Understanding Peripheral Neuropathy Treatment Options

TL;DR: Peripheral neuropathy treatment options range from medications and physical therapy to a nutrition review. Some people use several approaches together. At Innovare Tx in Addison, TX, our multi-modal neuropathy program reviews possible contributors to your symptoms alongside your medical care. Individual results vary.

If you’ve recently been diagnosed with peripheral neuropathy — or you’ve been battling numbness, tingling, and burning pain in your hands or feet for months — you’re probably wondering: can neuropathy be treated, and what are my options?

The short answer is that it depends on the cause. Some causes can be treated in their own right, and symptoms can often be managed, but established nerve damage is generally not reversed.

As someone with 27 years of medical experience, I often hear from people who want to know what else is available besides a prescription.

This guide walks you through the main peripheral neuropathy treatment options, along with the benefits and limitations of each.

What Is Peripheral Neuropathy? A Brief Overview

Peripheral neuropathy occurs when the peripheral nerves — the vast communication network that sends signals between your brain, spinal cord, and the rest of your body — become damaged or dysfunctional.

Peripheral neuropathy affects millions of people in the U.S., according to the National Institute of Neurological Disorders and Stroke.

Common Causes Include:

• Diabetes (the most common cause; about one-third to one-half of people with diabetes have peripheral neuropathy, according to the NIDDK)
• Chemotherapy treatment
• Autoimmune conditions (lupus, rheumatoid arthritis)
• Vitamin deficiencies (B1, B6, B12)
• Alcohol use disorder
• Physical trauma or repetitive stress injuries
• Idiopathic causes (no identifiable origin)

Symptoms That Impact Daily Life

The symptoms of peripheral neuropathy go far beyond “a little tingling.” Patients commonly describe:

• Burning, stabbing, or electric-shock pain — often worst at night
• Numbness in the feet and hands, making it difficult to feel temperature changes or injuries
• Loss of balance and coordination — leading to falls and fractures
• Muscle weakness that affects walking, gripping objects, and routine tasks
• Sleep disruption from constant pain or restless legs
• Emotional toll — anxiety, depression, and frustration from chronic pain

Left unmanaged, neuropathy can limit your mobility, independence, and quality of life, and reduced sensation and balance can raise the risk of falls.

There are options to talk through, and an evaluation can look for causes that can be treated in their own right.

Peripheral Neuropathy Treatment Options: A Complete Breakdown

Understanding your neuropathy treatment choices starts with knowing what’s available. Here are the major categories, along with honest assessments of each.

1. Medications: The Standard First Step

Most physicians start with prescription medications to manage neuropathic pain. The most commonly prescribed include:

• Gabapentin (Neurontin) — An anticonvulsant that reduces nerve pain signals. Effective for some patients, but common side effects include drowsiness, dizziness, weight gain, and brain fog.
• Pregabalin (Lyrica) — Similar mechanism to gabapentin, with similar common side effects.
• Duloxetine (Cymbalta) — An SNRI antidepressant that also modifies pain signaling. Can help with both pain and the depression that often accompanies chronic neuropathy. Side effects may include nausea, dry mouth, and fatigue.
• Topical treatments — Capsaicin cream and lidocaine patches provide localized relief with fewer systemic side effects.

The limitation: Medications manage symptoms and do not repair nerve damage, and side effects can be a problem for some people.

Medications have a role, and your prescriber can help you decide how they fit into your plan.

2. Physical Therapy: Rebuilding Function and Preventing Falls

Physical therapy for neuropathy is one option. A physical therapist can design a program focused on:

• Balance training: Working on proprioception (your body’s sense of where it is in space)
• Strength exercises: Working on muscle weakness
• Gait retraining — Improving walking patterns to compensate for loss of sensation
• Desensitization techniques — Gradually reducing hypersensitivity in painful areas
• Mobility preservation — Keeping joints flexible and functional

At Innovare Tx, our physical therapist Rowena Calleja, PT works with neuropathy patients as part of the care team at the same clinic.

3. Electrical Nerve Stimulation

Electrical stimulation therapies use controlled electrical impulses and are intended to modulate pain signals or work muscles:

• TENS (Transcutaneous Electrical Nerve Stimulation) — Portable units that patients can use at home, intended to interrupt pain signals
• NMES (Neuromuscular Electrical Stimulation) — Stimulates weakened muscles

These are non-invasive, drug-free options some people try. Evidence varies, and individual responses vary.

4. Nutritional Optimization

Nutritional deficiencies can cause or worsen peripheral neuropathy, so a confirmed deficiency is worth correcting. Evidence for supplements beyond that is more limited:

• Vitamin B12 — Essential for myelin sheath maintenance (the protective coating around nerves). Deficiency is common, especially in patients over 60 or those taking metformin for diabetes.
• Vitamin B1 (Benfotiamine): A fat-soluble form of thiamine. A 2026 review concluded routine use cannot be recommended outside documented thiamine deficiency.
• Vitamin B6 — Important for nerve function, but must be carefully dosed — excess B6 can actually cause neuropathy.
• Alpha-lipoic acid (ALA): An antioxidant studied in diabetic neuropathy. A 2026 review reported short-term symptom improvement across randomized trials, but called the evidence for long-term nerve function very limited and inconclusive. Ask your provider before starting it.

Important: Supplementation should be guided by lab work. At Innovare Tx, we can order bloodwork through our primary care services to look for deficiencies and talk through what they mean for you.

5. A Note on PRP and Other Orthobiologics

Some patients ask about orthobiologic medicine, particularly PRP (Platelet-Rich Plasma).

PRP is an autologous procedure: a small sample of your own blood is drawn and spun in a centrifuge to concentrate the platelet fraction, which is then delivered by injection. Because the material comes from you, there is minimal risk of allergic reaction or rejection.

