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Best drugs for neuropathy



by Nathan Wei, MD, FACP, FACR

Nathan Wei is a board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit




Before discussing specific drugs, it is important to focus on the goals of treatment.

The goal of treatment may be to identify and treat the underlying cause, cure the disorder if possible, give the patient maximum independence and self-care ability; and control the symptoms. As a rule, the first steps are to treat the underlying medical problem (such as diabetes) or remove the cause (such as alcohol). The next is to identify any potential drug-induced causes of neuropathy.

Physical therapy, occupational therapy, and orthopedic interventions may be recommended to promote self care ability and independence. For example, exercises and retraining may be used to increase muscle strength and control. Appliances such as wheelchairs, braces, and splints may improve mobility or ability to use an affected arm or leg.

Safety is an important consideration for people with neuropathy. Lack of muscle control and reduced sensation increase the risk of falls and other injuries. The person may not notice a potential source of injury because he or she can't feel it. For this reason, people with decreased sensation should check their feet or other affected areas frequently for bruises, open skin areas, or other injuries, which may go unnoticed (because there is no pain) and become severely infected. Often, a podiatrist can determine if special orthotic devices are needed.

Safety measures for people experiencing difficulty with movement may include railings, various appliances, removing obstacles such as loose rugs, and other measures as appropriate. Safety measures for people having difficulty with sensation include adequate lighting (including lights left on at night), testing water temperature before bathing, use of protective shoes (no open toes, no high heels, and so on) and similar measures. Shoes should be checked often for grit or rough spots that may cause injury to the feet.

People with neuropathy (especially those with polyneuropathy or mononeuropathy multiplex) are prone to new nerve injury at pressure points (knees and elbows, for example). They should avoid prolonged pressure on these areas from leaning on the elbows, crossing the knees, or assuming similar positions.

Over-the-counter or prescription pain medications may be needed to control nerve pain. Anticonvulsants (phenytoin, carbamazepine, gabapentin), tricyclic antidepressants, or other medications may be used to reduce the stabbing pains that some people experience. Whenever possible, medication use should be minimized to avoid side effects. A patch containing lidocaine, a local anesthetic (Lidoderm) may be helpful for localized pain. A new medicine – Lyrica- is a gabapentin like drug that has promise in the treatment of neuropathic pain.

Narcotics should be avoided when possible.

Adjusting position, using frames to keep bedclothes off tender body parts, or other measures may also be helpful to reduce pain.

Autonomic changes may be treated symptomatically. They may be difficult to treat or respond poorly to treatment.

• Postural hypotension (low blood pressure) -- use of elastic stockings and sleeping with the head elevated may help. Fludrocortisone or similar medications may be beneficial in reducing postural hypotension for some people.
• Reduced gastric motility -- medications that increase gastric motility (such as metoclopramide), eating small frequent meals, sleeping with the head elevated, or other measures may help.
• Bladder dysfunction -- manual expression of urine (pressing over the bladder with the hands), intermittent catheterization, or medications such as bethanechol may be necessary.
• Impotence, diarrhea, constipation or other symptoms are treated as appropriate.



Get more information about best drugs for neuropathy and related issues as well as...


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Click here Second Opinion Arthritis Treatment Kit







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