We will cover many different treatment options on this website. To avoid feeling overwhelmed by the information, we feel that the best way to think about treatment approaches and options for diabetic peripheral neuropathy or polyneuropathy is by dividing the treatments into groups. It is then easier to understand the goal of each treatment. Some treatments have multiple goals. For example, Tai Chi helps motor symptoms (through improving balance, strengthening) and mood (through relaxation, meditation). Cymbalta helps with sensory symptoms (pain, numbness, tingling) as well as mood (has anti-depressant effects). We are confident that you will find this method of looking at the various treatment options very helpful. To read about the details of each treatment, please go to the article/post on that particular treatment.
1. Treatments to control blood sugar: This is the first and most important step that you can take to control neuropathy. In has been proven that better blood glucose control results in better control of neuropathy symptoms (less numbness, tingling, pain, weakness, etc).
- Medications for blood glucose control
- Special diets for diabetics
- Exercise treatments
- Relaxation and meditation
2. Treatments for sensory symptoms (numbness, tingling, pain)
- Oral Medications for numbness, tingling and nerve pain: Modern medications used in the medical field and considered to be effective specifically for numbness, tingling and nerve pain symptoms associated with neuropathy are Gabapentin (brand name is Neurontin), Nortriptyline (amitriptyline is similar but with slightly more side-effects), Pregabalin (brand name is Lyrica), Duloxetine (brand name is Cymbalta). There are many other medications, from acetaminophen, ibuprofen and naproxen to narcotics. More details can be found in the articles about these medications.
- Topical creams, ointments, lotions and patches for numbness, tingling and nerve pain: Capsaicin, Lidoderm patch.
- Supplements and herbal treatments
- Desensitization:
- Acupuncture
- Sympathetic nerve blocks:
- Spinal cord stimulator
3. Treatments for motor symptoms (weakness, clumsiness, loss of position sense or ‘proprioception’)
- Self-exercise programs: Tai-chi
- Physical therapy
- Occupational therapy
4. Treatments for effects on neuropathy on mood (depression, anxiety)
- Qi-gong
- Lifestyle change
- Meditation
- Psychotherapy and counseling
- Medications for depression
- Medications for anxietY