Peripheral Neuropathy Pain Management: Dealing With The Condition

Affecting nearly 2.5% of the world population, nerve pain is certainly widespread; however, because of its “invisible” nature, it is often not well understood, diagnosed, or treated. 

But just because the pain, distress, and abnormal sensations are not immediately noticeable to others, it does not mean that nerve pain isn’t serious or life-changing.

It is important to educate yourself about the causes and symptoms of neuropathy and look for a pain management strategy that is sustainable and efficient in the long term. 

With Relatyv’s Neurofunctional Pain Management approach, individuals with peripheral neuropathy today have an alternative option to deal with their condition that does not rely on medications or surgery. Let’s take a look at how these treatment options for peripheral neuropathy can help.

What Is Peripheral Neuropathy?

Simply, peripheral neuropathy refers to damage to the nerves in the peripheral nervous system (PNS), which are the nerves that lie outside of the brain and the spinal cord. 

There are three types of nerves in the PNS:

• Motor nerves – Motor nerves are the ones controlling the movement of muscles and are responsible for carrying movement-related signals to the brain. 
• Sensory nerves – Sensory nerves transmit signals relating to sensations to the brain, which include touch, temperature, and vibration. A high concentration of these nerve fibers can be found in the skin of the fingertips and palms.
• Autonomic nerves – Autonomic nerves are responsible for managing body functions we don’t have direct control over, such as breathing, digesting, and sweating. 

When these nerves become damaged, motor, sensory, and autonomic signals are unable to reach the brain, thus leading to a cascade of symptoms, including numbness, extreme sensitivity to touch, and spasms. In severe cases, this can lead to muscle atrophy, erratic heartbeat, digestive problems, and loss of bladder or bowel control. 

Nerve damage can affect a single nerve (mononeuropathy) or multiple nerves in different areas of the body (polyneuropathy), and there are over 100 forms of neuropathy. Depending on what nerves the damage extends to, a patient might experience different neuropathic pain.

What Causes Peripheral Neuropathy?

While it sometimes manifests as a lack of sensitivity and numbness, peripheral neuropathy is most commonly a condition of burning, tingling, and stabbing pain that fires on the peripheral nervous system. Patients who experience the pains of peripheral neuropathy explain that there is a burning or irritating sensation in the fingers, hands, toes, and feet. While this pain can vary between a light tingling and an intense burning; however, it is ultimately the loss of function and quality of life that affects patients the most, such as loss of balance and reduced quality of sleep or lack of sleep altogether due to ongoing neuropathy pain. 

Loss of function can lead to loss of balance when peripheral neuropathy exhibits in the feet. This can be especially dangerous the older the patients get and the longer their type 2 diabetes goes untreated – the most common cause of peripheral neuropathy. However, patients aren’t always as concerned with the cause of their condition as they are with the solution for treatment.

Understanding The Types Of Pain Caused By Peripheral Neuropathy

With over 7 trillion nerve endings present in the human body that can potentially become damaged, it is easy to see why neuropathy can manifest itself with a variety of different symptoms. 

Nonetheless, understanding how neuropathy can affect your body is the first step to accurately diagnosing nerve pain, uncovering the underlying causes of this condition, and finding a suitable treatment program. Let’s start by looking at the common consequences of nerve pain below.

Burning Pain

Burning pain, especially in the hands and feet, is one of the most common symptoms of neuropathy. Burning sensations are a result of damaged nerve endings in the epidermis (skin), which can become overactive and send improper signals to the brain. 

Nerve damage to sensory nerves (sensory neuropathy) is one of the leading causes of burning feet.

Paresthesia Pain

People with neuropathy often describe their pain as tingling, prickling, or “pins and needles” sensations. These manifestations of neuropathy fall under the category of paresthesia pain, which is caused by improper nerve signaling. This is due to abnormalities or damage to the pathway that connects a peripheral nerve to the brain’s sensory cortex.

Hyperaesthesia

Hyperesthesia refers to the hypersensitivity to touch caused by damaged sensory nerves that become overactive and begin to send improper pain, touch, and temperature signals to the brain. Although this might not directly lead to pain, hyperesthesia can cause you to experience an excessive perception of stimuli. 

For example, you might begin to experience discomfort when the bed sheets are touching your skin at nighttime. This can make it difficult to fall asleep and can lead to sleep disturbances. 

