Treating Neuropathy: Some Alternatives for Relief

Last updated:

Patricia Braden liked hiking for hours in the woods and walking her Corgi-mix dog near her home in Greensboro, NC. The retired clinical psychologist also enjoyed long conversations with friends, family, and her clients.

But those days are over because of peripheral neuropathy and the side effects — such as problems with balance and concentration — of drugs used to treat it.

She is not alone. An estimated 20 million people in the US have some form of peripheral neuropathy, according to the National Institute of Neurological Disorders. The condition results from damage to the peripheral nervous system, the nerves running from the brain and spinal cord to the rest of the body.

Symptoms are numbness and a prickling or tingling sensation in your feet or hands, which can spread to the legs and arms. Other signs include sharp, throbbing, freezing or burning pain, extreme sensitivity to touch, and a lack of coordination that can lead to falls.

2 Kinds of Drugs Used to Treat Neuropathy

The drugs to treat neuropathy fall into 2 classifications: antidepressants and anti-seizure medications, though it is not totally clear why they work for nerve pain. Many patients also experience a host of sometimes debilitating side effects from the drugs. The good news is that there are several alternative treatments and therapies that many patients have used to find relief that can minimize the use of medications.

David Cornblath, MD, professor of neurology at Johns Hopkins Hospital in Baltimore and a specialist in peripheral neuropathy, said the 3 main drugs approved for treating diabetic neuropathy — the most common type of neuropathy — “all have positives and negatives.”

He said the anti-seizure medication Neurontin (gabapentin) has the fewest side effects. Lyrica (pregabalin, another anti-seizure medication) comes next, and the antidepressant Cymbalta (duloxetine, a serotonin and norepinephrine reuptake inhibitor) has the most.

Doctors prescribe those same drugs for other kinds of neuropathy, such as the category of idiopathic neuropathy (meaning no known cause) into which Braden and many others fall. They are also used for fibromyalgia, another nervous system disorder with some of the same symptoms as neuropathy.

According to Cornblath, “Many start with gabapentin. It’s well-tolerated. But relief rarely occurs until people get to 1,800 milligrams a day,” he said. “Many are underdosed.”

However, “many patients find the side effects of increased dosages intolerable,” said Marlene Dodinval, executive director of The Foundation for Peripheral Neuropathy, a nonprofit in Buffalo Grove, IL.

Common side effects of the 3 drugs include fatigue, nausea, drowsiness and confusion, and weight gain or loss, in addition to side effects specific to each drug and the possibility of drug interactions. But they can be more extreme: The FDA requires manufacturers of antiepileptic drugs to carry warnings about increased risks of suicidal thoughts and behaviors. Antidepressants may also increase suicidality, especially for children, young adults and teenagers. In trials, patients who took an antiepileptic drug had almost twice the risk of suicidality as those who did not.

Falls, Forgetfulness and Other Side Effects

The 83-year-old Braden has not been immune from side effects. “I’ve fallen 3 dozen times in the last 10 years.” To help alleviate the sharp pain and the sensation that she likened to wearing iron shoes, her doctor put her on a high dose of Neurontin, which made her forget words in the middle of a thought, as did the Cymbalta that she takes.

“The thing I struggle with is, I don’t know if the benefit is worth the side effects,” she said.

Others have a similar dilemma. Valerie Lloyd, a retired government employee, could take more Neurontin for her painful chemotherapy-induced peripheral neuropathy, but is deterred by the side effects. “It’s in my feet, hands, and sometimes lips,” she said. “I feel OK in the morning, and that’s when I shop and garden. By about 6 in the evening, I get a burning, electrical feeling, the pins and needles.”

Lloyd started on three 300mg capsules of Neurontin a day, working up to 4 and 5 capsules daily.

“My doctor said I could take 6, but the thought of taking more turns me off. I didn’t like the way it made my feet feel swollen and fat,” she said. “I stopped taking it and it was a different kind of pain, so I went back” on Neurontin.

Alternatives to Medication for Nerve Pain

However, medications aren’t the only way to treat nerve pain. Lloyd, a 65-year-old Alexandria, VA, resident, said she has found some relief in a foot cream whose main ingredient is capsaicin, a substance found in hot peppers, and thought to reduce chronic neuropathic pain by making nerves less sensitive to pain messages.

Water aerobics also help her “feel a little better about my strength and definitely helps my state of mind.”

This approach is consistent with a slew of mind and body therapies and other complementary and integrative therapies, according to The Foundation for Peripheral Neuropathy.

Carolyn Hicks, a psychologist and landscape painter in Northampton, MA, found relief in one such therapy — acupuncture — when the 70-year-old got peripheral neuropathy after chemotherapy for breast cancer. “I found that it was very helpful having more energy and balance and also in mitigating symptoms associated with neuropathy such as numbness and tingling, aches and sensitivity to the cold, and burning in fingers and toes,” she wrote in an email.

Elayne Goldstein, a 68-year-old retired teacher from Philadelphia, developed numbness and pain “like a knife was slicing my foot” after a knee replacement 2 years ago. She was on a high dose of Neurontin but weaned herself down to 300mg at night “because I didn’t want to be on medication.”

