Peripheral neuropathy causes excruciating pain most often in the hands and feet. Many people with this condition often end up taking pain medications that either don’t help or cause side effects. While this condition is difficult to treat, there are options and patients don’t have to simply accept the pain and give up activities that bring them joy. If you have painful peripheral neuropathy, it’s best to work with a board-certified pain medicine specialist and/or a neurosurgeon to find the right treatment for you. Neurosurgery One has a team of neurosurgeons and pain specialists who work together to treat painful peripheral neuropathy using over-the-counter and prescription medications, topical pain relief patches, and injection therapy. If those treatments fail, you may be a candidate for neuromodulation. In this blog, we take a closer look at peripheral neuropathy treatment and when to consider neuromodulation.
Painful peripheral neuropathy is a condition in which nerve damage causes pain in the extremities—most often the hands and feet. When it comes to conditions that affect a patient’s quality of life, painful peripheral neuropathy is one of the worst. It has a greater impact on quality of life than heart disease and cancer, according to a survey of patients by the International Neuromodulation Society.
And the condition is expected to become even more common as our population ages and more patients develop type 2 diabetes and osteoarthritis, which can lead to pinched nerves. Another cause of painful peripheral neuropathy is shingles, but this can largely be avoided by getting vaccinated.
You may have painful peripheral neuropathy if you experience the following symptoms in your hands or feet: numbness or tingling, pain, extreme sensitivity, muscle weakness, or paralysis. Patients with painful peripheral neuropathy often describe the pain as burning, sharp, constant, sporadic, deep, severe, or crushing. It may make it difficult to work, perform household duties, participate in social and recreational activities, exercise, stand or sit for long periods, walk farther than short distances, or sleep restfully.
If you answer “yes” to any of these three questions, you probably have painful peripheral neuropathy:
- Do your feet hurt at night? Are sheets irritating?
- Do you feel like you are walking on nails or marbles?
- Do you feel like ants are stinging your feet?
Painful Peripheral Neuropathy Treatment
While painful peripheral neuropathy usually cannot be cured, your symptoms can be managed. Treatment will depend on the underlying cause of your neuropathy. For instance, if your neuropathy is caused by diabetes, you’ll first need to work with your primary doctor or diabetes care provider to manage your blood sugar to keep your neuropathy from getting worse.
Painful peripheral neuropathy usually can be treated with medication, including over-the-counter or prescription pain medication, nonsteroidal anti-inflammatory drugs (NSAIDs), anticonvulsants, antidepressants, and topical anesthetics. Research suggests, however, that traditional pain medication, especially NSAIDs, are not particularly effective for the treatment of painful peripheral neuropathy unless more than one type is prescribed, according to an article published in The Journal of the American Osteopathic Association.
At Neurosurgery One, we have opened the only specialty clinic in the south Denver metro area to address painful peripheral neuropathy, where we start by understanding your symptoms and the treatments you have tried. We will often begin by determining whether a combination of medication is right for you.
Unfortunately, many of the medications used to treat painful peripheral neuropathy have negative side effects. If the side effects of your medication outweigh the relief they provide or your medication is no longer providing relief, we will talk with you about alternatives, including neuromodulation.
Neuromodulation Cuts Pain from Peripheral Neuropathy
Neuromodulation, also called spinal cord stimulation, is an option for patients who haven’t found relief with medication or who experience negative side effects from medication.
Neuromodulation uses electricity to interrupt pain signals on their way to the brain. The electricity is painlessly delivered via an implantable stimulator placed near the spinal cord. Patients control the device via a remote, increasing stimulation when pain worsens and decreasing it when pain subsides.
To assess whether neuromodulation will help you, we first test the process with an external stimulator for 3-7 days. If that brings relief, we implant the permanent stimulator in an outpatient procedure in our surgical center. We then help the patient learn how to control the stimulation via the remote.
Patients who respond well to the trial and have a permanent stimulator placed typically can expect a 50-75% reduction in their pain. For many patients, even 50% less pain means a significantly higher degree of daily function and often the use of less pain medication. That translates into being able to stand or walk for longer periods of time, enjoying activities that were made unbearable due to pain, and spending more time with your family and friends. Or, in other words, enjoying more of the things that really matter.