Many patients come into the office complaining of numbness and tingling of the toes and feet. Sometimes patient may say they have a “crawling” sensation or burning sensation. These are symptoms of a possible peripheral neuropathy. Peripheral neuropathy basically means ‘problems of the nerves in the limbs’. Peripheral neuropathy can be due multiple factors, however, the most common is diabetes. Other causes may be trauma, pressure, vitamin deficiencies, alcoholism, infections, autoimmune diseases, inherited disorders, exposure to poisons, and even tumors.
I am asked frequently by patients as to which medications are the best for peripheral neuropathy. There are many different type and they all work in various manners. I am going to give a brief list of the more common medications commonly used for peripheral neuropathy.
Amitryptiline and nortryptiline are tricyclic antidepressant medications originally used to treat depression. However, these medications have also been shown to interfere with the processes that cause you to feel pain. Cymbalta is a much newer medication that has been shown to be effective for nerve pain in patients with diabetes. Normal side effects of anti-depressants include nausea, drowsiness, dizziness, constipation, and poor appetite.
Gabapentin (Neurontin), pregabalin (Lyrica), Topamax, and carbamzepine (Tegretol) are medications that not only prevent seizures caused from epilepsy, but also prevent nerve pain. Lyrica is a newer and commonly prescribed medication for peripheral neuropathy.
Pain medication is commonly used for mild peripheral neuropathy. Severe caution must be used when prescribing these medication in order to prevent dependence, sedation and constipation.
This patch contains a topical anesthetic which causes mild to moderate numbness of the superifical layers of the skin and improve pain symptoms.
Transcutaneous Electrical Nerve Stimulation
A “TENS” unit is a machine in which electrodes send a mild electric through the painful limb. This treatment must be done frequently to have the greatest potential for success.
If you have peripheral neuropathy, please come see Dr. Silvers or Dr. Hadfield at Advanced Foot & Ankle Center and we can help relieve your symptoms.