It is also important to note that neuropathy can cause the opposite of hyperesthesia as well, which is hypoalgesia. Hypoalgesia – or the reduced ability to feel pain – can lead to some of the most severe complications of neuropathy. Indeed, if you are unable to feel pain, you might let an infected wound go untreated, which can cause ulcers and gangrene, or inadvertently expose your skin to excessive heat or cold.

Allodynia Pain

Allodynia is a form of hyperesthesia that causes you to experience excessive pain in response to stimuli that should be painless or only cause mild sensations. This is due to sensory nerves becoming damaged and misfiring, thus sending improper signals to the brain. 

If you have allodynia pain, daily actions such as brushing your teeth or holding a cup can cause severe pain. This type of pain affects 15-20% of patients with neuropathy.

Managing Complications Of Peripheral Neuropathy

When it comes to peripheral neuropathy, patients should carefully explain the nature and symptoms of their condition to their doctor and confirm a diagnosis before seeking treatment. Once a confirmed diagnosis has been reached, patients are often presented with various treatment options. However, according to Maher R. Khdour in the Journal of Pharmacy and Pharmacology published in February 2020, “ . . . peripheral neuropathy is often inadequately treated.” Khdour also raises the concern that “. . . neuropathy is a highly prevalent, disabling condition, the management of which is associated with significant costs.” While insulin levels will balance out with the level of blood sugar if patients are careful, patients may also wonder what steps they can take in managing the complications associated with peripheral neuropathy.  

Khdour continues to list some of these treatments, which include “the use of specific anticonvulsants and antidepressants for pain management in patients with diabetic peripheral neuropathy” (2020). Medications of all sorts are a known cause of peripheral neuropathy. Often, a regimen of medications taken by a patient with type 2 diabetes may be partially to blame for the persistent neuropathy. Some patients may also choose to undergo expensive surgery to address the pain.

Traditional Methods Of Relieving Neuropathy Pain

The complexity of the nervous system, coupled with the existence of over 100 forms of neuropathy, makes treating nerve pain a clinical challenge. Because of this, most healthcare providers and patients resort to traditional treatments such as over-the-counter medicines, massages, and topical creams. 

Although these treatment options might be a suitable short-term solution for neuropathic pain, patients need to be aware of the full picture. Below, we’ll look at the most commonly prescribed traditional methods of relieving neuropathy pain and their implications.

Over-The-Counter Medications

Over-the-counter medications for neuropathy include painkillers (such as acetaminophen) and nonsteroidal anti-inflammatory drugs (such as Ibuprofen).

These medications are accessible and affordable, and they might be effective in temporarily reducing the pain you experience. However, they don’t come without side effects. 

Some complications of pain relievers patients should be aware of include:

• Digestive issues, constipation, and nausea
• Fatigue and headaches
• Blurred vision
• Dry mouth 
• Sleep disturbances
• Increased risk of heart attacks and strokes
• Increased risk of gastrointestinal ulcers and bleeding
• Kidney malfunction and failure

If taken over long periods, NSAIDs and painkillers can also lead to dependency.

Topical Creams, Balms, Rubs, And Gels

Topical creams can help adults with peripheral neuropathy caused by diabetes or with nerve pain deriving from the complications of shingles. In particular, capsaicin (the active component in chili peppers) cream can help provide long-lasting desensitization of the local nerve endings, thus stopping pain signals from traveling to the brain.

Other rubs, gels, balms, and sprays that can reduce nerve pain include:

• Counterirritants containing menthol or camphor
• Topical forms of nonsteroidal anti-inflammatory drugs
• Lidocaine creams
• Topical salicylates (the active compound in aspirin)

Physical Therapy And Massage Therapy

Massage therapy can help temporarily decrease the pain associated with nerve damage by relaxing the muscles and easing the pressure on damaged nerves. Additionally, massage techniques that include light stroking, gliding, and vibration can boost blood circulation in the areas affected by nerve pain, which can help regenerate damaged tissues and promote healing. 

Studies conducted in 2020 also show that foot massages can ease burning sensations, boost relaxation, and improve sleep quality in patients with hyperesthesia.

Acupuncture

Acupuncture is an alternative therapy that involves inserting small needles into the body’s pressure points. It can help with neuropathic pain by stimulating the nervous system, but it also has other benefits, including:

• Stimulating the blood flow in the area affected by peripheral neuropathy, thus promoting nerve regeneration.
• Triggering the release of endorphins, which are the body’s natural painkillers. 