At night she wears a magnetic wrap “because something compressing it seems to help.” She also teaches yoga dance to seniors. “When I’m moving, I don’t feel any pain.”

Jennifer Buttaccio, an occupational therapist in Chicago, advises patients on better managing daily activities, strengthening exercises, and pain management strategies to find relief.

“I can recommend a patient talk to their doctor about having their vitamin B12 and magnesium levels checked,” she said. “I can also tell them to see if the doctor will provide them with a script for physical therapy to see if there are more specific modalities, strengthening, and pain management strategies that can be implemented.”
First published: Aug 3, 2017

DISCLAIMER: MedShadow provides information and resources related to medications, their effects, and potential side effects. However, it is important to note that we are not a substitute for professional medical advice, diagnosis, or treatment. The content on our site is intended for educational and informational purposes only. Individuals dealing with medical conditions or symptoms should seek guidance from a licensed healthcare professional, such as a physician or pharmacist, who can provide personalized medical advice tailored to their specific circumstances.

While we strive to ensure the accuracy and reliability of the information presented on MedShadow, we cannot guarantee its completeness or suitability for any particular individual's medical needs. Therefore, we strongly encourage users to consult with qualified healthcare professionals regarding any health-related concerns or decisions. By accessing and using MedShadow, you acknowledge and agree that the information provided on the site is not a substitute for professional medical advice and that you should always consult with a qualified healthcare provider for any medical concerns.

Recommend More Articles Like This?

Show Comments (10)
0 0 votes
Article Rating
Notify of
Most Voted
Newest Oldest
Inline Feedbacks
View all comments
Linda Cade

I have learned that I am damned if I do and damned if I don’t!

janice meyer

this helped me alot, to understand certain things,

cbd foot cream for neuropathy

Thank you for this article. I am hopeful that it will help me with my neuropathy. I will share this info with my community as well
[email protected]

Robert Frenz

600 mg of Gabapentin before bed lets me sleep but screws up my balance. 300 mg isn’t quite enough. I’ve tried quitting the stuff and ended up with burning feet and insomnia. I sure wish there were a solution.

David Fishman

Even 100 mg gabapentin is too much for me taken once a day at night. Yes it minimizes the neuropathy, pain, tingling and throbbing and yes it helps me sleep. But the next day I feel like I have a bad persistent hangover. Muscle weakness. Confusion, dizziness. Pounding headache. Complete loss of appetite. Inability to do anything other than continually nod off in a chair. Takes about 48 hours to get out of my system. This drug is not worth it for me. I have returned to using a high dose topical capsaicin daily which works fine for 12 hours.

Korban Dallas

I am prescribed 300mg. 3x daily but usually only take 2 per day unless I can’t stand it. The reason I tolerate pain is because I always seem to run out and all my doctors are unreliable to write a prescription every month. Yes, I need a fucking prescription wrote out every month and sometimes I go a week or more because I can’t get it until he sees me. I suffer in agony because between Dr. and pharmacy I always get screwed over because drug addicts made them change the law so getting gabbies are like pulling teeth. I could buy crack easier than get the medicine I have been taking over 10 years.

James Monette

I went to a podiatrist for the first time about 35 years ago with the beginnings of foot neuropathy. He did no tests except the foot tickling routine, then prescribed special hard inserts for my shoes. Since then the routine has largely been the same. Finally I figured out for myself that the inserts were useless and actually made my condition worse. On my own I discovered that soft seamless shoe liners helped my feet. Once, back in 2017, I noticed that my current podiatrist wore shoes with low backs at his office. I tried them and gained some relief from the burning pain and have not looked back. It would seem that these doctors should realize the simple things that help to relieve neuropathy and share them with their patients but they do not. I also discovered that tight socks cause me more pain, loose weave work socks are more bearable. Another thing I discovered the hard way is that Gabapentin has severe withdrawal symptoms. I had to go to the emergency room to get more pills when I ran out. Currently I am prescribed 2400 mg every 24 hours. I told the doctor today that I had decreased my Gabapentin by 600 mg., he asked me when did I get my medical degree? I also have developed hammer toes over the last decades, I did not learn that from a podiatrist during this period, I had to learn about it myself this year. The podiatrist said there is nothing I ca; do about it now, he did take my foot size and is going to order some nice sneakers for me. Another medication prescribed for me last year is Duloxitine. From what I have read in this article that may not be such a good idea. I have learned helpful things in this article that I can put to good use, thanks.


I’ve been taking Gabapentin for 2 months now and ever since I’ve started taking it my hair is falling out if I take this for 2 more months I will be bald, my Doctor doesn’t believe it’s the gabapentin that is causing my hair loss but I’ve made no other changes in the past 2 months. I take gabapentin for neuropathy in my feet it seems to help but I don’t want to be bald so I guess I will just have to deal with the pain in my feet. Kinda sad when your doctor won’t take your word for what it’s worth and change your medication. Now a days the medical professionals are becoming less and less helpful and less sympathetic with their patients. Just my opinion maybe I need to look for a new Doctor.

Would love your thoughts, please comment.x