What Are The Best Treatments For Neuropathy? (Updated: June 2018)

UPDATE: We have evaluated several treatment options for nerve pain for 2018 and sorted out what works and what does not. Click here to visit our top recommended treatment.

When people have nerve damage, they sometimes develop what is known as “neuropathy”. In the vast majority of cases, this is peripheral neuropathy, which means the nerves in the extremities (arms, feet, and hands) are damaged. It is an incredibly common condition in the elderly, as well as in people with type 1 or type 2 diabetes.

This condition affects the way the central nervous system communicates with the nerves. These include the sensory nerves, which are used for feeling things such as touch and pain; the motor nerves, which control muscle movement; and the autonomic nerves, which regulate the body’s automatic functions such as bladder function and blood pressure. The symptoms experienced and the treatment they require, will vary depending on which nerves are affected and what has caused nerve damage.

Neuropathy is often a progressive condition. This is why it is very important to seek medical help if you experience muscle weakness in your extremities; loss of coordination and balance; shooting, stabbing, or burning pain in specific areas; or regular tingling and numbness in the hands or feet. This is particularly true if you are also in a high risk category, which includes being elderly, having diabetes, or suffering from a condition that is commonly linked to nerve damage.

The best treatment will depend entirely on the type of neuropathy and its causes. Often, treatment is hit and miss, which means patients have to try numerous forms of treatment before one is found that works for them. That said, certain treatments are offered more regularly and as they have been found to be very effective in many people. Let us take a look at the most common treatments:

1. Prescription Medication

The first step should always be to try over-the-counter medication. When this is no longer effective, or not effective enough, a number of other treatment options are available. If neuropathy is caused by an autoimmune or inflammatory condition, various drugs are available. These include immunosuppressive drugs like azathioprine, cyclosporine, or prednisone.

In some cases, patients may be offered plasmapheresis. This means that their blood is removed and cleaned, taking out antibodies and immune system cells, before being returned. This is quite an invasive procedure, but it can help to suppress immune system activity and reduce inflammation. Alternatively, abnormal immune system activity can be suppressed using immunoglobulins, which are administered intravenously. Medication such as rituximab can also be beneficial.

Not all neuropathy is caused by autoimmune or inflammatory conditions, however. Hence, other forms of medication can also be used, such as:

Antidepressants, which modulate pain by working on the brain, spinal cord, and peripheral nerves. Examples include serotonin-norepinephrine reuptake inhibotors like venlafaxine, duloxetine, and desvenlafaxine. Tricyclic antidepressants may also be used, particularly amitriptyline.

  • Anticonvulsants, which affect the peripheral nerves, the brain, and the spinal cord. Examples include carbamazepine, topiramate, pregabalin, and gabapentin.
  • Antiarrythmic medication, including mexiletine, which is particularly beneficial if the the condition is very painful.

Anticonvulsant and antidepressant medications tend to be the most effective. Narcotic agents are usually added if and when any of the above medications are no longer effective, or not effective enough. However, many narcotic agents can lead to the development of dependency and addictions, which is why they are seen as a last resort option.

Interestingly, tapentadol has recently been developed. This is a drug that is a norepinephrine reuptake inhibitor and also has opioid activity. This means it is both an antidepressant and a narcotic agent.

Some people may also benefit from topical medication for pain relief. Commonly, physicians will prescribe capsaicin, which changes the pain receptors in the peripheral nerves and is derived from hot peppers; or lidocaine, which is an anesthetic. Generally, topical medication is only offered if the pain is chronic and localized, which is often seen in people who have herpes zoster (shingles) neuralgia pain.

The main medications that are tried before all others at present are:

  • Amitriptyline, which is used for the treatment of depression and chronic headaches
  • Duloxetine, which is used for the treatment of depression and bladder problems
  • Gabapentin and pregabalin, which is used to treat anxiety, chronic headaches, and epilepsy

2. Acupuncture

Acupuncture is an Eastern form of medicine that has been accepted as being effective and is often offered after a diagnosis of a medical condition. Essentially, the sensory nerves, found just under the skin, are stimulated with the use of needles. As a result, the body releases endorphins and other pain-relieving hormones, leading to numerous positive effects.

Usually, patients require sessions of acupuncture if they are to experience sustainable relief. In the Orient, it is believed that acupuncture releases Qi, which is life energy, which flows through the meridians in the body. They believe that all medical conditions are caused by blockages in the Qi, and acupuncture is used to release it.

3. Transcutaneous Electrical Nerve Stimulation (T.E.N.S.)

TENS stands for transcutaneous electrical nerve stimulation. It is a form of noninvasive pain relief treatment that can help with various conditions. It is commonly used, for instance, by pregnant women, even during labor, and by those with chronic back pain. It is also believed to be able to help those with nerve damage.

The machine has a number of electrodes, which are placed on the skin in the areas where the pain is found. Gentle electrical currents are then sent through the electrodes. Clinical trials have not yet been able to fully confirm or deny whether TENS is effective, but some studies have shown that people with peripheral neuropathy, in particular, have been able to benefit from it.

4. Changes in Diet and/or Exercise

Neuropathy, or nerve deterioration, is a complex condition and no two people experience it in exactly the same way. The degree of pain that people experience also gets to become progressively worse, with flareups and periods of relative calm in between. Generally speaking, this condition of the nerves requires some form of medical treatment, usually in the form of prescription medication.

It is vital, however, that the right pain medication is chosen. Not only does it have to address the symptoms of neuropathy, but it must also be appropriate for the body chemistry of the individual.

Furthermore, if patients already use other forms of treatment, either for the same condition or for a different one, the medication must compliment those. But what is perhaps most important of all, is that those who suffer from nerve damage should follow a healthy diet and exercise regime.

