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Relieving peripheral neuropathy pain

Created date

September 22nd, 2014
peripheral nerves
peripheral nerves

Peripheral neuropathy (PN) occurs when peripheral nerves—the network of nerves responsible for transmitting information from the central nervous system (brain and spinal cord) to other parts of the body—stop working correctly. According to the Neuropathy Association, about 20 million Americans suffer from PN, and it is more common among older adults.

“Pain is the most common symptom of PN,” says Adrian Hepner, M.D., vice president of clinical research and regulatory affairs at BioDelivery Sciences International. “Neuropathic pain results from injury to the nerve itself, which causes it to send out abnormal signals.”  

Other symptoms include numbness, tingling, pricking sensations, muscle weakness, and sensitivity to touch. 

There are more than 100 types of PN. People can be genetically predisposed, or it can be acquired as a result of an underlying condition. “Common causes in older adults include diabetes or other metabolic diseases, circulation problems, alcohol use,  infections, vitamin deficiencies, or trauma,” Hepner says. “Some medications can also cause PN as a side effect, such as chemotherapy drugs.”

Diabetes is a very common cause. According to the National Institutes of Health, up to 70% of people with diabetes have some form of PN.

Living with PN

PN can make getting around difficult, especially if it’s in your legs and feet, which are very common sites. Treatment is essential to avoid complications such as wounds or falls. “Optimizing treatment of other medical conditions is important to keep PN from getting worse,” Hepner says. “People can also keep it from getting worse by adopting healthy lifestyle measures such as losing weight, eating a balanced diet, avoiding alcohol, and, of course, being physically active.”

Exercising may seem difficult, but it can really help. “Exercise impacts how your nerves get blood and oxygen,” Hepner explains. “Being more active can help delay the onset of PN, or it may actually improve your symptoms.” 

To get more active, you may need some assistance in the form of special shoes or braces. Seeing a podiatrist can help you get fitted. “Improperly fitting shoes are the number one cause for problems in our patients,” says Lloyd Bowser, DPM, podiatrist at Oak Crest, an Erickson Living community in Parkville, Md.

A shoe has to fit right or you are at risk for stumbling and falling. “You might get an injury such as a twisted ankle, or something worse such as a fracture,” Bowser says. “Any pressure from a shoe can compress your nerves as well as your veins, arteries, and the soft and hard structures of your foot.”

Effective treatments

Aside from lifestyle changes, there are several treatment options for people with PN. “Neuropathic pain doesn’t tend to respond well to medicines that you’d typically use for other types of pain,” Hepner says. “Many medicines are actually approved for other uses, such as anti-epileptic drugs and antidepressants, but they’ve been found to be effective for reducing symptoms for some people who have PN.” 

Some people need injections of anesthetics such as lidocaine, and in very severe cases, people may resort to surgery to have the nerves destroyed.

Promising research

The National Institute of Neurological Disorders and Stroke, is responsible for much of the research regarding PN. Some current projects include investigating the mechanisms involved in diabetic neuropathies; genetic factors responsible for developing PN, and developing more effective pain-relief therapies.

Research is also being conducted on neurotrophic factors, which are proteins produced by the body that protect nerve cells from injury. Scientists hope to learn more about how they work and whether these substances can be used for treatments that can reverse nerve damage and cure PN.

Hepner describes a therapy that he has been researching, which is still in the initial testing phase. “We are studying a gel that can be applied to the skin,” he says. “It’s made with a drug called clonidine, which is typically used to control high blood pressure.”

Preliminary research suggests that the gel may not be absorbed into the bloodstream. If that turns out to be true, the drug may be unlikely to interact with other medicines that someone is taking. And it may also be unlikely to produce side effects.

“This gel is similar in texture to hand sanitizer,” says Andrew Finn, M.D., executive vice president of product development at BioDelivery Sciences International in Raleigh, N.C. “It seems to penetrate to the nerves, and does not leave any residue.”

“Drug interactions are a big concern for older adults,” Hepner says. “Adding another pill for pain to their medication regimen can increase the risk of interactions and side effects. Topical medicines may be another option.”

If you have symptoms of PN, see your doctor right away. Early intervention is crucial to minimize pain and preserve your daily function. If you are interested in emerging research on the topic, your doctor can also advise you as to whether new therapies are appropriate for you.



National Institute of Neurological Disorders and Stroke’s Brain Resources and Information Network (BRAIN)


P.O. Box 5801

Bethesda, MD 20824



American Chronic Pain Association (ACPA)

P.O. Box 850

Rocklin, CA 95677




60 East 42nd Street

Suite 942

New York, NY  10165



1701 North Beauregard Street

Alexandria, VA 22311