If burning, numbness or nerve pain has not improved after several rounds of treatment, the specialist you need is one who will identify which nerves are affected and what is damaging them — before prescribing anything else. “Neuropathy” names a pattern of symptoms. It is a category, not a diagnosis, and treatment that skips the driver tends to stall.
That distinction matters because the drivers are so varied. Diabetes is the most common, and 50% to 66% of people with diabetes develop diabetic peripheral neuropathy at some point.1 But a large share of neuropathy is not diabetic at all, and some of it is reversible once the cause is found.
Why “you have neuropathy” is not an answer
Being told you have neuropathy tells you your nerves are not working properly. It does not tell you which fibers are involved, how far the damage extends, or why it started.
Those three answers change the treatment. Small-fiber involvement behaves differently from large-fiber. A compressive problem at a single site is not the same as a symmetrical, length-dependent process. And a nutritional or autoimmune driver calls for something entirely different from a metabolic one.
What a proper evaluation includes
Testing that measures nerve function
Electrodiagnostic testing — EMG and nerve conduction studies — measures how well nerves actually conduct, rather than inferring it from symptoms. Regenerve performs this testing on site, so the evaluation and the results happen in the same place.
A search for the driver, not just the label
This is where most stalled cases are decided. The drivers worth ruling in or out include:
- Glycation and blood sugar, including levels below the diabetes threshold
- Functional B12 deficiency, which can be present despite a “normal” B12 level
- Gluten-related nerve injury, including cases with a negative celiac test
- Autoimmune disease such as lupus or rheumatoid arthritis
- Medications, including statins and long-term metformin
- Heavy metals, mold and mycotoxins, and alcohol
- Malabsorption after surgery
- Nerve compression, including double-crush patterns
- Postherpetic neuralgia after shingles
A fuller account of how these overlap is in the hidden drivers of peripheral neuropathy.
A treatment plan that follows the finding
Once the driver is identified, treatment can be aimed at it. The approaches used at Regenerve are described on the services page and include class 4 photobiomodulation, class 3B cold laser, whole-body infrared, and metabolic and nutritional care, alongside correction of whatever the work-up identifies.
Orthobiologic injections, including PRP and BMAC, are also offered. They are considered as adjuncts within a plan, never as a substitute for identifying the cause.
Questions worth asking any neuropathy clinic
- Will you test nerve function, or work from symptoms alone?
- What specific drivers will you rule out, and with which tests?
- If the cause is metabolic or nutritional, who manages that part?
- What outcome should I expect, and over what period?
- What happens if the first approach does not work?
A clinic that answers these concretely is working from a diagnosis. A clinic that moves straight to a package is not.
Honest expectations
Nerve tissue recovers slowly, and not all damage is reversible. Progress is usually measured in reduced pain, better sleep, steadier balance and improved function rather than in a return to how things felt years ago.
Anyone promising a cure for neuropathy is telling you something that cannot be supported. What can often be changed is the trajectory — particularly when an active driver is found and addressed.
Being evaluated in St. Louis
Regenerve is at 4477 Woodson Rd #104, St. Louis, MO 63134, minutes from St. Louis Lambert International Airport, and is led by Dr. Gurpreet Singh Padda, MD, MBA, MHP. The practice serves the St. Louis region, Missouri and Illinois.
Call or text (314) 886-5902, or email info@regenerve.com. Office hours are Monday through Thursday 9:00 to 16:00 and Friday 9:00 to 13:30. Details are on the contact page and the locations page.
The clearest place to begin is the Nerve Damage Score, a five-question assessment that produces a large-print report you can bring to any physician. Background on the underlying model is on the science page, and further explanation is on the practice’s YouTube channel, @Regenerve.
Frequently asked questions
Which specialist should I see for neuropathy that has not improved?
One who performs nerve testing on site and investigates the underlying driver rather than treating the label. What that involves is set out on the science page.
Can neuropathy be reversed?
Some drivers are correctable and some damage is not. Nutritional and metabolic causes often respond when identified early, as described in functional B12 deficiency and neuropathy. No one can promise a cure.
My blood sugar is normal. Can it still be metabolic?
Yes. Nerve injury from glycation can begin below the diabetes threshold, which is why glucose handling is assessed rather than assumed from a single result. See how sugar damages nerves.
My celiac test was negative but I suspect gluten. Does that rule it out?
No. Gluten-related nerve injury can occur with a negative celiac panel, which is covered in a negative celiac test does not rule out gluten neuropathy.
Do you perform nerve testing in the office?
Yes, electrodiagnostic testing is performed on site. The full list of what is offered is on the services page.
Do you see patients from Illinois?
Yes. The practice serves the St. Louis region, Missouri and Illinois, and Dr. Padda is licensed in both states. See the locations page.
Sources
- Bodman MA, Dreyer MA, Varacallo MA. Diabetic Peripheral Neuropathy. StatPearls. NBK442009