Originally Posted by drswier (Post 520420)

Hi

I am a new member and as a physician have extensive experience with patients who have peripheral neuropathy.

You should realize that peripheral neuropathy is only part of a diagnosis. It basically means dysfunction or disease (pathos) of the peripheral nerve.
It can be caused by chemotherapy (particularly taxol and cis platin or carbo platin)
, alcoholism, high lead levels, vasculitis (inflammation of the bloodvessels) of the nerves, diabetes (diabetic neuropathy), vitamin B deficiency, compression of the nerves (compression neuropathy) or a combination of the above.
The symptoms of peripheral neuropathy can also be mimicked by a central nerve compression (like a herniated disc in the neck or back (lumbar spine).
The best strategy to help patients with peripheral neuropathy is to make an accurate diagnosis, optimize the patients’ metabolic problems and decompress the peripheral nerves at places of narrowing if indicated.
Peripheral nerve decompressions are performed by only a handful surgeons in the country, typically plastic and reconstructive surgeons who have specialized in peripheral nerve decompression. They will be willing to decompress your peripheral nerves only when they feel that your symptoms are the result from a compression neuropathy, because a surgeon can only improve a mechanical compression of your nerves and can not alter a metabolic problem with the nerve.
However, sometimes patients can have both a metabolic nerve problem as well as a compression of the nerve. For instance a diabetic with diabetic neuropathy can have carpal tunnel syndrome as well, and a decompression of the carpal tunnel would help the patient greatly with his or her symptoms, although it would not change the diabetic neuropathy part of the problem, only the compression neuropathy part of the problem.
Sadly most physicians are only willing to treat patients with medications like neurontin and lyrica, which treats the symptoms (sometimes) but does not change the cause of the problem.
Also many physicians are not very well educated about the additional options and studies which have been published in several centers showing the progress that has been made with peripheral nerve decompressions. In patients who are good candidates 85% has an excellent outcome and no longer has any pain, or greatly improved pain symptoms.
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dr swier