Can Peripheral Neuropathy Be Reversed? Expert Neurologist Answers

One of the most common questions patients ask when diagnosed with peripheral neuropathy is: can this be reversed? The answer isn't simple—it depends on what's causing your neuropathy, how long you've had it, and how quickly treatment begins.

The good news is that many forms of peripheral neuropathy can be improved, stabilized, or even reversed when the underlying cause is identified and treated promptly. In this guide, we'll explore which types of neuropathy respond to treatment and what you can do to give yourself the best chance of recovery.

Understanding Nerve Regeneration

Unlike the central nervous system (brain and spinal cord), peripheral nerves have a remarkable capacity for regeneration. When nerve fibers are damaged, they can regrow and potentially restore function—if the conditions are right.

Factors that support nerve recovery:

• Early identification and treatment of the underlying cause
• Removal of ongoing damage (stopping alcohol, controlling blood sugar, correcting deficiencies)
• Adequate nutrition to support nerve repair
• Time—regeneration is slow but possible

Factors that limit recovery:

• Long duration of nerve damage before treatment
• Severe or complete nerve destruction
• Ongoing exposure to the damaging agent
• Certain irreversible causes

Reversible vs. Irreversible Causes of Neuropathy

Not all neuropathies are created equal when it comes to reversibility. Here's a breakdown:

Potentially Reversible Causes

Less Reversible Causes

Cases Where Neuropathy Often Improves

Vitamin Deficiency Neuropathy

Neuropathy caused by vitamin B12 deficiency is one of the most successfully treatable forms. When caught early, many patients experience significant or complete recovery with appropriate supplementation. However, if deficiency has been present for years with severe nerve damage, some symptoms may persist despite treatment.

What to expect: Improvement often begins within weeks to months of starting B12 therapy, though full recovery may take 6-12 months or longer.

Autoimmune and Inflammatory Neuropathies

Conditions like chronic inflammatory demyelinating polyneuropathy (CIDP) and Guillain-Barré syndrome respond remarkably well to immunotherapy. Many patients achieve:

• Significant improvement in strength and sensation
• Stabilization of progressive symptoms
• Long-term remission with maintenance therapy

The key is early diagnosis and treatment. Autoimmune neurology evaluation can identify these treatable conditions.

Compression Neuropathies

Carpal tunnel syndrome and other compression neuropathies often improve dramatically with appropriate treatment:

• Mild cases: Splinting, activity modification, anti-inflammatory measures
• Moderate to severe: Surgical decompression often provides relief

Recovery depends on how long the nerve was compressed and how severely it was damaged.

Diabetic Neuropathy: A Complex Picture

Diabetic neuropathy deserves special attention because it's the most common cause of peripheral neuropathy. While it's often described as "irreversible," the reality is more nuanced:

• Early diabetic neuropathy may stabilize or even improve with tight glucose control
• Prediabetes neuropathy can sometimes reverse with weight loss and glucose management
• Established diabetic neuropathy typically won't fully reverse, but progression can be halted
• Symptoms can often be well-controlled even when nerve damage persists

The most important factor is achieving and maintaining good blood sugar control as early as possible.

The Role of Early Intervention

Time is critical in neuropathy treatment. Here's why early intervention matters:

When nerves are damaged but not destroyed:

• The supporting structure (nerve sheath) remains intact
• Nerve fibers can regenerate along this pathway
• Recovery is more likely and more complete

When nerve damage is long-standing:

• Supporting structures may break down
• Regeneration becomes more difficult
• Full recovery is less likely

This is why getting a comprehensive neurological evaluation at the first sign of symptoms is so important. Don't wait for symptoms to become severe before seeking help.

Treatment Approaches That Support Nerve Recovery

Addressing the Underlying Cause

This is the most important step. Treatment depends on the cause:

• Vitamin deficiencies: Supplementation
• Autoimmune conditions: Immunotherapy
• Diabetes: Glucose optimization
• Thyroid disorders: Hormone management
• Alcohol-related: Cessation and nutrition
• Medication-induced: Discontinuing the drug
• Compression: Decompression or surgery

Supporting Nerve Health

Beyond treating the underlying cause, several strategies may support nerve repair:

Nutritional support:

• Adequate B vitamins (especially B12, B1, B6)
• Alpha-lipoic acid (antioxidant with some evidence for diabetic neuropathy)
• Acetyl-L-carnitine (may support nerve regeneration)

Lifestyle factors:

• Regular exercise improves circulation and may support nerve health
• Smoking cessation (smoking impairs circulation to nerves)
• Limiting alcohol
• Maintaining healthy weight

Physical therapy:

• Helps maintain strength and function during recovery
• Balance training to prevent falls
• Strategies to protect numb areas from injury

Managing Symptoms

While waiting for nerve recovery, symptom management is important for quality of life:

• Neuropathic pain medications: Gabapentin, pregabalin, duloxetine
• Topical treatments: Lidocaine patches, capsaicin cream
• Physical therapy: Maintains function and prevents complications
• Assistive devices: As needed for balance or mobility

What About Small Fiber Neuropathy?

