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There is a large variety of treatment options available for peripheral neuropathy. Some are more successful than others and some are dependent on the causes and type of neuropathy being treated.

Treatments can be broken down into a few broad categories; pharmaceuticals, surgery and alternative medicine.

Topical medications that one can apply to their skin such as Zostrix, Capsaicin, Biofreeze can offer relief but often the relief wears off after long term use. These medications, which are numerous only offer symptomatic relief. They are good for early symptoms or for adjunctive therapy in addition to oral medications.

Oral medications can be categorized into prescription, over the counter or supplemental.   Many of the over the counter medications and vitamin supplementations have little or no scientific evidence but are often taken by patients in an attempt to relieve pain. Examples are Evening Primrose Oil, Grape Seed Extract, Vitamin B6 and B12.

Prescription supplemental medications do have some scientific studies or journal articles studying their use and can be of benefit for many patients. Examples are Metanx and Foltx tablets. These are prescription products you must obtain from a physician. These mediations help relieve pain but also attempt to treat the underlying cause by altering biochemistry within the nerve.  In my opinion (Dr. Still) Metanx has shown to be an excellent medication. It is well tolerated and effective in helping many patients get some feeling back and it can reduce pain.  I would estimate that 2/3 of the patients that receive Metanx and take it at a dose of 2 tablets/day benefit in some way.  Currently, the only drawback to Metanx is that many insurance companies do not cover it.  I look at this medication as just important as any other for a patient with peripheral neuropathy.  Especially for patients with diabetes that are taking Metformin for their glucose control.  Metformin can actually deplete a patients' important enzymes in vitamin B metabolism,  Metanx helps supplement these enzymes for those patients.  Metanx can take anywhere from 1 week to four months to show benefit from the time a patient starts taking it.  Again, it does not always help but with virtually no side effects why would a patient with peripheral neuropathy not try this medication.  If a pharmacist or another physician calls Metanx a "vitamin" then they simply don't know the complex chemistry of this medication.  Do not accept substitutes for this medication, they are not as effective.  I would also like to point out I am not paid in any way or endorsed by the makers of the medication - Pamlab pharmaceuticals - I just know it works most of the time.  In scientifically based studies Metanx has been shown to increase epidermal nerve fiber density, which may lead to improved sensation and a decrease in numbness.

Other oral prescriptions are numerous and can have varying affects and relief of pain. None of them offer a cure, they are for symptomatic relief. Examples are Lyrica, Cymbalta, Neuronntin (Gabapentin), Ellavil (Amittryptiline), Effexor, Nortryptiline, Tegretol (Carbamezepine).  Lyrica is now one of the more widely used medications and is effective in pain relief.  Neurontin (Gabapentin) is also a very commonly used medication.  Dr. Still is a sponsored speaker for Pfizer pharmaceuticals and lectures on Lyrica to physicians.

Another product that is available for patients with neuropathy is Nutri-Nerve.  This is a medical food supplement and can be obtained by calling the company that distributes it at (800) 344-9993 for more infomation.

This is described on the Nerve Testing & Surgery Page.

These treatment options consist of acupuncture, massage, anodyne therapy, infrared light therapy, magnet therapy and more. Some of these methods have a scientific basis behind them and others simply offer pain relief temporarily with anecdotal evidence. There are many alternative treatment options that patient can pursue. However, one is encouraged to not fall for gimmicks or scams and evaluate the treatment with common sense and ask other patients that may have undergone that treatment before how effective it was.

MASSAGE AND ACUPUNCTURE : My recommended massage therapy practice is Absolute Health Massage Therapy (www.absolutehealthmassagetherapy.com) operating out of Arvada Olde Town Acupuncture and Wellness Center.  Ask for Rachel Duran, CMT.   Arvada Olde Town Acupuncture and Wellness Center (www.oldetownacu.com) is also my preferred practice for acupuncture.  Both can be reached at (720) 898-9552.