Is polyneuropathy curable?
Whether polyneuropathy is curable in an individual patient depends on the type of polyneuropathy, how bad it is and how long it has been present. In some forms of polyneuropathy, such as Guillain-Barré syndrome, polyneuropathy after chemotherapy or alcoholic polyneuropathy, there is a good chance of cure. Other forms, such as Diabetic Polyneuropathy and Idiopathic Polyneuropathy are unfortunately rarely curable.
Virtually every patient wonders whether polyneuropathy is curable, i.e. whether the symptoms and limitations will eventually disappear. Most of the times it is very difficult to give them a clear answer. Mostly it depends on what form of polyneuropathy is present and especially how long the polyneuropathy has been present.
When polyneuropathy has started only recently, the chances of recovery are still relatively high. However, the chances decrease the longer the disease persists. For example, if a polyneuropathy has just started due to chemotherapy and the chemotherapy was only given for a short period of time, then there is a very good chance of improvement and even a complete cure. Usually, polyneuropathy improves within a year after chemotherapy. If the problems persist after that, the chances of complete recovery are poor, unfortunately.
The same applies to the so-called Guilain-Barré syndrome, which appears very suddenly and develops extremely quickly. It can often be treated very well with immunoglobulins and in many cases it is cured completely. However, the longer the problems persist, the worse the chances of improvement. There are other forms of polyneuropathy with good chances of complete recovery. If the polyneuropathy was triggered by alcohol and one manages to abstain from alcohol, there is a good chance of recovery.
It is different in chronic forms of polyneuropathy. For example, if one has been suffering from diabetic polyneuropathy for a long time or from a slowly developing idiopathic polyneuropathy (this is the form of polyneuropathy for which no cause can be determined), then the chances of complete recovery are very poor.
However, even in these cases, there are ways to relieve the symptoms and slow down the deterioration.
As I said, it depends mainly on the type of polyneuropathy. I will now discuss different forms of polyneuropathy individually, but not all of the numerous types.
Acute inflammatory demyelinating polyneuropathy (Guillain-Barré syndrome)
Acute inflammatory demyelinating polyneuropathy can now be treated quite well. This is usually done with immunoglobulins. Although the disease often starts frighteningly quickly, going from complete health to not even being able to walk in a very short time, many patients are completely cured.
I myself have a friend who developed this form of polyneuropathy while still in high school. However, he was fully recovered after only a couple of weeks. In about 80% of cases, the disease ends so mildly. However, this should not obscure the fact that about 20% of patients suffer permanent damage and the disease often (up to 5% of cases) even leads to death.
Polyneuropathy due to chemotherapy
For about 15 years, drugs that cause nerve damage as a side effect have been increasingly used in chemotherapy. They are very effective against cancer - but also cause polyneuropathy. This is particularly the case with metastatic breast cancer, but also other types of cancer.
Measures against polyneuropathy should be taken as early as possible, because the less pronounced the polyneuropathy is, the sooner it will disappear.
By far the simplest measure is to wear compression or ice gloves while receiving chemotherapy as an infusion to protect the hands. The feet can be protected by compression stockings or cooling packs. Compression and cold reduce the blood flow to the hands or feet. As a result, less of the active ingredient in the chemotherapy reaches them and cannot damage the nerves there. A Japanese study found an impressive protective effect from this method.
Detailed instructions on how to use the gloves can be found here: Gloves during chemotherapy: Small trick, big effect
It is important to first clarify whether the chemotherapy you are receiving can cause polyneuropathy at all. For a listing of various chemotherapy agents, see the table on the following page: Polyneuropathy.
Another useful measure is balance training. Through training, the nervous system learns to compensate for the damage caused by chemotherapy. Patients who complete such training can walk more safely and report less pain and discomfort. However, it is important to start as early as possible. You can find exercises to do yourself here: Exercises for polyneuropathy
Vibration training is another useful training method. To do this, you stand on a vibrating plate. The vibration is a very strong stimulus for the nerves. Several studies showed that patients who underwent vibration training during chemotherapy had less severe symptoms of polyneuropathy. (A sample study can be found here: Streckmann et al. 2018).
However, not all vibration training is the same. This type of training is supposed to address the nerves with this training, not the muscles. So the training should be different from the vibration training that is common in gyms, where muscle training is the goal. The main difference is the duration. With such a strong stimulus as vibration, the nerves tire very quickly. Therefore, you should only spend 30 seconds to one minute on the vibration plate before taking an equally long break.