It is very important, if you have a neuropathy diagnosis, that you focus on leading a healthy lifestyle. You should make sure that your weight is within the healthy range, that you avoid various toxins, that you eat a nutritious, balanced diet, and that you exercise regularly. You should also avoid alcohol and smoking, as these constrict the blood vessels. Additionally, a good diet improves any issues with the gastrointestinal system.

Exercise, meanwhile, can stop muscles from wasting away. Instead, it will strengthen them, thereby also reducing the frequency of cramps. It is important, however, to perform exercises that are suitable to your physical ability.

Importance of a Healthy Lifestyle for People with Neuropathy

When people experience pain, it means that their tissue is injured or inflamed, and/or that they are ill. Often, pain starts suddenly and it is common for it to get worse under emotional distress. This means that mental health must also be considered in the diagnosis and treatment of pain. This is particularly true in people who suffer from chronic pain, such as neuropathy, as they must be able to accept a continuous reduced quality of life.

Often, chronic pain is a symptom of an underlying disease. For instance, neuropathy is commonly associated with diabetes. However, many people who suffer from this condition find themselves trapped in a vicious cycle. They experience pain, which causes emotional distress, which makes the pain worse. The knowledge that this medical condition is hard to treat makes this even worse.

What this demonstrates is just how important it is that people focus not just on medical treatments and medication, but that they also focus on themselves. They must identify the root cause of the pain they experience and treat it appropriately. Someone who does not lead a healthy lifestyle, in other words, will experience the symptoms in a far stronger degree.

Determine What Contributed to the Condition

If you have been diagnosed with peripheral neuropathy, diabetic neuropathy, or any other form of nerve damage, you must start by determining what has contributed to this condition. For instance, compression, autoimmune disorders, hormonal deficiencies, vitamin deficiencies, medication-related toxicity, toxin exposure, and infections can all lead to this deterioration of the nerves.

Either way, when nerve damage occurs, the nerves’ axons can regenerate over time, so long as the cell of the nerve itself hasn’t died. Hence, it is possible to experience recovery if treated in the right way, at the right time. In other words, this is a symptom and not a disease itself, and it is vital that the disease is identified and treated to protect the nerves.

Regular Exercise Can Help

A healthy lifestyle is important in every individual, but even more so in someone with neuropathy. This means that you must maintain a healthy weight, avoid toxin exposure, getting regular physical exercise, making sure your diet is balanced and nutritious, ensuring you consume the right levels of vitamins and minerals (supplementing when necessary), not smoking, and avoiding alcohol. These things all have a positive impact damaged nerves.

People with neuropathy often experience cramps, which can be reduced through exercise. It also helps to make the muscles stronger and stops them from wasting away. In terms of types of exercise, people with this condition should focus on at least walking regularly at a brisk pace. Doing so three times per week can greatly reduce the pain associated with this nerve damage. Meanwhile, sports such as tai chi, Pilates, and yoga can all be beneficial.

Eat Healthy and Nutritious Meals

A healthy meal can improve energy levels for people with neuropathy.

Meals should be healthy and nutritious. People with neuropathy must be particularly mindful of consuming the right amount of vitamins and minerals and it is usually recommended that they supplement their diet. They should eat meals rich in lean protein, whole grains, vegetables, and fruits. By adopting healthy eating regimes, various gastrointestinal symptoms can be avoided, while at the same time ensuring there are no deficiencies.

Avoid Smoking and Alcoholic Drinks

Avoid smoking and drinking when you have nerve pain.

People with neuropathy must give up smoking. Smoking has a constricting effect on the blood vessels, which means that it becomes difficult for nutrients to reach the peripheral nerves. Smokers usually have far worse symptoms associated with this condition than non-smokers. Furthermore, they are more likely to develop complications associated with neuropathy, particularly in the feet.

Drinking alcohol should also be avoided as much as possible. This is because alcohol can make the symptoms of nerve deterioration far worse.

Neuropathy and Diabetes

If neuropathy is associated with diabetes, living a healthy lifestyle becomes even more important. Diabetics need to focus strongly on self-care, looking after their feet in particular. They must also ensure that they properly treat wounds. The same is true in people whose ability to feel pain has been impaired. Furthermore, diabetics must ensure that their blood glucose levels are properly monitored.

5. Herbal and Vitamin Supplements

Last but not least, you may want to consider adding herbal and vitamin supplements your diet. Many people with neuropathy, and particularly those who are alcoholics, may want to take vitamin B12 supplements because patients have often been found to have a vitamin B12 deficiency.

Meanwhile, vitamin B supplements like Methyl B-12benfotiamine, as well as alpha-lipoic acid, which is a type of antioxidant, may also help. Also, some people claim that herbal remedies are effective, although scientific evidence is still lacking. You may want to consider supplementing with certain vitamins and minerals, or try premade formulas like Nerve Renew. Vitamins and minerals may not cure neuropathy, but they may provide significant relief from the symptoms.


By focusing on these elements, quality of life can be improved and pain can be alleviated. Not just that, it enables those nerves where the cell is still alive to regenerate, thereby reducing the extent of the condition. Unfortunately, there is no absolute cure for this yet, not in the least because it can be caused by so many different factors. If it is a form of acute neuropathy associated, for instance, with an illness or injury that can be resolved, the condition may also go away.

Either way, whether chronic or acute, neuropathic symptoms can always be alleviated by making healthy lifestyle choices. Not only does it ensure the pain is not as bad and that nerves can regenerate where the cell is still alive, but living a healthy lifestyle also helps to prevent future injuries and illnesses. In so doing, it may also help to prevent making your condition worse. That being said, it is very important that you consult with a physician before making any significant lifestyle choices, so that you exercise to your own abilities and take vitamins and minerals that you actually need. A nutritionist and personal trainer should be able to help with this.

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