Prevention of Neuropathy
Prevention of neuropathy depends on optimal management of predisposing conditions, such as diabetes. Once neuropathy emerges as part of a predisposing illness, management of that underlying cause can prevent advancement of the disease or mitigate its severity.
Pain is a large component of neuropathy, and its prevention is a cardinal feature of neuropathic management. For patients with neuropathic pain, pain can be prevented with anticonvulsants such as gabapentin and pregabalin. Antidepressants that impact the re-uptake of pain-related neurotransmitters, serotonin and norepinephrine, can be used as adjuncts. Narcotic agonist/antagonists (e.g., tramadol), low dose narcotics, or NSAIDs can be available for those who have breakthrough spikes of pain.
Interventional injections of anesthetic or steroids can prevent continued symptoms of neuropathy from compressive inflammation syndromes. When these fail, or if the compression is a mechanical distortion of the bone anatomy, a therapeutic or pre-emptive decompression via surgery can both eliminate the compression as well as prevent further damage to the nerves already involved.
For patients who do not benefit from the more conservative remedies that medical management or physical therapy hope to achieve, or who require multiple injections, nerve ablation via radiofrequency (thermal) destruction is useful if the nerves are purely sensory. (Destruction of motor nerve components may cause damage that cannot be healed or undone.)
The diagnostics used for neuropathy can be repeated serially to identify the severity of disease in hopes of preventing its progression.