What is Neuropathy?
Peripheral Neuropathy refers to a problem with nerves, specifically the peripheral nerves throughout the body, not the central nervous system of the brain and spinal column. That is why it is commonly called Peripheral Neuropathy.
Neuropathy often causes weakness, numbness or pain, usually in the hands and feet. The pain is sometimes described as stabbing, burning or tingling.
What are some of the symptoms of Peripheral Neuropathy?
Some symptoms of peripheral neuropathy are a gradual onset of tingling numbness in your hands or feet that spreads upwards into your body. Many describe the feeling as a freezing or burning sensation that is sensitive to touch.
What causes Peripheral Neuropathy?
Neuropathy is caused by a number of different underlying medical conditions, the most common of which is diabetes.
High levels of blood sugar can damage the walls of blood vessels that supply oxygen and nutrients throughout the body, especially the tiny vessels in the ends of the hands and feet. Skin in these extremities eventually becomes damaged, and the accompanying loss of sensation makes it more prone to further damage.
In the United States, roughly half of those with diabetes suffer from diabetic neuropathy, most often resulting in foot problems and ulcers.
Peripheral nerve damage can also be caused by:
• Some forms of cancer, such as lymphoma and myeloma, as well as some chemotherapy medications
• Chronic kidney or liver disease
• Some infections, like shingles, Lyme disease and HIV
• Some forms of medicine used to treat HIV
• Connective tissue diseases like rheumatoid arthritis, Sjögren’s syndrome and systemic lupus erythematosus
• Inflammatory conditions like sarcoidosis and coeliac disease
• Hereditary neuropathies, the most common of which is Charcot-Marie-Tooth disease
• Excessive alcohol intake
• A lack of B12 or folate vitamins
• Exposure to poisons or toxins, such as insecticides and solvents
• Injuries that require the setting of bones and/or plaster casts can pressure nerves
In some cases, the cause of the neuropathy is impossible to diagnose. This is referred to as idiopathic neuropathy.
Diagnosis and Treatment for Peripheral Neuropathic pain
Because neuropathy refers to nerve damage that can occur anywhere in the body, a doctor will need to determine exactly where the damage is and what is causing it.
A physical exam, which may include a blood test, and a full medical history, including symptoms, lifestyle, habits, family history and possible exposure to toxins, should be a part of every diagnosis.
The doctors at Advocate Pain Management Clinic offer a non-invasive, pain-free peripheral neuropathy test that takes less than five minutes. This sweat scan analysis is preferred over more expensive biopsy options that involve removing skin or nerve tissue.
Other ways to diagnose neuropathy include:
• A neurological exam, checking reflexes, sensations, posture, coordination and muscle strength and tone
• Imaging tests like magnetic resonance imaging (MRI) or computerized tomography (CT) scans
• Nerve function tests, like electromyography, an autonomic reflex screen, or sweat and sensory tests
• A nerve biopsy, to examine for abnormalities
• A skin biopsy, to examine nerve endings
Treatment options for Peripheral Neuropathy?
The goal in treating neuropathy is to manage the cause and relieve symptoms. Because peripheral nerves have limited capacity to regenerate, treatment may only stop the progression, not reverse the damage. Early diagnosis and treatment is important.
Medications are often used to treat neuropathy. Over-the-counter pain medications and nonsteroidal anti-inflammatories can relieve mild symptoms. Prescription painkillers may be needed for more severe symptoms. Highly addictive opioids like tramadol and oxycodone are generally only prescribed when other treatments fail.
In some cases of severe physical impairment, physical therapy can help regain strength and avoid muscle spasms and cramps.
Patients who experienced injury or nerve compression may require surgical treatment, and/or the use of mobility aids, such as a can, walker or wheelchair.