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Am I getting correct treatment for peripheral neuropathy?

Q: I am a 45 years old male who experienced mild pain in palm and feet without burning sensation two years back. The doctor prescribed me Methycobalamin 1500 mcg one tablet daily for two - three months along with Superactive capsule. I got temporary relief after taking these medicines. Now again I feel mild pain in palm and feet but this time with burning sensation. I consulted my doctor again who has now prescribed me Gabapentin + Methycobalamin 600 SR and diagnosed it as peripheral neuropathy. I have taken the medicine for three weeks and only a little improvement. In the past two years, I also had a severe back pain with strain in lower spine but only once. I am taking medicine for high blood pressure regularly for the last eleven years. I take Amlopress 5 mg and Losartan potassium 25 mg daily and my blood pressure is under control with these medicines. Do I need any further treatment for peripheral neuropathy?

A:The symptoms of tingling / numbness and / or weakness that starts in the fingers / palms and toes / feet is considered typical of peripheral (meaning away from brain towards periphery of the body) neuropathy (meaning pathology or disease of the nerves). The most common causes are diabetes mellitus, chronic alcohol consumption, vitamin B12 deficiency, certain drugs / medicines, vasculitis (swelling and damage to small blood vessels that supply the nerves) and a genetic predisposition to have this illness. Taller people are known to have early / severe symptoms, as the farther the nerve fibres have to go, the lesser their circumference, and weaker their capacity. Rarely, cervical (neck) spine disease (like disc prolapse, etc) can also cause symptoms similar to peripheral neuropathy. While some like Vitamin B12 deficiency peripheral neuropathy are curable, most other neuropathies can only be controlled / slowed down by strict reduction in risk factors (sugar / alcohol / drugs). In your case, the symptoms appear to be those of early peripheral neuropathy. Please get simple tests done - nerve conduction studies, serum vitamin B12 levels - and a consultation with a qualified neurologist.

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