Additional Treatments for Neuropathic Pain

Neuropathic pain is often difficult to treat, and a number of therapies may need to be explored to reduce pain and improve daily functioning.

Psychological Treatments

Getting help with stress, depression, or anxiety related to neuropathic pain can have a positive impact on an individual’s perception of pain.

See Stress-Related Back Pain

Psychologists and psychiatrists are trained in a number of potentially useful therapies for dealing with chronic neuropathic pain, such as:

• Cognitive behavior therapy. Self-defeating thoughts and behaviors are identified and reframed by the therapist to help the individual be more positive, productive, and healthy.
• Biofeedback. The body’s stress-related processes are monitored, with the information provided to the individual. Techniques to control stress and reduce the perception of pain are then developed.
• Relaxation strategies. Muscle tension can aggravate pain. Many people find breathing exercises, meditation, and visualization relaxing ways to cope with life’s challenges. Medical studies on the benefits of these approaches is limited, but since there are no side effects, there is no risk in an individual trying one or all of these techniques.
• One-on-one or group counseling. Talking over the challenges that come with neuropathic pain can be helpful. Meeting in a group session allows individuals to share experiences and learn coping techniques from others who face similar problems.

Some psychologists and psychiatrists offer online counseling for those who have difficulty traveling to the therapist’s office.

Acupuncture

First used in ancient China to treat pain, acupuncture has found a place in modern medicine. During the treatment, an acupuncturist inserts hair-thin needles at selected points in the body. Many people consider the process relaxing.

Medical studies have shown acupuncture to be helpful in relieving the pain of diabetic neuropathy and two types of peripheral neuropathy: Bell’s palsy (affecting a facial nerve), and carpal tunnel syndrome (affecting the arm). ¹ Dimitrova A, Murchison C, and Oken B. Effects of Acupuncture on Neuropathic Pain: A Systematic Review and Meta-analysis Published online before print April 8, 2015, Neurology April 6, 2015 vol. 84 no. 14 Supplement.

Transcutaneous Electrical Nerve Stimulation (TENS) and Percutaneous Electrical Nerve Stimulation (PENS)

Two treatments using pulses of mild electric current have been helpful for some types of neuropathic pain. The current interferes with pain signals, relieving pain. No medication is needed for either transcutaneous electrical nerve stimulation (TENS) or percutaneous electrical nerve stimulation (PENS).

See How Electrotherapy Works to Ease Pain

Transcutaneous Electrical Nerve Stimulation (TENS). To begin the procedure, electrodes are attached to the skin. When the stimulation is turned on, there is a slight tingling sensation. Battery-operated TENS devices can be worn on the body and used multiple times a day. The individual controls the level of stimulation.

See Transcutaneous Electrical Nerve Stimulators (TENS)

The medical literature has noted short-term benefits from TENS for people with diabetic neuropathy. ² Dubinsky RM, Miyasaki J. Assessment: efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2010;74(2):173-6.

Percutaneous Electrical Nerve Stimulation (PENS). In addition to electrical stimulation, as in TENS, thin needles are placed near nerves in a painful area, and the stimulation is begun. PENS is typically used if TENS has not provided the needed relief.

See Percutaneous Electrical Nerve Stimulation and Electrical Muscle Stimulation

The medical literature has shown PENS to be helpful for short-term relief of neuropathic pain. ³ Raphael JH, Raheem TA, Southall JL, Bennett A, Ashford RL, Williams S. Randomized double-blind sham-controlled crossover study of short-term effect of percutaneous electrical nerve stimulation in neuropathic pain. Pain Med. 2011;12(10):1515-22.

Soreness and bruising of the affected area are the most common side effects with TENS and PENS. There is also a less common risk of nerve damage or infection.

See All About Electrotherapy and Pain Relief

The lack of medication can be an advantage for people concerned about medication interactions, risks, and side effects.

Antibody Treatments

Therapies to control autoimmune and inflammatory conditions related to neuropathy include antibody treatments. Antibodies are designed to fight off infection, but some people with neuropathy need help in getting the balance right.

Intravenous immunoglobulin, or IVIg, uses injections of concentrated antibodies from blood donated by healthy people. The antibodies are placed in a sterile solution before being injected. Injections are typically given about once a month.

Plasmapheresis, or plasma exchange, takes blood from an individual, then returns it to the body after its antibodies are removed. An individual may need multiple treatments a week.