Treatment has two separate parts: addressing the underlying cause where one is found, which can halt or occasionally improve the neuropathy, and treating the symptoms, which makes daily life tolerable. The first matters more for the long term.
Treatment has two separate parts: addressing the underlying cause where one is found, which can halt or occasionally improve the neuropathy, and treating the symptoms, which makes daily life tolerable. The first matters more for the long term.
This is the part that gets skipped when a prescription for nerve pain is the whole plan. Glucose control in diabetes and pre-diabetes slows progression. Correcting vitamin B12 deficiency can produce genuine improvement, and it is worth remembering that metformin lowers B12. Thyroid disease is treatable. Stopping alcohol matters. Reviewing medications identifies culprits including some chemotherapy agents and, less obviously, excess vitamin B6, which causes neuropathy in overdose as well as deficiency.
Medications used for nerve pain can reduce it substantially, though rarely eliminate it. Several classes are used and response varies between individuals, so more than one attempt is normal rather than a failure. Each is started low and increased gradually, because starting high produces side effects that end the trial prematurely. Ordinary painkillers work poorly for nerve pain, which surprises people. Ask what to do about a missed dose, since some should not be stopped abruptly.
Where sensation is reduced, injuries go unnoticed, and an unnoticed foot ulcer is the complication with the most serious consequences. Daily inspection including between the toes and the soles, using a mirror or asking someone if reaching is difficult, catches problems while they are minor. Well-fitting footwear, checking inside shoes before putting them on, and never walking barefoot outdoors all matter. Physical therapy helps balance, which reduces falls where position sense is affected.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.