A pilot study conducted in 2017 showed that acupuncture might be beneficial to improve nerve conduction (how fast electrical impulses travel through the nerves). 76% of the study’s participants also reported a reduction in nerve pain.

Herbal Supplements

As seen above, neuropathy can be caused by certain nutritional deficiencies. In these cases, patients might benefit from incorporating some supplements into their diet to support nerve regeneration, provide pain relief, help control blood sugar levels, and relieve inflammation. 

These supplements include:

• B vitamins such as B12, B1, and B6
• Antioxidants such as alpha-lipoic acid
• Amino acids such as acetyl-L-carnitine and n-acetyl cysteine
• Natural extracts such as fish oil and curcumin (turmeric)

Opioid Drugs (Morphine Derivatives)

Opioid drugs such as oxycodone can be used to treat the symptoms of neuropathy when other treatments have failed. In a study conducted in 2021, nearly 44% of patients who received a diagnosis of neuropathy between 2014 and 2018 were prescribed opioids as part of their therapy. 

Although opioids might help patients with neuropathy find relief from their pain in the short term, they can lead to a cascade of complications, including addiction, drowsiness, euphoria, constipation, and slowed breathing.

Drawbacks Of Using Traditional Methods In Managing Neuropathy

Most of the traditional methods for managing neuropathic pain are symptomatic, which means that they don’t have curative or disease-modifying effects. This means that they don’t address the underlying cause of neuropathy. 

What’s more, not all treatments are equally effective for all patients, who will need to go through trial-and-error, multiple lines of treatments, and steep care costs. Here are just some of the downsides of choosing the treatment options seen above.

1. Inaccurate Diagnosis

For most patients and healthcare providers, the priority is to address the pain deriving from nerve damage. However, often, the underlying reason for this condition is left untreated. This not only makes the chosen line of treatment inefficient, but it can also lead to severe complications if another disease goes unaddressed. 

For example, if neuropathy is caused by undiagnosed diabetes, simply treating the symptoms of nerve pain can expose a patient to complications linked to inadequately managed blood sugar levels, including ulcers, chronic kidney disease, and retinopathy.

2. Costly Treatments

Undergoing multiple lines of treatment can be extremely costly for patients. In a 2019 review, patients with peripheral neuropathy paid an average of $23,183 for the first line of therapy and $37,880 for the second line of therapy. 

Given the impact that nerve pain therapies can have on a person’s financial life, it is crucial for healthcare providers to avoid the trial-and-error phase where possible.

3. Time-Consuming Process

Neuropathy is a neurodegenerative disease, meaning that, if left untreated, it will progressively cause the death of more and more nerve fibers. Because of this, it is important for patients to find an effective treatment option in the shortest amount of time possible. 

Although doctors commonly prescribe one medication after another until one is found effective, obtaining an accurate diagnosis should be the first step to treating peripheral neuropathy.

4. Low Success Rates

Although there are several pharmaceutical treatment options for neuropathic pain, the benefits that these bring are limited and subjective. 

A 2021 trial comparing the efficacy of neuropathy medications showed that the most efficient treatment (nortriptyline, a type of antidepressant) only improved symptoms by 50% in a quarter of patients. The other drugs in the comparison (duloxetine, mexiletine, and pregabalin) were even less efficient and caused significant side effects.

5. Risk Of Side Effects

Undergoing several lines of treatment can expose patients to significant side effects, including dependency in the case of NSAIDs and opioids. Additionally, medications and herbal supplements can interact with one another and affect the efficiency of other drugs. 

For example, in people at risk of heart problems, taking NSAIDs for nerve pain can increase the risk of myocardial infarction.

6. Limited Knowledge And Expertise

Although therapies such as NSAIDs, massage therapy, acupuncture, and herbal supplements are readily available and affordable, patients lack the knowledge and expertise to use these treatments effectively.

7. Lack Of Personalization

No one treatment is equally effective for all patients with neuropathy, mostly because this condition can be caused by a range of risk factors and manifest itself with a variety of symptoms. 

Nonetheless, traditional treatment options tend to be a “one-size-fits-all” approach, which does not take into account the individual needs of a patient, such as existing health conditions, lifestyle factors, and health goals.

Coping With Emotional Effects Of Living With PN: Managing Stress & Anxiety

Living with peripheral neuropathy can have a profound impact on a person’s mental and emotional health. Experiencing debilitating pain can cause a loss of productivity, missed days at work, reduced wages, social withdrawal, and inhibited mobility. And, because of this, it isn’t surprising that, according to a 2020 study, around 65% of people with neuropathy suffer from depression, and 73% of those with nerve pain battle severe anxiety. 

