Question: My husband has peripheral neuropathy. He is in otherwise good health and does not have diabetes. He was a farmer for many years and often came in contact with pesticides. Could this be the cause? Do you have any advice for treatment?

Dr. Hibberd's answer:
Peripheral neuropathy (meaning loss of peripheral nerve function, often sensation loss but may affect motor and positional senses also) is frequently seen as a complication of poorly controlled diabetes, however there are many other causes, including environmental, home, or work exposure to chemicals, heavy metals, and various pesticides. Industrial, automobile, chemical workers and farmers are often found to be at increased risk of inadvertant exposure. Remember that lead exposure in our home and the soil around our homes (especially if downwind from sources of pollution, such as from factories that may have closed many years ago) may also be a cause of neuropathy. Environmental contamination is very common, and is easily tested for.
The first goal of treatment in neuropathy is manage the underlying causes. Be sure to have your neuropathy investigated properly by your physician. Often the neuropathy will improve, or at least slow its progression with proper treatment. Spontaneous remission of chronic neuropathy is not commonly seen without addressing the underlying causes
The second goal of treatment is to relieve any discomforting or painful symptoms.
If your husband does have painful neuropathy, over-the-counter pain medications generally will relieve mild pain, but for more severe symptoms, your doctor may recommend prescription painkillers.
Anti-seizure medications such as gabapentin (Gralise, Neurontin), topiramate (Topamax), pregabalin (Lyrica), carbamazepine (Carbatrol, Tegretol), and phenytoin (Dilantin, Phenytek) are often added to more severe cases to help in relieving nerve pain. Other forms of treatment include local anesthetic patches, and topical capsaicin cream, and targeted physical and occupational therapy. Your doctor can decide the best treatment for neuropthic pain. Its degree of control and remission will be dependant upon the varius causes found and your age and general medical condition.