When functioning normally, nerve tissues receive nutrient rich, highly-oxygenated blood that is carried to them by microscopic capillaries; tiny-tiny-tiny blood vessels that are easily clogged.
Ischemia is one of those scientific words which simply mean “tissue death due to starvation.” This is vitally important to understand, because peripheral nerves are living tissues requiring nourishment.
When these tiny nutrient and oxygen carrying vessels do become clogged, many nerve tissues fail to receive the needed nutrients and oxygen in order to survive. When this happens the peripheral nerves become damaged.
It’s the same that happens when an occluded artery causes a massive heart attack – only with neuropathy, it happens on a massive scale damaging literally millions of microscopic peripheral nerves.
In the case of diabetes, too much glucose fills your bloodstream clogging the capillaries and preventing the nerve tissues from receiving the nutrients and oxygen they need. In compressive forms of neuropathy, the direct physical pressures placed on the nerves by aberrant joint function shut down the flow of O2 and nutrients to the nerves – much like what happens if you run over a water hose with a car tire.
Painful sensory neuropathies are rarely correctable with drugs. This is because they don’t address ischemia.
Neurontin (Gabapentin) is actually an anti-convulsive designed to treat seizures.
Elavil (Amitriptyline), Tofranil (Imipramine) and Cymbalta (Duloxetine) are anti-depressants.