Dr. Gott: Neuropathy treatment not always effective

Dear Dr. Gott: In your column, you wrote, “Regardless of its cause, your neuropathy can be treated.” Please, please, please tell me how. I have suffered intense pain, burning, numbness, pain, pain, pain for three years from idiopathic neuropathy. I have an internist, have been treated by a neurologist and have seen a podiatrist. I am taking 360 milligrams of Neurontin, 1,200 milligrams Trileptal and 10 milligrams Lortab daily. I have also (in desperation) tried hypnotism, acupuncture and reflexology, and I am currently sleeping on magnets and bars of soap under the sheets. I have tried taking mega-doses of vitamin B. I also have neighbors and relatives suffering. Please help!

Dear Reader: Please note that I said “treated,” not cured. Your treatment has not been effective, however, and you seem to have exhausted most of your possibilities. Unfortunately, you have idiopathic (no known cause) neuropathy (nerve malfunction), so it is virtually impossible to get to the bottom of your pain syndrome. You are reduced to treating your symptom, not its unknown cause.

I recommend a stepped approach. Some readers have written that their neuropathic pain has been controlled, believe it or not, by rubbing Vicks VapoRub over the affected area. Because this off-the-wall remedy is safe and inexpensive, I suggest that you try it first. If this isn’t effective, try Lyrica, a new prescription product that has just been released for the treatment of neuropathic pain. If this is ineffective, progress to professional pain management, which would include the judicious use of narcotics.

At this point, I would like to assure you that you do not have to live out the rest of your life in agony. What you need now is a concerned and supportive medical team that will identify and answer your needs.

If, to live in relative comfort, you need high doses of pain-relieving medication, so be it. You are entitled to pain relief. (If, on the other hand, you were a drug addict seeking a fix, your therapy would be entirely different.)

I believe that your internist is your best first-line resource. If he or she feels comfortable prescribing narcotics or Lyrica for you, fine. Your doctor is the best judge of your health needs. If he or she feels uncomfortable, you should get a referral to a pain clinic.

You do not have to give up hope for relief, but resolution may take some uncomfortable twists and turns. Be ready to adapt and, by all means, be honest in your dealings with medical personnel.

To give you related information, I am sending you a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.