Question
My pain gets worse as time goes by from head to toe hot cold numb and sharp no sleep exhaustion flashes of light and ringing in my ears when my nerves jump it sounds and feels like thousands of springs bouncing around the inside of my head I have tryed meditation , medication , stretching , and ......... gabapenten zoloft panlor ss helps the best but I'm just getting worse . I tryed stepping back the amounts which was a big mistake , nerve conductive test diagnosed my condition , also spinal stenosis , I am 47 and work for my medical bills , any thoughts Ideas , besides new age herbal tryed that stuff . Do I have to feel like crap the rest of my Life ? Thank you so much Tom

Answer
Hi Tom and thanks for writing,

Anti-oxidant treatments are gaining more popularity with DPN and I would suggest discussing this with your GP. Traditional pharmacological treatments are those you are on including Tricyclic Antidepressants and Anticonvulsants.

[from: http://neurology.org/cgi/content/abstract/55/7/915] Tricyclic antidepressants and anticonvulsants have become the mainstay in the treatment of pain in polyneuropathy. Within the last decade, controlled trials have shown that numerous other drugs relieve such pain. To estimate the efficacy of the different treatments, the authors identified all placebo-controlled trials and calculated numbers needed to treat (NNT) to obtain one patient with more than 50% pain relief. The NNT was 2.6 for tricyclic antidepressants, 6.7 for selective serotonin reuptake inhibitors, 2.5 for anticonvulsant sodium channel blockers, 4.1 for the anticonvulsant calcium channel blocker gabapentin, and 3.4 for the mixed opioid and monoaminergic drug tramadol, as calculated from a sufficiently large number of patients. Favorable point estimates of NNT of 1.9 for the NMDA-antagonist dextromethorphan and 3.4 for L-dopa were determined from a limited number of data. For capsaicin, the NNT calculated from many exposed patients was 5.9, but most of the data are controversial owing to trial methodology. Finally, the NNT for the antiarrhythmic sodium channel blocker mexiletine was 38, but this value may be biased because of a lack of dichotomous data in several positive trials. Tricyclic antidepressants are at the moment still the drugs of first choice, and drugs such as gabapentin, carbamazepine, and tramadol may be tried if contraindications or tolerability problems are encountered with the tricyclics.

You sound like you have not had much luck with non-traditional treatments, but I would encourage you to look into a good Acupuncturist as I know many people who have received significant relief from Acupuncture.

Please hang in there, I fully empathize how depressing chronic pain is - it can wear you down, but we always have to keep looking for what treatments work for each of us. You might also want to ask for a referral to a Neurologist and ask what the latest treatment methods are - have you ever tried transcutaneous electrostimulation?

I hope this helps and I wish you all the best,

Margot