Symptoms can be mild to severe, but treatment usually helps. There are many different treatments, and you and your health care professional will decide which is best for you. Treatment options might include medications, therapies and procedures that involve surgery or implanted devices.
Your doctor will begin by taking a detailed medical history, asking questions about your symptoms and how they’ve changed over time. Bloodwork may help identify vitamin deficiencies, toxins, or endocrine diseases that can cause neuropathy. An ultrasound or CT scan of your spine or a magnetic resonance imaging (MRI) scan can look for herniated disks, spinal problems and other conditions that could be causing your symptoms. An electromyography (EMG) test measures the function of your nerves. For this test, your health care provider tapes flat electrodes to the skin over a muscle or group of muscles, then sends small electrical shocks through the nerves in the area. The results are recorded and analyzed to identify any abnormal nerve function.
If there isn’t a clear cause for your symptoms, your doctor might recommend watchful waiting or prescribe medicine to improve your symptoms. The pain relievers acetaminophen or NSAIDs might help. The antidepressants serotonin and norepinephrine reuptake inhibitors duloxetine (Cymbalta) and extended-release venlafaxine (Effexor XR) or desvenlafaxine (Pristiq) might also reduce your symptoms. These drugs work by interrupting faulty transmissions of pain signals to the brain.
Acupuncture or massage might relieve your symptoms by easing tension in the muscles. Your doctor might use these treatments along with cognitive behavioral or psychotherapy approaches that teach you coping techniques and change old beliefs about pain.
For some people, spinal-cord stimulators that send low levels of electricity into your spinal cord might help. These implanted devices might block painful nerve signals or replace them with nonpain ones.
Surgical procedures can treat certain neuropathies, such as herniated disks in the neck or back and tumors that compress nerves. Surgical technology is continually improving, and most surgeries are minimally invasive.
If a condition like diabetes or shingles has caused your neuropathy, treating it might reverse your symptoms and improve your quality of life. Some neuropathic pain is unreversible, but you and your health care provider might still be able to find ways to ease your symptoms and manage them. You might even be able to eliminate your symptoms entirely. Your doctor can suggest other strategies to help you cope with your neuropathic pain, such as exercise, stress reduction and complementary methods and techniques. These might include relaxation or meditation, yoga, tai chi and massage. They can help you improve your sleep and ease the discomfort from the pain, tingling and numbness.