An Overview of Peripheral Neuropathy from a Colorado Pain Clinic

What is peripheral neuropathy?

Peripheral neuropathy is a disorder of the peripheral nervous system that causes numbness, burning sensation, tingling, muscle weakness or touch sensitivity. As a result of the disorder, the nerves that carry information between the central nervous system and the rest of the body are damaged, causing pain, tingling, and numbnessPeripheral Neuropathy in the feet and hands.

Sometimes the nerves may fail to send a signal when something is harming you or may transmit signals even when nothing is actually causing pain. The malfunctioning of the nerves can make it harder to carry out routine activities.

Different types of peripheral neuropathy include:

  • Polyneuropathy – Damage to several nerves and limbs, such as diabetic neuropathy, which affects different nerves and limbs in the body. Usually it begins in the form of pain and tingling in the feet and travels up to involve the legs and may also affect fingers, hands, and arms.

 

  • Mononeuropathy – Damage to one nerve that may cause severe pain and muscle weakness, such as tarsel tunnel syndrome.

 

  • Mononeuritis multiplex – Damage to one or more nerves in different parts of the body. The painful condition involves two separate nerves. Least common form of peripheral neuropathy, the condition may be associated with rheumatoid arthritis and Lyme disease, among others.

What are the symptoms?

Peripheral neuropathy is associated with different symptoms, including numbness, tingling, burning sensation, weakness, pain, or loss of balance in the lower extremities. The symptoms start from tingling, numbness, or pain in the feet and travel up to affect legs. With a progressive neuropathy, there is a gradual loss of sensation in the feet, which can create walking difficulties.

The loss of sensation may result in formation of sores or ulcers in the feet. The affected person may begin to find problems in differentiating between cold and hot temperatures on their feet. With the loss of sensation, the burning pain may begin to turn dull, and eventually sensation disappears with severity.

Not only this, peripheral neuropathy may also affect muscles. Muscle weakness causes walking difficulties. For some people, neuropathy even involves hands and arms, making it difficult to perform daily activities.

Peripheral neuropathy is also associated with organ dysfunction, bladder leaking, erectile dysfunction, cardiac problems, digestive issues, and problems with blood pressure.

peripheral neuropathyWhat causes peripheral neuropathy?

Diabetes is the most common cause of neuropathy. With over 16 million people having diabetes in the US, there is a high risk of diabetic neuropathy in those with uncontrolled diabetes.

Other possible causes include infection, injury, inherited disorder, or systemic illness. Infection of herpes zoster can cause damage to peripheral nerves and result in neuropathy in the affected individual. Other possible causes of peripheral neuropathy may include:

  • Vitamin deficiency, especially vitamin B12 and folate
  • Chronic alcoholism
  • Diabetes mellitus
  • Autoimmune diseases
  • Dietary problems
  • Malnutrition
  • Inherited disorders, including amyloid polyneuropathy
  • AIDS, syphilis, kidney failure
  • Exposure to toxins, pesticides
  • Cancer treatment drugs
  • Statin drugs

Some people suffering from neurofibromatosis are at a risk of peripheral neuropathy. Certain medications to treat HIV/AIDS can also result in peripheral neuropathy symptoms. Radiation and certain types of chemotherapy are some of the known risk factors.

How is peripheral neuropathy diagnosed?

With so many different causes of peripheral neuropathy, a comprehensive medical history of the patient and physical exam will be required to determine the cause. Blood work is done to check for any common electrolyte abnormalities and level of exposure to toxins. It will also the doctor rule out any inflammatory disorders, such as rheumatoid arthritis.

Electrodiagnostic studies, including electromyelography (EMG), may be required, though these tests may not help diagnose small fiber neuropathy. X-rays or MRI can help determine the extent of joint destruction and nerve compression. An MRI shows the extent of nerve compression in the case of a herniated disc.

The doctor may require a muscle biopsy to rule out cancerous or tumor growth.

What is the treatment for peripheral neuropathy?

Pain-relieving drugs, anticonvulsants, and antidepressants are often prescribed to help moderate the peripheral neuropathy symptoms. Narcotic or non-narcotic pain killers provide temporary relief, and should not be used on a long-term basis, without doctor’s prescription.

Neurologic modifying drugs, such as Lyrica, can help to alleviate the burning symptoms from neuropathy.  Over-the-counter drugs, including Tylenol, and anti-inflammation medications can help heal mild to moderate pain. Several antidepressant medications are used to alleviate pain symptoms from neuropathy. Such drugs were primarily developed for depression and are now used in an off-label fashion for neuropathy.

It is important that the underlying cause of the problem is addressed as a preventive strategy. For example, in the case of diabetic neuropathy, it’s crucial that high blood sugar is addressed to prevent nerve damage.

  • Physical Therapy – Physical therapy and chiropractic treatment are often used in combination with medication therapy to help increase blood circulation to the affected area and reduce pain. They do not alter nerve problems but help modulate neuropathy symptoms.  Massage therapy, ultrasound, or Transcutaneous electrical nerve stimulation (TENS) are also used to relieve neuropathy symptoms. TENS involves placing adhesive electrodes on the skin to deliver electric current at different frequency levels.

 

  • Pain Management Procedures – Steroid injections are often used to help with neuropathy pain, depending on whether one or more nerves are being compressed. If someone is suffering from mononeuropathy, these steroid injections can be very effective in healing the pain symptoms and preventing the need for a surgery.

 

  • Spinal Cord Stimulator – When oral medications do not help control pain, spinal cord stimulation can prove effective in restoring sensation in the feet for neuropathy patients while alleviating the burning pain. According to a recent study conducted in Deaconess Hospital in Evansville Indiana, about 85% of persons experienced relief from diabetic neuropathy symptoms, with an improvement in sensation and pain reduction.

 

  • Nerve decompression is another treatment option where one nerve is being compressed and other therapies fail to provide sufficient relief. The therapy can improve sensation and reduce pain.

Peripheral neuropathy treatment is available at Colorado Clinic at 3 locations in Loveland, Greeley and Boulder. Call the closest location to you today!

http://www.healthline.com/health/peripheral-neuropathy#Overview1

http://www.fredhutch.org/en/treatment/long-term-follow-up/FAQs/peripheral-neuropathy.html#2

http://www.medicinenet.com/peripheral_neuropathy/page3.htm