Small fiber neuropathy deserves special mention. While it can cause significant symptoms (burning pain, tingling, autonomic dysfunction), small nerve fibers have greater regenerative capacity than large fibers.

When the underlying cause of small fiber neuropathy is identified and treated, many patients experience meaningful improvement. This is particularly true for:

• Small fiber neuropathy from autoimmune conditions
• Vitamin deficiency-related small fiber involvement
• Glucose intolerance-related small fiber damage

Getting an accurate diagnosis through small fiber skin biopsy is the first step toward identifying a treatable cause.

Realistic Expectations

It's important to have realistic expectations about neuropathy recovery:

Full reversal is possible for:

• Vitamin deficiency neuropathy caught early
• Some autoimmune neuropathies with treatment
• Compression neuropathies after decompression

Significant improvement is possible for:

• Many autoimmune neuropathies
• Early diabetic neuropathy with glucose control
• Medication-induced neuropathy after stopping the drug

Stabilization and symptom control is the goal for:

• Long-standing diabetic neuropathy
• Hereditary neuropathies
• Idiopathic neuropathy

Even when full reversal isn't possible, halting progression and managing symptoms can make a tremendous difference in quality of life.

When to See a Neurologist

Consider scheduling an evaluation if you have:

• New or worsening numbness, tingling, or pain in hands or feet
• Symptoms that haven't been clearly diagnosed
• A known neuropathy cause that might be treatable
• Symptoms despite being told "nothing can be done"
• Interest in exploring whether your neuropathy might be reversible

At Achilles Neurology Clinic in Beverly Hills, we take a thorough approach to neuropathy evaluation. Our goal is to identify any treatable cause and develop a comprehensive management plan tailored to your specific situation.

Frequently Asked Questions

Can peripheral neuropathy go away on its own?

In some cases, yes. Mild neuropathy from temporary causes (brief vitamin deficiency, short-term medication use, minor compression) may resolve once the cause is removed. However, most neuropathies require active treatment of the underlying cause to improve. Don't wait for symptoms to resolve on their own—seek evaluation.

How long does it take for nerves to regenerate?

Peripheral nerves regenerate slowly, typically about 1 inch (2.5 cm) per month. This means recovery from neuropathy affecting the feet (with nerves traveling from the spine) can take many months to over a year. Improvement often begins proximally (closer to the body) and gradually extends to the fingertips or toes.

What vitamins help repair nerve damage?

B vitamins are most important for nerve health, particularly B12, B1 (thiamine), and B6. However, taking vitamins only helps if you have a deficiency—taking extra vitamins when your levels are normal doesn't accelerate nerve repair. Alpha-lipoic acid may also support nerve health, particularly in diabetic neuropathy.

Can you reverse diabetic neuropathy?

Early diabetic neuropathy may improve with strict glucose control. Prediabetes-associated neuropathy can sometimes reverse with weight loss and lifestyle changes. However, long-standing diabetic neuropathy typically doesn't fully reverse, though progression can be halted and symptoms managed effectively.

Is neuropathy from B12 deficiency reversible?

Yes, B12 deficiency neuropathy is often reversible when caught early and treated with appropriate supplementation. The key is early diagnosis—neuropathy that has been present for years may not fully resolve, even with treatment. If you have unexplained neuropathy, B12 levels should always be checked.

What makes neuropathy worse?

Factors that can worsen neuropathy include: uncontrolled blood sugar, continued alcohol use, ongoing exposure to toxins or problematic medications, smoking (impairs circulation), vitamin deficiencies, and physical trauma to affected nerves. Identifying and addressing these factors can help prevent progression.

Take Action Today

If you're experiencing symptoms of neuropathy, the most important step you can take is getting an accurate diagnosis. Many causes of neuropathy are treatable, and early intervention offers the best chance of improvement.

About the Author

Dr. Achillefs Ntranos MD

Board-Certified Neurologist
Achilles Neurology Clinic

Dr. Achillefs Ntranos MD is a board-certified neurologist and MS specialist known for his thorough evaluations and compassionate approach. Originally from Greece, he trained at Johns Hopkins University and Mount Sinai Hospital before founding Achilles Neurology Clinic in Beverly Hills to deliver comprehensive, patient-centered neurological care. He specializes in MS, autoimmune neurology, neuropathy, headaches, and other neurological disorders, blending research-driven insights with personalized treatment plans.

Learn More About Dr. Ntranos(310) 774-7025