Treating neuropathy: Which medication is best? – Harvard Health Blog

Imagine experiencing burning, tingling, and numbness in your legs day in and day out, getting worse over time — and your doctors can’t find a reason for it.

That’s the situation for millions of people who suffer from idiopathic sensory polyneuropathy. The term “idiopathic” means that no cause can be identified; “sensory” refers to the type of nerve, in this case those carrying nerve signals such as pain or temperature; “poly” means “many” and “neuropathy” means nerve disease. So, this is a condition of unknown cause that damages multiple nerves; the most affected nerves tend to be those that provide sensation to the legs and feet.

Sometimes other terms are used, including cryptogenic neuropathy or chronic polyneuropathy of undetermined cause. For some people, neuropathy is due to diabetes, alcohol abuse, medications, or other conditions. But in nearly half of all cases, sensory polyneuropathy is idiopathic.

No cause, no cure

Regardless of which name is used, the condition is frustrating, annoying, and sometimes debilitating. And without an identifiable and reversible cause, there is no cure. While a number of medications are commonly prescribed, it’s not clear which is most effective or safest. So, doctors generally recommend a period of trial and error. One medication after another is prescribed, until one is found that is effective and doesn’t cause intolerable side effects.

Unfortunately, it can take many months or even longer to find a treatment that works. Doctors have little guidance to know which ones to start with. That’s why research comparing treatment options is so important — and yet, precious little comparative research on treatments for idiopathic sensory polyneuropathy has been published.

Researchers compare four treatments for neuropathy

Researchers publishing in JAMA Neurology describe the results of a unique trial in which 402 people with idiopathic sensory polyneuropathy were randomly assigned

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