Once neuropathy has developed, few types can be fully cured, but early intervention can improve outcomes.
Peripheral nerve fibers can slowly regenerate if the nerve cell itself is still alive. Eliminating the underlying cause can prevent future
nerve damage. Good nutrition and reasonable exercise can speed healing. Quitting smoking will halt constriction of blood vessels, so that they can deliver more nutrients to help repair injured peripheral nerves.
Mild pain may be relieved by over-the-counter analgesic medication. For patients who have more severe
neuropathic pain, neuroactive agents such as anticonvulsants or antidepressants are commonly prescribed; their action on the
central nervous system can calm nerve activity. Topical patches that act across the skin – for instance, delivering the anesthetic lidocaine or chili-pepper extract capsaicin – may also provide some relief. Another option is administration of a local anesthetic.
When pain does not respond to those methods, alternatives can include cannabinoids or opiate analgesics. If these measures are ineffective, in a small, select group of patients, opioids may be gradually introduced after carefully considering concerns and side effects. (2) Meanwhile, to relieve the most severe cases of neuropathic pain, nerves may be surgically destroyed, although the results might be only temporary and the procedure can lead to complications.
For some patients, a treatment regimen will also include physical or
occupational therapy In cases in which drugs are ineffective or side effects intolerable, an option for some patients may be use of an implanted electrical stimulator to interrupt pain signals by producing a mild
tingling sensation (paresthesia) in the painful area.
Neuromodulation for intractable peripheral neuropathic pain may be carried out through spinal cord stimulation or through peripheral nerve stimulation.