For most metabolic neuropathies, the best treatment is to correct the metabolic problem.
Vitamin deficiencies are treated with diet or injections. Abnormal blood sugar or thyroid function may need medication to correct the problem. Alcoholic neuropathy is treated with alcohol abstinence.
In some cases, pain is treated with medications that reduce abnormal pain signals from the nerves (duloxetine, gabapentin, pregabalin). Lotions, creams, or medicated patches can provide relief in some cases.
Clinical trials of new medications include antioxidants, neuroprotectants, insulin-like drugs, and aldose reductase inhibitors.
Weakness is often treated with physical therapy. You may need to learn how to use a cane or walker if your balance is affected. You may need special braces on the ankles to walk better.
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The outlook mainly depends on the cause of the disorder. In some cases, the problem can easily be treated. In other cases, the metabolic problem cannot be controlled and nerves may continue to become damaged.
Shy ME. Peripheral neuropathies. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 446.
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