not been studied by researchers, but prove beneficial on patients. Amino acids like acetyl-L-carnitine, some herbal supplements like primrose oil and St. John’s Wort, acupuncture and lifestyle changes like regular work-outs, eating healthy, quitting smoking, avoiding excess alcohol and monitoring blood sugar level help alleviate peripheral neuropathy.

Popular Questions & Answers

My mom is 70 years and has been taking pregabalin & methyl cobalamin 75/750 mg and gabapentin 400 mg with nortryptline 10 mg together for almost 12 years for diabetic neuropathy. Is it ok to stop any on of the medications like for like alternative days initially and eventually increase the gap. Which one should she stop if she decides to stop any one of it? Please advise.

MBBS, CCEBDM, Diploma in Diabetology, Diploma in Clinical Nutrition & Dietetics, Cetificate Course In Thyroid Disorders Management (CCMTD)
Endocrinologist, Dharwad
Hello, thanks for the query. I have seen the details mentioned. Please understand that diabetic neuropathy is a long term complication of diabetes. Therefore, unless blood glucose are in strict control, just taking other medications will not give ...
1 person found this helpful

I am almost 41. About 2 months ago I started having trouble swallowing solids. 6 weeks ago I had an anterior cervical discectomy with spinal fusion and since after the surgery I was struggling with even liquids that has gotten better and I can swallow some very soft solids however I take 3 spoonfuls or sips of something and feel bloated and uncontrollably full for hours. I alternate between diarrhea and constipation. I have frequent uti’s diabetic neuropathy, general fatigue. A few months ago I had what I think was a canker sore under my tongue all the way in the back together with an earache also on the left side and it took a month for it to go away I have the exact same thing in the exact same spot also with an earache on the same side x 10 days, medication for sore not helping hurts when I swallow. I also have not been able to regulate my body temperature for a while. For a few weeks I was sweating profusely but since my surgery i’ve been constantly freezing and about a week ago I started having cold sweats again. I’m either sweating, freezing or both at the same time and it changes from minute to minute. It was suggested that I may have autonomic neuropathy. I’m a breast and ovarian cancer survivor 3 1/2 years in remission. I receive botox injections for migraines every 90 days. I also have severe gerd but no heartburn that’s all I can think of off the top of my head.

ENT Specialist, Srinagar
You have basically gluten sensitivity to gluten allergy of gut and resistant iron deficiency anemia causing dysphagia. I want to see you and consult on mobile.

Hello sir I have severe pain in neck, spine entire sternum. I have been diagnosed with sero negative ra, fibromyglia and taken many medicines but pain comes back when I stop the course. I want to consult with you and request for help. Thank you minakshi roy.

Erasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPT
Physiotherapist, Chennai
Hydrotherapy hydrotherapy is the practice of using water to relieve aching muscles. Simply soak in a tub full of warm water (not hot as it can cause your blood pressure to drop). You can add essential oils or epsom salts to help relieve pain. A wa...

I am 70 years old with diabetes for last 22yrsi have been taking pregabalin 75, 2 capsules a day for last 13 yrs. Recently I am experiencing stomach ache and fatigue. Pl advise. Rama devi hyd.

Diabetologist, Hyderabad
buscogast 10mg మూడు సార్లు ఏస్కోండి తగ్గకుంటే డాక్టర్ దగ్గరరికి వెళ్ళండి

Hello doctor I have been taking afoglip m 500 mg in the morning after breakfast and carbophage 1000xr in the night for 7 years. Then last whole year with diet and exercise I slowly came off these medications was only taking carbophage xr 250 mg in the night past 3 months. Last month my hba1c was 6.9 and fasting 110, so now I have been taking carbophage xr 500 mg last 3 weeks now my fasting is 109 and 2 hrs pp after lunch or dinner is 170. Besides I have developed some numbness, tingling pain in feet .can you please suggest what I can do any medicine to take lower sugar.

MBBS, CCEBDM, Diploma in Diabetology, Diploma in Clinical Nutrition & Dietetics, Cetificate Course In Thyroid Disorders Management (CCMTD)
Endocrinologist, Dharwad
Hello, thanks for the query. Madam, I have gone through the details mentioned. It is good to know you have been able to control the glucose levels better since some time. The levels mentioned (fasting & pp) are quite good so is the hba1c%. As rega...
1 person found this helpful
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