Nerve Pain (Neuropathy) Treatment in Castle Rock
What is Neuropathy?
Neuropathy (also called peripheral neuropathy or nerve pain) is a condition caused by damage to the peripheral nerves - the nerves outside the brain and spinal cord. When these nerves are damaged, they send abnormal pain signals to the brain, causing burning, tingling, numbness, or shooting pain - often in the hands and feet.
Neuropathy is different from a pinched nerve (radiculopathy). A pinched nerve is caused by compression of a specific nerve root in the spine and causes pain that follows a specific pattern down the arm or leg. Neuropathy is caused by damage to the nerves themselves, often from diabetes, and tends to affect both sides in a "stocking and glove" distribution (hands and feet first, gradually spreading upward).
What Causes Neuropathy?
Diabetes: The most common cause. High blood sugar over time damages the small blood vessels that supply the nerves.
Chemotherapy: Certain cancer treatments damage peripheral nerves (chemotherapy-induced peripheral neuropathy or CIPN).
Alcohol use: Chronic alcohol use can directly damage nerves and also causes nutritional deficiencies that contribute to neuropathy.
Vitamin deficiencies: B12 deficiency in particular can cause neuropathy.
Autoimmune conditions: Diseases like lupus, Guillain-Barre syndrome, and chronic inflammatory demyelinating polyneuropathy (CIDP).
Infections: Shingles (post-herpetic neuralgia), HIV, and Lyme disease can all cause nerve damage.
Idiopathic: In many cases, no specific cause is identified despite testing.
What Does Neuropathy Feel Like?
Burning, tingling, or "pins and needles" in the hands or feet
Numbness or reduced sensation, especially in the fingers and toes
Sharp, shooting, or electric shock-like pain
Sensitivity to touch - even light contact with socks, shoes, or bedsheets may be painful
Muscle weakness, difficulty with grip, or unsteady balance
Symptoms that are often worse at night
How is Neuropathy Diagnosed?
Dr. Carrera's team evaluates neuropathy through a detailed history and neurological examination, including testing sensation, reflexes, and strength. Blood tests may be ordered to check for diabetes, vitamin deficiencies, thyroid disorders, and inflammatory markers. In some cases, nerve conduction studies (EMG/NCS) are ordered to assess the extent and type of nerve damage. Imaging (MRI) may be used to rule out spinal nerve compression that could be mimicking or contributing to the symptoms.
How is Neuropathy Treated?
Neuropathy treatment focuses on managing pain, slowing progression (by treating the underlying cause), and maintaining function.
Treating the underlying cause: If diabetes is the cause, improving blood sugar control is the most important step. If a vitamin deficiency is identified, supplementation can help. Reducing alcohol intake, adjusting medications that may be contributing, and managing autoimmune conditions all address the root problem.
Nerve-calming medications: Gabapentin and pregabalin are the most commonly used medications for neuropathic pain. They work by calming overactive nerve signals. Duloxetine (Cymbalta) and amitriptyline are also effective for many patients. These medications do not cure the nerve damage but can significantly reduce the pain.
Topical treatments: Lidocaine patches, capsaicin cream, and compounded topical medications can provide localized relief, especially for focal areas of nerve pain.
Spinal cord stimulation (SCS): For patients with neuropathy that is not adequately controlled with medications, spinal cord stimulation can provide significant relief. SCS is especially effective for diabetic neuropathy and has growing evidence in this area. The trial-first approach lets you test the device before committing.
Peripheral nerve stimulation (PNS): For localized nerve pain, peripheral nerve stimulation can target the specific nerve involved.
Physical therapy: Balance training and strengthening exercises help compensate for sensory loss and reduce the risk of falls.
Schedule an Evaluation
If you have burning, tingling, or numbness in your hands or feet that is affecting your daily life, Dr. Carrera's team can evaluate the cause and develop a treatment plan focused on reducing pain and protecting nerve function.