The Ultimate Neuropathy Quiz

"Neuropathy" is an umbrella term that covers a number of conditions affecting the nerves. Merriam-Webster defines neuropathy as "an abnormal and usually degenerative state of the nervous system or nerves."

Neuropathy presents in many different ways, but most commonly, patients will complain of a persistent burning\stinging sensation in their hands or feet. Doctors call this a typical "stocking/glove" presentation.

Twenty to thirty percent of diabetics will develop some type of neuropathy.

Neuropathy can also result from vitamin-B deficiencies, tumors, infections, cancer treatments and certain hereditary disorders.

The best way to treat neuropathic pain is by treating the underlying cause of the pain.

Doctors can't always determine the underlying cause of neuropathic pain. In these cases, and in situations where treatment of the underlying cause doesn't relieve the pain, it's necessary to treat the symptoms.

No one knows why, but patients with chronic pain often have low levels of serotonin and other neurotransmitters. Using antidepressants will increase these levels.

Anticonvulsants involving calcium channel alpha-2-delta ligands are another first-line treatment for neuropathy.

Tricyclics like Elavil (Amitriptyline) are often prescribed as a first-line treatment for neuropathy pain.

SNRIs (serotonin-norepinephrine reuptake inhibitors) like Cymbalta (Duloxetine) and Effexor (Venlafaxine) have been shown to be effective in treating neuropathic pain.

Calcium channel alpha-2-delta ligands such as Gabapentin and Pregabalin are considered to be first-line treatments for neuropathy pain.

Even though anticonvulsants and antidepressants are effective in treating neuropathic pain, about half of those who take them will not see any improvement. In these cases, topical pain relievers might help.

Lidocaine has been around since the 1940s. Typically, it's prescribed in 5 percent patches; up to three patches can be applied topically on a localized painful area and worn for 24 hours.

An increasing body of evidence supports the role of voltage-gated sodium channels in peripheral nerve pain and helps explain why blocking these channels helps to relieve neuropathic pain.

In one study, 33 percent of patients reported a 50 percent reduction in pain; 50 percent reported at least a 30 percent reduction after using a single high-dose capasicin patch.

The active ingredient in capsaicin is derived from chili peppers. Capsaicin patches and creams are widely available over the counter for the deep-heating treatment of minor muscle pain. The dosages required for the treatment of chronic neuropathic pain, however, are much higher and require a prescription.

The reported benefits of Cannabinoids, of which THC(the main psychoactive compound in cannabis or marijuana) is one, have been confirmed in multiple randomized trials. A recent review concluded that 15 out of 18 trials showed that cannabinoids provided a significant pain-relieving effect when compared with a placebo.

There's no doubt that opiates will reduce almost any kind of pain, including neuropathic. However, opiates are addictive and there are pros and cons to using them for long-term pain management.

In cases where first-line treatments are ineffective, scheduled long-acting opioids like fentanyl patches or extended-release oxycodone are preferred over shorter acting agents.

Alternative therapies like acupuncture have been shown to be effective in the treatment of neuropathic pain. In one study, acupuncture was shown to be more effective than medication in treating neuropathy induced by chemotherapy drugs.