The goals of treatment include treatment of the cause, if possible, supportive care to maximize self-care ability and independence, and control of symptoms.
The cause should be identified and treated whenever possible. This may include such things as the control of blood sugar levels for diabetics, abstinence from alcohol, and taking daily nutritional supplements. If medications (such as some treatments for HIV) are causing the problem, these should be identified and changed, if possible.
MAXIMIZE SELF-CARE AND INDEPENDENCE
Physical therapy, vocational therapy, occupational therapy, and orthopedic interventions may be recommended to promote self-care ability and independence.
For example, exercises and retraining may increase muscle strength and control. Appliances such as wheelchairs, braces, or splints may provide mobility or help support an extremity so that it can be used.
CONTROL OF SYMPTOMS
Safety is an important consideration for people with neuropathy. Lack of muscle control may increase the risk of falls or other injuries. Also, decreased sensation may increase the risk of falls and injuries because the person is unable to perceive a potential source of harm.
Safety measures for people with difficulty in movement may include the use of railings, removal of obstacles (such as loose rugs that may slip on the floor), and other measures as appropriate.
Safety measures for people experiencing difficulty with sensation include awareness of the lack of sensation and compensation through other measures. Specific measures may include the use of adequate lighting (including lights left on at night), testing of water temperature before bathing, use of protective shoes (such as those with no open toes and with no high heels), and similar measures.
People with decreased sensation should check their feet (or other affected area) frequently for bruises, open skin areas, or other injury, which may go unnoticed and become severely infected.
Shoes should be checked inside frequently for grit or rough spots that may injure the feet.
People with neuropathy are prone to new nerve injury at pressure points (such as knees and elbows). They should avoid prolonged pressure on these areas from leaning on the elbows, crossing the knees, or being in similar positions.
Over-the-counter analgesics or prescription analgesics may be needed to control pain (neuralgia). Various other medications may be used to reduce the stabbing pains that some people experience, including anticonvulsants (phenytoin, carbamazepine, neurontin) or tricyclic antidepressants. Whenever possible, medication use should be avoided or minimized to reduce the risk of side effects.
Positioning, keeping bedclothes off a tender body part, or other measures may be helpful to control pain.
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