PRP, PPP, BMAC, and A2M are considered investigational and are not FDA-approved for the treatment of any specific condition, including peripheral neuropathy. We’re transparent about that. Whether an orthobiologic procedure is an appropriate option for you is a decision to make with your provider after a clinical evaluation.

6. Lifestyle Steps to Discuss

These lifestyle steps are commonly recommended:

• Blood sugar control: For diabetic neuropathy, working toward the A1c target your care team sets is the foundation of care
• Regular low-impact exercise — Ask which activities are right for you, especially if your feet have reduced sensation
• Smoking cessation — Smoking constricts blood vessels and starves nerves of oxygen and nutrients
• Alcohol moderation — Alcohol is directly neurotoxic and worsens most forms of neuropathy
• Foot care: Daily inspection, proper footwear, and moisture management can help you catch problems early
• Stress management: Stress can make pain feel worse

Weight can also be part of the picture. If it is, ask whether our medically supervised weight management program fits.

Why Some People Use More Than One Approach

Neuropathy can affect sensation, strength, balance, and sleep, and more than one factor can be involved. Medicine may ease pain for some people, while physical therapy works on balance and strength, and labs can look for a deficiency. Using more than one approach does not guarantee a better result, so ask your provider what makes sense for you.

The Innovare Tx Neuropathy Program: How We Combine Multiple Modalities

At Innovare Tx, we built our neuropathy program around looking at the whole picture rather than one symptom.

Here’s how our multi-modal peripheral neuropathy program is set up:

Step 1: Comprehensive Evaluation

Every patient starts with a thorough assessment, including:

• Detailed neurological examination
• Comprehensive bloodwork (vitamin levels, metabolic panel, A1c, inflammatory markers)
• Referral for EMG/nerve conduction testing when needed
• Balance and gait assessment by our physical therapy team
• Full medical history review to identify underlying causes

Step 2: Customized Multi-Modal Treatment Plan

Based on your evaluation, we create a personalized plan that may include:

• Nutrition guidance based on lab results
• PEMF, red light, and cold laser sessions (cash-pay). Research on these for neuropathy is limited, and they may not help you
• Physical therapy with Rowena Calleja, PT — focused on balance, strength, and fall prevention
• Medication review, including medications that may be contributing to side effects
• Lifestyle and dietary coaching tailored to your specific type of neuropathy

Step 3: Ongoing Monitoring and Adjustment

We track your progress with structured symptom and functional assessments, adjust your plan as needed, and keep you involved in your care.

Our clinic has physical therapy and medical care under one roof, so your care team can coordinate. Meet our care team.

Who Is This Program For?

Our neuropathy program is designed for patients who:

• Have been diagnosed with peripheral neuropathy and want a comprehensive treatment plan
• Want to discuss options alongside their current medications
• Are experiencing balance problems or have had falls related to neuropathy
• Have diabetic neuropathy and want to review their options

Talk With Us About Your Options

If you’re living with peripheral neuropathy in the Dallas-Fort Worth area, our multi-modal neuropathy program is available in Addison, TX.

Charles Ortega, PA-C, MPAS brings 27 years of medical experience. Our team takes the time to understand your specific situation, because no two neuropathy patients are the same.

Call us at (214) 233-3094 to schedule your neuropathy evaluation, or visit us at 16901 Dallas Parkway, Suite 210, Addison, TX 75001. You can also book online through our scheduling portal.

Insurance: we accept 200+ plans, including Aetna, BCBS, Cigna, Medicare, and UHC. Financing available through Cherry, Affirm, and CareCredit. See our insurance & billing page for details.

Frequently Asked Questions About Peripheral Neuropathy Treatment

Can neuropathy be treated, or is it permanent?

It depends on the cause. Some causes can be treated in their own right, and symptoms can often be managed, but established nerve damage is generally not reversed. At Innovare Tx, our neuropathy program combines a nutrition review, physical therapy, and PEMF, red light, and cold laser sessions. Research on those modalities is limited, and individual results vary.

Which treatment is best for peripheral neuropathy?

It depends on the cause and your symptoms. Standard options include medicines for nerve pain, physical therapy for balance and strength, and treating causes such as a vitamin deficiency or high blood sugar. No single approach suits everyone, so your provider helps you weigh the options.

How long does neuropathy care take?

We cannot say when, or whether, you will notice a change, because it varies with the severity and cause of your neuropathy. Your provider sets the schedule, tracks your progress with structured symptom and functional assessments, and adjusts your plan as needed.

Does insurance cover neuropathy treatment?

Some parts may be covered, depending on your plan. PEMF, red light, and cold laser sessions are cash-pay; office visits, labs, physical therapy, and any EMG/nerve conduction testing may be billable to insurance. We accept 200+ plans, including Aetna, BCBS, Cigna, Medicare, and UHC. Our team can help check your benefits before you start. For out-of-pocket costs, we offer financing through Cherry, Affirm, and CareCredit.

How is your neuropathy program different from taking gabapentin?

Gabapentin is a prescription medicine for nerve pain. Our program is a set of services: a review of possible contributors such as nutritional deficiencies, physical therapy for balance and strength, and PEMF, red light, and cold laser sessions. It is not a replacement for a prescribed medicine, and we are not saying it works better. Individual results vary.

Is peripheral neuropathy treatment painful?

Most of these options are non-invasive. Physical therapy is tailored to your current ability level and progresses gradually. Tell your provider if anything is uncomfortable.

Can diabetic neuropathy be reversed?

Established nerve damage is generally not reversed. Working toward the A1c target your care team sets is the foundation of slowing progression, and symptoms such as burning and night pain can often be managed. It is also worth ruling out other contributors, such as a B12 deficiency.