The goals of treatment include finding the cause, maximizing self-care ability and independence, and controlling symptoms.

The cause should be identified and treated whenever possible. This may include such things as controlling blood sugar levels for diabetics, abstaining from alcohol, and taking daily nutritional supplements. If medications (such as some treatments for HIV) are causing the problem, these should be identified and changed, if possible.

MAXIMIZE SELF-CARE AND INDEPENDENCE

Physical therapy, vocational therapy, occupational therapy, and orthopedic interventions may be recommended to promote self-care ability and independence.

For example, exercises and retraining may increase muscle strength and control. Appliances such as wheelchairs, braces, or splints may provide mobility or help support an extremity so that it can be used.

CONTROL OF SYMPTOMS

Safety is an important consideration for people with neuropathy. Lack of muscle control may increase the risk of falls or other injuries. Also, decreased sensation may increase the risk of falls and injuries because the person is unable to perceive a potential source of harm.

Safety measures for people with difficulty in movement may include the use of railings, removal of obstacles (such as loose rugs that may slip on the floor), and other measures as appropriate.

Safety measures for people experiencing difficulty with sensation include awareness of the lack of sensation and compensation through other measures. Specific measures may include the use of adequate lighting (including lights left on at night), testing of water temperature before bathing, use of protective shoes (such as those with closed toes and low heels), and similar measures.

People with decreased sensation should check their feet (or other affected area) frequently for bruises, open skin areas, or other injury, which may go unnoticed and become severely infected.

Shoes should be checked inside frequently for grit or rough spots that may injure the feet. Patients with sensorimotor neuropathy should be evaluated by a podiatrist to reduce the risk of injury to the feet.

People with neuropathy are prone to new nerve injury at pressure points (such as knees and elbows). They should avoid prolonged pressure on these areas from leaning on the elbows, crossing the knees, or being in similar positions.

Over-the-counter analgesics or prescription analgesics may be needed to control pain (neuralgia). Various other medications may be used to reduce the stabbing pains that some people experience, including anticonvulsants (phenytoin, carbamazepine, neurontin) or tricyclic antidepressants. Whenever possible, medication use should be avoided or minimized to reduce the risk of side effects.

Positioning, keeping bedclothes off a tender body part, or other measures may be helpful to control pain.

If the cause of the sensorimotor polyneuropathy can be identified and successfully treated, and if the damage is limited to the axon or myelin sheath -- leaving the cell body intact -- there is a possibility of full recovery from peripheral neuropathy.

The extent of the disability varies (from no disability to partial or complete loss of movement, function, or sensation). Nerve pain may be quite uncomfortable and may persist for a prolonged period. Occasionally the disorder causes severe, life-threatening symptoms.

• Partial or complete loss of movement
• Partial or complete loss of control of movement
• Partial or complete loss of sensation
• Difficulty swallowing
• Recurrent or unnoticed injury to any part of the body
• Deformity