Patients who experience numbness and tingling from neuropathy should talk to their doctor. Generally, neuropathy isn’t dangerous, but it can be disruptive to daily activities.
Your healthcare professional will take a full medical history and do a physical exam. This will include checking your tendon reflexes, strength and tone, balance, posture, coordination and family history of diseases affecting the nervous system.
Physical Therapy
When you visit your healthcare provider, they’ll ask about the symptoms you have and take a medical history. They may order a physical and a neurological exam to look for the cause of the neuropathy. They may also order a nerve and muscle ultrasound, which is an experimental way to scan muscles and nerves for signs of damage like severed or compressed nerves. They’ll do blood tests to check for diabetes, vitamin deficiencies, liver and kidney dysfunction, infections, metabolic disorders, and immune system problems. They might also order a DNA test for certain hereditary neuropathies.
Most types of peripheral neuropathy occur when sensory nerves, motor nerves, or autonomic nerves are damaged. NYU Langone neurologists can prescribe medications to relieve the pain caused by these conditions. They can include antidepressants, opiate drugs, or, in some cases, topical treatments such as lidocaine. Medications to treat the pain vary by which type of nerves are affected and the severity of the neuropathy.
Pain Medication
Pain medication is an important part of treatment, especially if your nerves are damaged. Your doctor may recommend antidepressants that also relieve pain, such as duloxetine (Cymbalta). Anti-seizure medicines, such as pregabalin (Lyrica), can reduce nerve pain. They act by blocking the activity of chemicals that send pain signals to your brain.
A doctor will check your blood and body fluids for signs of diseases that can affect the nervous system, including diabetes, vitamin deficiencies, liver and kidney problems, infections and other metabolic disorders. Blood tests can detect abnormal proteins, antibodies and other factors that may lead to peripheral neuropathies.
Many underlying conditions can be treated to improve or prevent neuropathy, such as controlling diabetes and avoiding exposure to harmful substances. If your neuropathic pain is caused by compression of a specific nerve, you can avoid the cause, such as not leaning on an elbow (ulnar neuropathy). Your doctor may prescribe pain medicines to ease neuropathic pain or other symptoms.
Acupuncture
Acupuncture involves placing sterile needles into specific points on the body to stimulate key areas that can reduce pain and discomfort. Other complementary and alternative therapies such as massage therapy and meditation can also help reduce nerve pain.
A number of things can cause neuropathy, including physical injury, diabetes, and chemotherapy drugs. Some conditions such as kidney and liver disorders can cause high levels of toxic substances in the blood that can damage nerve tissue. Vitamin deficiencies and certain medications can also cause neuropathy, such as neuropathic pain drugs or some anti-seizure medicines.
Symptoms of peripheral neuropathy therapy depend on the type and extent of damage to the nerve fibers, which are outside the spinal cord and brain. Some neuropathies affect a single nerve (mononeuropathy). Others are more widespread and have been diagnosed as polyneuropathy. Surgery can relieve some conditions that affect a single nerve, such as protruding disks that compress the nerves in the back or neck, or tumors that compress the nerves in the arms or legs. However, cutting the affected nerves to reduce pain can actually make symptoms worse, because nerve cells above where the cut occur continue to generate painful signals.
Surgery
Surgical procedures may help with some conditions that cause peripheral neuropathy. For example, protruding disks in the back or neck that compress nerve roots can be corrected with surgery. Nerve surgery may also be an option for those with mononeuropathies that result from injury or entrapment of one particular nerve. However, cutting or injuring a nerve is not recommended because it worsens the condition and can leave you with chronic neuropathic pain and weakness (known as phantom pain).
Blood tests can check your blood sugar, vitamin levels, liver function, kidney functions and other body fluids for problems that can lead to neuropathy, such as diabetes, metabolic syndrome, vitamin deficiencies and infections. Blood tests can also reveal certain inherited disorders, such as Fabry disease and familial amyloidosis.
Electromyography and nerve conduction velocity tests measure the electrical activity in your muscles and nerves. Skin biopsies allow specialists to examine small fiber neuropathies that don’t show up on standard tests. A lumbar puncture (spinal tap) or CT scan of the spine can show herniated disks, spinal stenosis and tumors that affect nerves. Muscle ultrasound can detect muscle and nerve damage, including a compressed nerve.
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