| ASKTHE EXPERTS Q: I have neuropathy in my feet. Can you recommend any good shoes to wear with this condition? | Answer: N Watch Slideshow Peripheral neuropathy is a frustrating problem. There have been advances in the medical treatment of peripheral neuropathy, with the FDA approval of drugs like pregabalin (Lyrica) and duloxetine (Cymbalta) for diabetic neuropathy. Unfortunately, there is no single answer to what type of shoes to wear. Ultimately, this comes down to what you find comfortable and meets your needs. In general, people tend to like good walking shoes, whether in the form of some type of sneaker or running shoe, or the more formal leather shoes. Some people can only tolerate open toed sandals or "flip-flops." There is no medical answer to this question: the real answer is what works for you. Thank you for your question. Medical Author Dr. Standiford Helm II
Medical Editor Dr. Melissa Conrad Stöppler Last Editorial Review: 2/20/2007 v v v Q: I have neuropathy in my feet following chemotherapy for testicular cancer. Are there any new treatments or medicine that will relieve the pain and tingling? | Answer: Peripheral neuropathy has been area of exciting new developments in medicine. We have for decades used antidepressant and anti-seizure medications for neuropathic pain. Recently, one medication from each class, duloxetine and pregabalin, has been approved by the FDA for diabetic peripheral neuropathy, which is very close to the type of neuropathy which you have. These drugs are either easier to use, have fewer side effects, or are slightly more effective than other options. We are also using opioids more often to treat peripheral neuropathy. Implantable devices, such as spinal cord stimulators, can be tried, but have had limited success in treating peripheral neuropathy. Thank you for your question. Medical Author Dr. Standiford Helm II
Medical Editor Dr. Melissa Conrad Stöppler Last Editorial Review: 2/14/2007
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Q: I have seen the Rebuilder Treatment System sold on the Internet. It claims to effectively treat neuropathy. The company states this device is FDA approved. Has it been scientifically proven to be safe and effective? | Answer: For The FDA is concerned about the safety of devices. In this instance, the device has a 510k "approval," which means that it is "substantially equivalent" to another device which had previously been shown to be safe. Medical devices must have some form of FDA approval prior to being marketed. Since this device is approved, it is legal to market it. This approval says nothing about the effectiveness of the device. Effectiveness is a separate issue not addressed by the FDA. It is up to the purchaser to determine whether the information provided is sufficient to document effectiveness. Thank you for your question. Medical Author Dr. Standiford Helm II
Medical Editor Dr. Melissa Conrad Stöppler Last Editorial Review: 1/2/2007 v v v Q: What kind of relief or treatment is there for peripheral neuropathy? | Answer: Peripheral neuropathy is when the peripheral nerves (as compared to the spinal cord or brain) become the source of pain. One way to look at pain is whether it is in response to an appropriate stimulus, such as someone stepping on your toe, or whether the pain occurs for no obvious reason; malfunctioning of the nerves themselves becomes the source of the pain. Peripheral neuropathy can occur for many reasons, including as a consequence of diabetes, following trauma, toxins, and in alcoholism, to name a few causes. Peripheral neuropathy can also occur for no obvious reason. Treatment depends in part upon the cause of the neuropathy. In general, physicians prescribe drugs that alter the processing of pain information in the spinal cord. Examples would include antidepressants, anti-epilepsy drugs, certain alpha-2 agonists, and opioids. Peripheral neuropathies can be frustrating to treat. As a general rule, the drugs used have a number needed to treat of about three, meaning that you have to treat three people to get one who has a 50% reduction of pain. Much of this treatment is off label, meaning that the drugs are prescribed for a different use than one of their FDA-approved indications. However, two new medications which have received specific FDA approval for diabetic peripheral neuropathy are pregabalin and duloxetine. Thank you for your question. Medical Author Dr. Standiford Helm II
Medical Editor Dr. Melissa Conrad Stöppler Last Editorial Review: 12/5/2006 v v v Q: Does the weather affect neuritis? | Answer: Weather can influence a number pain problems, most commonly those affecting the joints, for example, arthritis. We are all familiar with someone with a bad knee or a bad back being able to tell when bad weather is coming, presumably because the low pressure is increasing their joint stiffness. However, problems with the nerves are not usually thought of as becoming worse with cold or rainy weather. Thank you for your question. Medical Author Dr. Standiford Helm II
Medical Editor Dr. Melissa Conrad Stöppler Last Editorial Review: 5/30/2007 | 
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