Peripheral Neuropathy: Causes, Symptoms, and Treatment

Peripheral neuropathy is loss of function, pain, weakness or numbness resulting from damage to the peripheral nerves of the body. It is estimated that 25-30% of Americans, and a whopping 60-70% of all diabetics are affected by this disorder. All ages can be affected, but risk increases as you get older. Some of the most common causes are traumatic injury, infection, metabolic illnesses, exposure to toxins, and diabetes. While a healthy lifestyle is important to prevent peripheral neuropathy, knowing the causes, symptoms and treatments available will help those affected seek early and more effective care.

What is Peripheral Neuropathy?

Communication between the brain, the spinal cord and the peripheral nerves is what allows our bodies to function as one unit. Impulses are sent from the brain, through the spinal cord, to the peripheral nerves, directing body functions and movement. Information is then sent back to the brain about the world around us, and sensations such as touch, temperature, pain, or pressure. Neuropathy can be caused by an interruption anywhere within this system, causing a disturbance in the function of one or several nerves.

There are 3 types of nerves:

Sensory: nerves that mediate our senses, such as smell, touch, taste, hearing, and sight

Motor: nerves that mediate movement

Autonomic: nerves that regulate bodily functions such as digestion, heart rate, and other involuntary responses.

The symptoms of neuropathy are often dependent on the function, location and type of nerve that has been damaged or destroyed.

Symptoms of Neuropathy

The symptoms of neuropathy often develop gradually, initially presenting as numbness, prickling, or tingling. Other descriptions include feelings of “pins and needles,” electric shock, sharp or jabbing, freezing or burning, or a feeling of wearing socks or gloves. The location or type of nerve affected will determine the exact symptoms. Some people experience pain from an otherwise normal stimulus, such as touch or cold, while others cannot feel any pain, pressure or temperature change. Neuropathy can also cause severe pain, especially at night, which interferes with sleep and can cause emotional problems.

Motor nerve neuropathy can cause muscle weakness, muscle twitching, cramps, spasms, loss of control, loss of tone, loss of dexterity, difficulty walking, falling, and even paralysis.

Autonomic nerve neuropathy can affect blood pressure or heart rate, cause decreased sweating, create problems with urination, cause constipation or diarrhea, cause digestion problems, and can even cause sexual dysfunction.

Causes of Peripheral Neuropathy

The most common cause of peripheral neuropathy is trauma, including that from falls, sports injuries, motor vehicle accidents, nerve compression from repetitive stress, pressure on a nerve from casts or crutches, or from surgery. Diabetes is another very common cause. Other causes include infections such as HIV or Lyme Disease, autoimmune disorders, kidney disease, cancer, hormonal imbalances, liver disease, thyroid disease, some medications, chemotherapy, toxic substances, radiation therapy, spinal nerve compression, vitamin deficiencies, being overweight, and alcoholism.

Diagnosis and Treatment of Neuropathy

Early diagnosis and treatment of peripheral neuropathy is key to improvement of symptoms. After conducting a thorough history and physical that includes checking your tendon reflexes, muscle strength and tone, ability to feel sensations, posture and coordination, your healthcare provider may order blood tests, and other diagnostic tests. Nerve conduction studies (NCS) measure the time it takes for nerves to stimulate muscles to twitch, and electromyography (EMG) evaluates the health of muscle tissue by measuring electrical activity. CT scans and MRIs can be used to look for herniated disks or tumors, which can put pressure on a nerve. Sometimes a muscle biopsy, which is the removal of a small piece of muscle to be examined under a microscope, is needed to evaluate neuropathy.

Treatment options for neuropathy will often vary by patient, based upon the location, severity of symptoms, and underlying causes. The goal of therapy is to relieve pain, maintain function, and improve quality of life; and treatment is determined by the underlying cause of the neuropathy. Controlling diabetes and other treatable illnesses is very important. Physical therapy, including exercise, massage, transcutaneous electrical nerve stimulation (TENS) and other treatments are often beneficial. Occupational therapy can help someone cope with loss of function and pain.

Medications often used to control pain include non-steroidal anti-inflammatories such as ibuprofen, as well as many anti-seizure and anti-depressant medications. Topical patches such as lidocaine or capsaicin are also often effective. On the other hand, narcotics are generally not effective for neuropathic pain, and can lead to addiction.

Sometimes procedures such as steroid injections, nerve blocks, spinal cord or peripheral nerve stimulation or surgery may be needed. Acupuncture has also shown promise in the treatment of neuropathy.

The outlook for recovery depends on the cause, but the sooner treatment is initiated, the better the chance that nerve damage can be slowed or repaired. Left untreated, neuropathy can lead to permanent damage and chronic disability, so it is important to report tingling, numbness, pain or weakness as soon as you experience these symptoms. It is also very important to control chronic illnesses such as diabetes and maintain a healthy lifestyle. You should also eat a healthy diet, rich in fruits, vegetables, whole grains, and lean proteins, get regular exercise, and avoid repetitive motions, prolonged cramped positions, exposure to toxins, smoking and excessive alcohol intake. You should also make sure to always take safety seriously, to prevent injury.

If you would like to know more about peripheral neuropathy, or to schedule an appointment with one of our highly-qualified providers, please call Tarpon Orthopedics at 9725961059, or request an appointment online.

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