In additionally, classical fitness training also seems to have a positive effect on polyneuropathy in chemotherapy. This is not quite as great as the effect of balance training or vibration training, but it is still there. That's another reason to stay physically active during cancer treatment. You can find more info here: Exercise against cancer.
After chemotherapy, the nerves often recover
Compared to other forms, polyneuropathy triggered by chemotherapy has the distinct advantage that the trigger of the polyneuropathy eventually disappears. This is because when chemotherapy is over, the nerves are also no longer get damaged and can recover.
Therefore, after chemotherapy, most patients report that their symptoms slowly improve. However, this is usually only the case during the first year. Symptoms that persist after more than 12 months unfortunately usually remain. However there are some people who keep improving for longer, if they keep training.
In diabetic polyneuropathy, unfortunately, the prospects for complete recovery are relatively poor. Here, too, however, an improvement is possible. If diabetes is diagnosed and treated early, polyneuropathy can usually be prevented. If the polyneuropathy is just beginning and blood sugar is controlled quickly, there is hope for improvement. However, the symptoms of diabetic polyneuropathy often start so slowly that they are not noticed until it is too late. Therefore, significant improvement of symptoms rarely occurs.
However, there are some measures that can slow down or even stop polyneuropathy in diabetes. That means, you can rarely cure polyneuropathy in diabetes, but you can prevent it from getting worse.
The most important measure to do this is obvious: reduce blood sugar. If the long-term values (Hba1c) are below 7, the nerves are basically out of danger. For this, in addition to the right medications and a low-sugar diet, proper exercise is also important.
Exercise alone can cause growth of nerves and improvements in the ability of nerves to live in diabetes (Singleton et al. 2014; Gholani et al. 2018). Thus, diabetic polyneuropathy offers better opportunities for improvement through training than the other forms of polyneuropathy.
You can find detailed information and exercises here:
Proper supply of vitamins is crucial, too. Those who suffer from vitamin deficiency and diabetes at the same time are more likely to develop polyneuropathy in addition. This is the case especially for vitamin D. However, vitamin supplements should only be taken if there is a deficiency. Taking vitamin supplements if you already have enough vitamins in your body does not bring any additional benefit and is rather dangerous. It is therefore best to have the vitamin levels in your blood measured first.
Is alcoholic polyneuropathy curable?
In alcoholic polyneuropathy, there is a surprisingly good chance of cure. If you manage to completely abstain from alcohol, the nerves often heal and the symptoms disapear. Again, of course, it depends on how severe the damage is and how long it has existed for.
B vitamins may be helpful in alcoholic polyneuropathy. These are withdrawn from the body by the alcohol, creating a deficiency. This is especially true for vitamin B1. It is believed that polyneuropathy can be positively influenced by the administration of B vitamins. However, again, it only makes sense to take vitamins if there actually is a deficiency. Taking more vitamins than the body actually needs is not beneficial.
Polyneuropathy of unknown cause
There are some factors that may promote polyneuropathy that are generally little known. If you suffer from polyneuropathy of unknown cause, then you should pay special attention to these factors to at least slow down the progression.
Few people know, for example, that sleep apnea can trigger or aggravate polyneuropathy. In sleep apnea, interruptions in breathing occur repeatedly during sleep. This causes a lack of oxygen, which has a negative effect on the nerves. Especially those who snore heavily and suffer from polyneuropathy should therefore be examined for sleep apnea. You can download a scientific papar on the topic here: Lüdemann et al. (2001)
Exposure to lead and other toxins (e.g., solvents) can trigger and promote polyneuropathy. Those suffering from polyneuropathy should therefore try to avoid contact with such materials as far as possible. However, heavy metals can also accumulate in the body and cause chronic problems. In the case of acute poisoning, drugs are given intravenously to bind the heavy metals and transport them out of the body. If you suspect that heavy metals have accumulated in your body for a long time, you can also eat certain foods that are also able to remove toxins from your body. Especially suitable for this purpose are garlic, broccoli and cilantro.
As you can see, even if no cause of polyneuropathy can be found, treatment is certainly possible. For example, if you suffer from sleep apnea and vitamin deficiency at the same time and drink a lot of alcohol, then there are already several factors that favor polyneuropathy. However, if you correct these problems by using a cpap to sleep, taking the appropriate vitamins, and abstaining from alcohol, the chances of improvement, or at least of stopping the worsening, are much greater.