While consulting a specialized mental health professional should always be the first port of call, there are some other complementary strategies you can use to manage the stress and anxiety arising from peripheral neuropathy:

• Use massage therapy to ease the pain in the hands and feet and boost the release of feel-good hormones such as endorphins. 
• Practice relaxation techniques such as meditation, yoga, breathing exercises, and body scans. 
• Improve your bedtime routine to better cope with the sleep disturbances deriving from nerve pain. 
• Find support from others who are struggling with nerve pain.
• Be open about your condition and concerns with your loved ones. 

When it comes down to managing and coping with neuropathy, a critical role is played by the treatment option you have chosen. Educating yourself about the treatment options available and partnering with a specialist can help you maintain hope and find the most efficient solution for your needs.

Lifestyle Changes to Mitigate Peripheral Neuropathy Pain

Your lifestyle choices can have a profound impact on your ability to contain nerve damage, avoid the complications of neuropathy, and improve your nerves’ functionality. 

Some steps that you can take to better cope with neuropathy and improve your overall health include:

• Exercise regularly – Not only does exercise trigger the release of pain-relieving endorphins, but it also improves muscle strength and boosts circulation. This can counteract the negative effects of nerve damage on the muscles and improve the supply of oxygen and nutrients to damaged nerves. 
• Improve your diet – A well-balanced diet can help improve how you feel mentally and physically, and it can also help you manage conditions such as diabetes and obesity, which are risk factors for neuropathy. Additionally, supplementing B vitamins, introducing healthy fats, avoiding gluten, and eating more fruits and vegetables can help you avoid nutritional deficiencies, improve nutrient absorption, and boost your musculoskeletal system. 
• Reduce alcohol and nicotine intake – As seen above, alcohol and nicotine can have neurotoxic effects. Avoid further damage to your nerves by quitting smoking and reducing your alcohol intake. 
• Improve your personal care routine – Several of the complications deriving from neuropathy can be avoided with a thorough personal care regime. For example, consider checking your feet for wounds and infections to avoid ulcers, and massaging your hands and feet to improve circulation in the areas affected by neuropathy.

When looking to modify your lifestyle to ease the pain deriving from neuropathy, it is essential to work with a specialized lifestyle counselor who can help you design a nutritional and exercise routine for your health needs and goals.

When to Seek Medical Care for Uncontrollable Peripheral Neuropathy Pain

Neuropathy can have a unique impact on a person’s life. For some, the numbness and tingling sensations are temporary side effects of health events, such as undergoing chemotherapy. However, for others, peripheral neuropathy can be a debilitating or disabling condition. 

If you have noticed that your nerve pain is interfering with your daily activities, you should not think twice about seeking medical care as soon as possible. Obtaining an accurate diagnosis and selecting an appropriate treatment option can help you limit the consequences of peripheral neuropathy and, in some cases, reverse nerve damage. 

Be sure to look beyond traditional treatment options, and select a therapy that is designed around your needs, medical history, and goals with the help of Relatyv – let’s look at how Neurofunctional Pain Management can help below.

Live A Pain-free Life With Relatyv

For patients seeking treatment for peripheral neuropathy when the affected areas are numb, the use of traditional medications would seem counterintuitive. However, solutions for peripheral neuropathy may be both simple and lasting– especially when considering a solution with Relatyv.

Relatyv uses a proprietary Neurofunctional Pain Management treatment program that may effectively relieve pain, restore health, and magnify the quality of life for patients suffering from chronic peripheral neuropathy and its symptoms.

Neurofunctional Pain Management is a combination of high-pulse electrical stimulation and specialized hydration therapy that enhances the pain relief effect while also balancing and restoring health for patients in the Neurofunctional Pain Management program. Many patients report relief of pain and increases in function and quality of life after just one treatment. Many patients also report substantially long periods of pain relief after completing a full course of Neurofunctional Pain Management therapy that can endure for many months to over a year of pain relief without medications, surgeries, or invasive procedures. Neurofunctional Pain Management is the next generation of pain management. 

Patients who experience these sessions of pain treatment will tell you that they wish they had started sooner and that they had not put off such an effective and long-lasting treatment. Relatyv is on a mission to bring effective and lasting pain relief to millions of patients suffering from chronic pain across the nation. Our mission is to relieve pain, restore health, and magnify the quality of life without medication, surgery, or invasive procedures.