How to Treat Neuropathy in Feet

Neuropathy is a disease affecting the peripheral nervous system (PNS). Your PNS controls body movements, sensations, and automatic functions like blood pressure and sweating. If your nerves are damaged, a variety of symptoms may appear depending on the type of nerves that are damaged. Neuropathy in feet affects 2.4% of the population and 8% of people over age 55 experience the disease.^{[1]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source} Diabetes is a leading cause, but neuropathy can be inherited or caused by infections, other diseases, and trauma. For this reason, it's important to work with your doctor to manage treatment.

Part 1

Part 1 of 3:

Making Lifestyle Changes

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1
Walk regularly. Try to walk outside at least three times a week. Or, do an exercise that is safe and comfortable for you. You can ask your doctor to recommend a proper exercise regimen. Exercise will improve your blood flow and nourish damaged nerves. Walking reduces your overall blood sugar levels and makes diabetes easier to control. If you successfully control your diabetes, your neuropathy will lessen.
- If you struggle with setting aside time to exercise, remember that you can take small steps to be active. For example, you can clean up the house, play with the dog, or hand wash your car. All of these will get your blood flowing.
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Soak your feet. Fill a small container or tub with warm water and add 1/4 cup of Epsom salt for each cup of water. Make sure the water isn't over 100 degrees. Set your feet in the container or tub so that the water covers them. The warmth of the water can relax you and distract from the pain in your feet. And, Epsom salts contain magnesium which can relax your muscles.^{[2]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- If you have an infection or swelling, ask your doctor before soaking in Epsom salts.
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3
Reduce or avoid alcohol. Alcohol can be toxic to your nerves, especially if they are already damaged. You should limit yourself to four drinks spaced over the course of a week. Some forms of neuropathy are actually caused by alcoholism, so you should eliminate alcohol if you have any neuropathy.^{[3]XResearch source} Stopping drinking can relieve your symptoms and prevent more damage.^{[4]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- If alcoholism runs in your family, you may not want to drink at all. Consider giving alcohol up entirely to stay safe and healthy.
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Take evening primrose oil. This natural oil found in a wildflower is available in pill form. Ask your doctor to recommend a specific dose of the supplement evening primrose oil. Studies have shown that the fatty acids it contains can improve symptoms of neuropathy.^{[5]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source} These fatty acids improve your nerve function.
- Other sources of the beneficial fatty acid (GLA) include borage oil and black currant oil.
5
Try acupuncture. Acupuncture is a traditional Chinese medicine in which needles are placed on specific pressure points. Stimulating these pressure points, or acupoints, causes the body to release endorphins, which soothe pain. The acupuncturist will insert four to ten needles into acupoints, and leave them there for about half an hour. You will need six to twelve sessions over a period of three months.^{[6]XTrustworthy SourceHarvard Medical SchoolHarvard Medical School's Educational Site for the PublicGo to source}
- Check the reputation of your acupuncturist before your appointment. Make sure that the facility and needles are sterile to avoid blood-borne diseases.
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Consider complementary and alternative therapies. In addition to acupuncture, you can try meditation and low-intensity transcutaneous electrical nerve stimulation (TENS) for relief of neuropathy symptoms.^{[7]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source} The TENS procedure uses a small battery pack to charge probes that are placed around areas where you're experiencing pain. The probes and battery create a circuit through which an electrical current passes to stimulate the area. Studies have shown that TENS is effective in treating certain kinds of neuropathic pain, although more research is needed.^{[8]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
- Of meditation methods, you can try walking meditation, sitting meditation, Qigong, or Tai Chi. Studies showed pain reduction with regular meditation.^{[9]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}

