Neuropathy is a general term denoting disturbances in the normal functioning of the peripheral nerves. The causes of neuropathy are varied and so is the treatment. Many a times, the neuropathy is almost irreversible and the treatment is mainly focused on preventing further progression of the nerve damage and other supportive measures to prevent any complications due to neuropathy.
Neuropathies due to nutritional deficiencies are mainly treated with the replenishment of the deficient nutrient. Neuropathies due to deficiency of vitamins like cobalamin, thiamine, pyridoxine, niacin are treated by giving the vitamin supplementation orally or by intramuscular injection of the vitamin if deficiency is due to defective absorption of vitamins from the diet. Treatment may or may not completely reverse the neuropathy and alleviate the symptoms and in many cases there is some permanent damage to nerves and persistent symptoms despite therapy. Recently neuropathy due to copper deficiency has also been discovered. It too is treated with oral copper salts or intravenous injection of copper salts. Again the response is variable and may take many months.
Entrapment neuropathies like carpal tunnel syndrome, radial neuropathy, meralgia paraesthetica, etc are treated based on specific cause and the nerve involved. Carpal tunnel syndrome treatment varies from medical approaches like NSAID (like Ibuprofen), local injection of steroids in wrist, and avoiding aggravating factors like typing in wrong positions, use of hand tools etc. If symptoms not alleviated by this approach, then surgery is also an option and is most often curative if no permanent damage to nerve has already occurred. Again, each neuropathy is unique and treatment is variable.
The treatment of neuropathies secondary to other diseases is the treatment of the primary disease causing the neuropathy. If neuropathy is due to Myxedema, caused by lack of thyroid hormone, then treatment is replacing the thyroid hormone. Treatment of Diabetic Neuropathy is mainly supportive. In diabetic neuropathies, some forms like Mononeuropathies are reversible but most are irreversible. Strict control of blood glucose levels to slow the further progression is of paramount importance. Other treatment is based on the symptoms, like pain is managed with NSAID and many other drugs. Similarly the neuropathy associated with Rheumatoid Arthritis often responds to the treatment of Rheumatoid arthritis (with immunomodulators).
Treatment of neuropathy due to food allergy is avoiding the allergen food item causing neuropathy. Neuropathy may also be due to toxic effect of certain drugs like Chloroquine, Phenytoin, anti-Cancer drugs and numerous others. Treatment in this case is mainly discontinuation of the drug or dose reduction. There may be some specific treatment in certain cases, like neuropathy due to isoniazid can usually be prevented by giving pyridoxine along with it.