- Gabapentin compounded cream—we use as a high potency cream to hands, feet or other body parts likely delivering 10x the dose of oral dosing.
- Gabapentin oral—we start with 10-25 mg but often use 1800—2400 mg which may be occasionally needed ifor severe panic and treatment resistant insomnia.
- Pregabalin-related to gabapentin, but they do not have identical outcomes. We go as high as required after fun education.
- Lidocaine-well known for use by dentists, oral/throat pain and surgery, pain patches, and surgery throughout the body. Excess dosing can alter heart rhythm.
- Prilocaine—like lidocaine but less heart risk. It is often added to lidocaine.
- Duloxetine-a double acting antidepressant for all types of pain, with pain receptors aid in the brain. This is the main treatment for chemotherapy-induced peripheral neuropathy 1
- TCA– amitriptyline is a very old antidepressant rarely used for mood.
- TCA transdermal compounded cream to target burning, tingling, etc.
- Acupuncture-beneficial in some peripheral neuropathies.2
- Diabetes and Metabolic Trouble—reverse as able since it causes neuropathy. 3
- Exercise 3
- Peptides (or short amino acid clusters).
- Lower all inflammation-poor sleep, sugar or high carbohydrate diet, poor omega 3 levels, poor 100 trillion bacteria in gut, or any increased discomfort from antibiotics, herbs, antimalarials…. A huge topic alone.
- Address obesity.
- Stem cells—many types of stem cells, and our bias is elective C-section stem cells. High variability to aid any tissue. 4
- HBOT (Hyperbaric Oxygen Therapy)- Useful in diabetic neuropathy. Pressures from 1.4-2.4 ATA pressure are used with the goal of flooding tissue and watery plasma of the blood with oxygen. 5
- Dorsal column spinal cord stimulation-neuropathic pain is outside the spine, in your arms, legs, torso and face. But can be modified by spinal precise waves and frequencies. 6
- Capsaicin dermal patch of 8%-a high concentration of synthetic capsaicin. A favorite in Europe for peripheral neuropathy pain. A mere single 30-min application of the patch provided 12 weeks of pain relief and improved sleep quality compared with placebo. It was not inferior to oral pregabalin in relieving pain with a faster onset of action and greater treatment satisfaction. 7
- Treat very common infections like Bartonella (30%plus of humans), Lyme disease, Babesia, and other biting insect infections. See our vast books, medical blogs, YouTubes, and Facebook for more diagnosis and treatments.
- Kazamel M, Stino AM, Smith AG. Metabolic syndrome and peripheral neuropathy. Muscle Nerve. 2021 Mar;63(3):285-293. doi: 10.1002/mus.27086. Epub 2020 Oct 24. PMID: 33098165.
- Dimitrova A, Murchison C, Oken B. Acupuncture for the Treatment of Peripheral Neuropathy: A Systematic Review and Meta-Analysis. J Altern Complement Med. 2017 Mar;23(3):164-179. doi: 10.1089/acm.2016.0155. Epub 2017 Jan 23. PMID: 28112552; PMCID: PMC5359694.
- Kazamel M, Stino AM, Smith AG. Metabolic syndrome and peripheral neuropathy. Muscle Nerve. 2021 Mar;63(3):285-293. doi: 10.1002/mus.27086. Epub 2020 Oct 24. PMID: 33098165.
- Alizadeh SD, Jahani S, Rukerd MRZ, Tabrizi R, Masoomi R, Banihashemian SZ, Tabatabaei MSHZ, Ghodsi Z, Pour-Rashidi A, Harrop J, Rahimi-Movaghar V. Human studies of the efficacy and safety of stem cells in the treatment of diabetic peripheral neuropathy: a systematic review and meta-analysis. Stem Cell Res Ther. 2024 Nov 19;15(1):442. doi: 10.1186/s13287-024-04033-3. PMID: 39563393; PMCID: PMC11577959.
- Weng J, Ren H, Guo Q, Huang K, Ding L. Efficacy and safety of hyperbaric oxygen therapy for diabetes peripheral neuropathy: A systematic review and meta-analysis. Medicine (Baltimore). 2024 Sep 6;103(36):e39699. doi: 10.1097/MD.0000000000039699. PMID: 39252242; PMCID: PMC11383719.
- D’Souza RS, Barman R, Joseph A, Abd-Elsayed A. Evidence-Based Treatment of Painful Diabetic Neuropathy: a Systematic Review. Curr Pain Headache Rep. 2022 Aug;26(8):583-594. doi: 10.1007/s11916-022-01061-7. Epub 2022 Jun 18. PMID: 35716275.
- Blair, H.A. Capsaicin 8% Dermal Patch: A Review in Peripheral Neuropathic Pain. Drugs78, 1489–1500 (2018). https://doi.org/10.1007/s40265-018-0982-7