Part 2

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Using Medical Treatments

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Take medications prescribed by your doctor. A variety of medications are available to treat neuropathy. Your doctor will focus on managing the medical disorder that's causing your neuropathy which will reduce symptoms and improve the nerve function in your feet.^{[10]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source} Your doctor may prescribe:
- Amitriptyline: This medication, originally used as an antidepressant, effectively treats neuropathic pain. You'll be started on the lowest dose, 25 mg a day. You can gradually increase the dosage to 150 mg per day. Always take the medication before going to bed. This drug should not be prescribed if you have a history of suicide risk.
- Pregabalin: This sedative is usually prescribed for pain associated with peripheral neuropathy caused by diabetes. You will start with the lowest possible dose, and increase it as your doctor suggests. The maximum dosage is 50 to 100 mg, taken three times per day by mouth. Maximum dosing may be increased over time to 600mg/day, but dosage over this amount isn't effective.
- Duloxetine: This medication is usually prescribed for pain associated with neuropathic pain caused by diabetes. The dosage starts at 60 mg orally. The dosage can be doubled and your doctor will review the treatment after two months. While you can double the dosage, most doses over 60 mg a day are rarely more effective and may actually cause other problems.
- Combination therapies: Your doctor may recommend combining several medications such as TCA, venlafaxine, or tramadol. These can provide better results for neuropathy than any single medication alone.^{[11]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
2
Use opiates as prescribed. Your doctor may prescribe long-acting opiates to treat the pain of your neuropathy. This is usually determined on an individual basis, because side effects include dependence (addiction), tolerance (they become less effective over time), and headaches.^{[12]XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source}
- Immunosuppressive agents such as cyclophosphamide may also be prescribed to treat a chronic type of neuropathy (dysimmune neuropathy) that may be resistant to other treatments.
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Talk with your doctor about surgery. Depending on the cause of your neuropathy, your doctor may recommend a decompressive surgery. This will release pressure from entrapped nerves which will let them function correctly. Decompressive surgery is often done for carpal tunnel syndrome. But, certain types of hereditary neuropathy that cause issues in the foot and ankle can also benefit from decompressive surgery.
- Amyloid peripheral neuropathy may be treated by a liver transplant, since this type of neuropathy is caused by metabolic liver problems.^{[13]XTrustworthy SourceJohns Hopkins MedicineOfficial resource database of the world-leading Johns Hopkins HospitalGo to source}

Part 3

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Improving Your Health

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1
Include more vitamins in your diet. If you aren't diabetic and have no other recognizable systemic disease then the neuropathy might be caused by deficiencies of vitamins E, B1, B6, and B12.^{[14]XTrustworthy SourceAmerican Diabetes AssociationHealth-based nonprofit focused on preventing and researching diabetesGo to source} However, talk with your doctor before taking a vitamin supplement. Your doctor will need to diagnose the cause of your neuropathy before advising supplements or medications.
- To get more vitamins from a healthy diet, eat plenty of green leafy vegetables, egg yolks, and liver.
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Take control of diabetes. Neuropathy usually develops many years after diabetes has been diagnosed. Good diabetic control can prevent or halt neuropathy. But once developed, it may not be possible to fully reverse the condition. Your doctor will focus on managing the diabetes and controlling the pain caused by neuropathy.^{[15]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- It's important to keep your blood glucose level in check. Target blood glucose level is 70-130 mg/dL at fasting and below 180 mg/dL two hours after breakfast. You should also keep your blood pressure under control.
3
Prevent injury and ulcer formation. You may notice less sensation and feeling in your neuropathic feet. This may make you more prone to injuries like cuts, pricks or scratches. Always wear socks or shoes when inside or outdoors. Repeated injury to your feet can easily lead to ulcer formation that is difficult to heal. You should also ask your doctor to examine your feet when you go in for regular visits.^{[16]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- Use loose fitting footwear such as a pair of backless slippers, but avoid shoes, sandals, or flip-flops that offer little support. Tight shoes may compromise adequate blood supply to pressure points of your feet and lead to ulcer formation in those areas.
- Keep your nails at a good length. This will prevent ingrown toenails. Just use caution when clipping. To avoid accidental cuts, don't use blades.
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Keep developed ulcers clean. Wash the ulcer area with warm salt water. Take a piece of sterile gauze and pour a little saline over it. Use this to clean the dead tissue over the ulcer. Then, dry the area and cover the ulcer with a sterile dressing. Take care to change the dressing once or twice a day, more often if it gets wet. If there is a foul smell from the ulcer, return to your doctor immediately because a bad smell indicates infection which can be serious.^{[17]XTrustworthy SourceCleveland ClinicEducational website from one of the world's leading hospitalsGo to source}
- Immediately inform your doctor that you have ulcers. If they're small, they can be treated easily with dressings and antibiotics. However, large ulcers can be difficult to heal. They can even lead to amputation of toes or feet.
5
Control the pain. The severity of neuropathic pain varies widely. If you're experiencing mild to moderate pain, take over-the-counter (OTC) analgesics. can be treated with over the counter analgesics. You may take 400 mg of ibuprofen or 300 mg of aspirin two to three times a day.^{[18]XTrustworthy SourceJohns Hopkins MedicineOfficial resource database of the world-leading Johns Hopkins HospitalGo to source}
- Do not forget to take anti-peptic drugs because the analgesics (Ibuprofen, etc.) are irritating to the stomach. For example, you could take 150mg of ranitidine twice daily before meals.
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Get medical treatment for underlying causes. Neuropathy due to kidney, liver or endocrine diseases can be corrected by treating the underlying disease. If you have nerve compression or local problems, it can be improved by physiotherapy or surgery.
- You should always talk with your doctor about neuropathy you're experiencing and before taking any supplements.

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You may be able to relieve symptoms by increasing hydration or wearing compression stockings.
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The disease can be acute or chronic. In the case of acute neuropathy, immediate medical examination is necessary.
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