- Pain from peripheral neuropathy can be treated with vitamins, medications,
diet and exercise
- Numb feet can be dangerous, so check them for cuts and sores
Regular pain medications usually don’t work for neuropathy pain
Numbness and pain are two sides of the same coin known as peripheral neuropathy
(PN). It may feel like arthritis pain, but the throbbing, burning or tingling
sensations in your hands or feet—whether they recur every now and
then or have crept up on you over the years—are unlikely to be helped
by an over-the-counter pain reliever or arthritis medication.
Dr. Johnson Moon, a neurology specialist at St. Joseph Health’s St. Jude Medical Center
says, “Pain medications like those used for joint pain generally
do not work for the pain from peripheral neuropathy.” That’s
because neuropathy is a form of nerve damage, while arthritis is a condition
that affects the joints. And that’s a difficult situation for the
20 million people in the U.S. who have some type of PN.
The human nervous system
The human body has two main parts to its nervous system: 1) The central
nervous system (CNS), meaning your brain and spinal cord, and 2) The peripheral
nervous system (PNS), which links the brain and spinal cord to the other
parts of your body, like the organs, skin, and muscles. Peripheral neuropathy
means there is damage in the peripheral system, and the messages going
to and from the CNS to points in the PNS are not working correctly. Either
too much ‘information’ (sensations of pain, heat, cold) or
too little information (numbness) can result.
Peripheral neuropathy is painful and dangerous
Damaged and ‘confused’ nerves do not operate correctly. For
instance, while you’re trying to sleep, a single bed sheet can feel
scratchy or even heavy. Many people with PN say they have worse neuropathic
pain at night than during the day, and they become unable to get a good
night’s sleep. The chronic pain often causes emotional difficulties
for the patient and their loved ones.
Damage to nerve endings in the autonomic nervous system (which controls
breathing, for instance) can lead to other problems like difficulty in
eating and swallowing, incontinence, constipation or diarrhea. When extremities
are numb, not being able to feel heat, cold or pain can invite burns,
frostbite, or undetected wounds which become infected.
often accompanies diabetes: 60% of people with PN have diabetes. Some 23% of people with PN have
no known cause, and the other 17% are either chemo-induced (10%), HIV/AIDs
(2%) related, or due to miscellaneous causes (5%). Diabetes and PN go
hand in hand because the high glucose associated with diabetes attacks
nerves and stops blood from flowing through them.
Alcohol may also be a risk factor. Dr. Moon says, “Excessive alcohol
use, even at a young age, can cause nerve damage that comes back later
in life.” Carpal tunnel syndrome from overuse of your wrists is
a form of PN. Advanced age and cancer are risk factors, too.
Pain and numbness are treated differently
Neuropathy pain may be reduced with medication or vitamins, but numbness
cannot be removed except by treating the underlying cause. Dr. Moon says
that no matter what the cause of the nerve damage, “pain treatment
for neuropathy patients varies. It could range from antidepressants to
seizure medicines, and from B-12 vitamins to folic acid and alpha lipoic
acid, depending on what works best for each individual.” Caution
must be exercised with prescription opioid pain medications, which can
easily become addictive.
Treating numbness requires a different approach. Dr. Moon says, “Numbness
is a negative symptom: the nerves are simply not working. To reverse the
numbness, the underlying cause of the PN must be treated. For example,
if you’ve got diabetes, you need to treat the diabetes; or, if you’ve
got low levels of vitamin B-12 or thyroid issues, those need to be addressed.”
Moon continues, “There are two dangers in numbness of the feet:
1) People can lose their balance and fall because they cannot feel their
feet, and 2) They may have open cuts or sores that don’t hurt because
they cannot feel the pain. Injuries can become bigger and even get infected
without the patient knowing it.” Muscle weakness from damaged nerves
connections between the brain and the muscles can also increase the risk
of falls and accidents.
It’s important for people with numbness in their feet to regularly
check for wounds or infection. This is a well-established part of self-care for
What’s the best way to find out if you have PN?
If your hands or feet are sensitive, painful, weak or numb, see your doctor.
Your primary care physician will talk with you about your symptoms, perform
a physical examination and may determine that you need to see a neurologist.
You may need some diagnostic tests (blood tests, neurological analyses,
etc.).The questions below are a partial listing from the
Foundation for PN that may be helpful as you prepare for your appointment.
- What is causing my symptoms?
- Are there certain types of tests that can determine what I have and the cause?
- Are the tests done in the hospital or doctor’s office and how long
will they take?
- Do the tests require any special preparation? What will the tests show?
- Will my insurance cover these tests?
- Is the condition temporary or permanent?
- What treatments are available and which are best for my condition? Are
there side effects? What if the medication/treatment does not work?
- How long will it take before the medication becomes effective?
- Are there any alternative medicines or procedures that I can do or take
along with the other prescribed medications?
- Would physical or occupational therapy help?
- What type of exercise do you recommend?
- Do I need to restrict any activities?
Relief is possible
Medications and lifestyle changes can be effective in treating neuropathy.
Dr. Moon says, “Some courses of treatment might be best for one
individual and not another. Make sure you get the proper diagnosis to
make sure you are treating the problem and underlying causes and managing
symptoms correctly and safely.” For many people, symptoms are eased
with exercise which can increase pain tolerance, take one’s mind
off the pain, and help the body’s blood vessels stay open, which
is essential for nerve health. Others find relief with vitamins or prescription
medications such anti-depressants or anti-seizure medicines. Dr. Moon
adds, “Along with any neuropathy treatment plan goes maintaining
a healthy diet, as nutrient-rich foods will help to both prevent the problem
and ease the symptoms, while also helping prevent or manage type 2 diabetes.
Finally, says Dr. Moon, “Peripheral neuropathy can be difficult to
diagnose because its symptoms can overlap or mimic those of other conditions.
See a doctor and/or neurologist to confirm the PN diagnosis and help you
manage any pain and numbness.”
Find a skilled St. Joseph Health physician
This information is not intended as a substitute for professional medical
care. Always follow your healthcare professional's instructions.