Neuropathy Treatment

Neuropathy is nerve damage that causes numbness, tingling, and pain in the hands and feet. Diabetes, alcoholism, vitamin deficiencies, medications, toxins, kidney failure, trauma, and varicose veins can each cause neuropathy. Family history and advanced age are also predisposing factors for developing neuropathy.


  • Burning
  • Numbness and tingling (mainly in the hands and feet but can occur in the arms and legs)
  • Pain
  • Cramping
  • Sensitivity to touch and temperature
  • Muscle weakness and atrophy
  • Slowed reflexes and reaction time
Neuropathy Diagnosis - Ortho Plus Clinic


Your medical provider will need to obtain a thorough history and physical at your initial visit. Then, depending on the information discussed at your appointment, your provider may use one or more of the following tests to accurately diagnose the damage's location.

  • Electromyography (EMG): Nerve damage is measured by the electrical activity of the muscles.
  • Nerve Conduction Study (NCS): Nerve damage is detected by the speed of electrical signals moving through specific nerves.
  • Nerve Biopsy: A small sample of nerve tissue is examined under a microscope for signs of damage.
  • Blood Tests: A complete blood count, thyroid function tests, and vitamin B12 levels can help to rule out other diseases that can cause similar symptoms.
  • Skin Biopsy: A small sample of skin is examined under a microscope for signs of damage to the nerve endings.
  • Neuropathy Testing: A variety of tests including vibration and thermal sensation are performed to assess the function of the nerves.
  • Testing of venous & arterial circulation:  Poor circulation can cause symptoms of neuropathy. Treatment of these problems can improve symptoms of neuropathy.

Treatments for Neuropathy

Diagnosing Neuropathy
  • Pain Relievers: Medications such as ibuprofen, acetaminophen, and naproxen can help relieve the pain associated with neuropathy. Tricyclic antidepressants such as amitriptyline and nortriptyline have been found to reduce pain in some forms of neuropathy. Anticonvulsant medications such as gabapentin and pregabalin can help reduce nerve pain.
  • Topical Creams & Ointments: Capsaicin cream, Lidocaine patches, and other topical agents can be applied to the skin to provide pain relief.
  • Steroid Injections: Steroids can reduce inflammation and provide pain relief in some cases.
  • Physical Therapy: Stretching, massage, and other physical therapy techniques can help reduce pain and improve function.
  • Vitamin Supplementation: B vitamins and other vitamins may be prescribed to help improve nerve health.
  • Venous Ablation:  Studies have shown that neuropathy symptoms usually improve with diagnosis and treatment of venous disease.
  • Peripheral Nerve Stimulation (PNS): A highly effective way to combat chronic pain. It involves placing a small electrical device (a wire-like electrode) next to one of the peripheral nerves located beyond the brain or spinal cord, which then delivers rapid electrical pulses that are felt as mild tingles (so-called paresthesias).
  • Spinal Cord Stimulator Implantation (SCS): A also a great tool for managing pain. This device is surgically placed under the skin and sends a mild electric current to the spinal cord, masking the pain signal and reducing the pain felt. The electrical pulses modify the pain signal to prevent it from reaching the brain.

Can Venous disease cause peripheral neuropathy?

Yes, venous disease can cause peripheral neuropathy. Venous disease can lead to reduced circulation in the legs, which can cause nerve damage and peripheral neuropathy. Peripheral neuropathy can cause pain, numbness, and tingling in the extremities.  Sensory neuropathy is now considered a symptom of venous insufficiency by some sources (1999 J Vasc Surg).  The connection between neuropathy and venous disease is thought to be related to ischemia due to venous microangiopathy and increased endoneurial pressure.  A study showed that 65% of patients with neuropathy and leg swelling or skin discoloration experienced improvement or resolution of neuropathy symptoms after treating the venous disease.

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