Peripheral Neuropathy

1 What is Peripheral Neuropathy?

Peripheral neuropathy is a disorder often characterized by pain and numbness in the hands and feet. It can also affect other areas of the body.

Peripheral neuropathy is caused by damage to the peripheral nerves as a result from infections, traumatic injuries, genetic and metabolic problems, and exposure to toxins.

Most individuals with peripheral neuropathy describe the pain as stabbing, burning, and at times, tingling.

With the use of proper medications and other treatment options, symptoms of peripheral neuropathy can improve.

2 Symptoms

Every nerve in the peripheral system has a particular function, so the symptoms of peripheral neuropathy generally depend on the type of nerves that are affected.

Nerves are classified into:

  • Sensory nerves
  • Motor nerves
  • Autonomic nerves

The sensory nerves are the group of nerves that receive signals from the skin such as pain, temperature, and touch.

The motor nerves are the group of nerves that control muscle movement, while the autonomic nerves are the group of nerves that control functions such as heart rate, blood pressure, bladder movement, and digestion.

Peripheral neuropathy falls into three categories:

  • Mononeuropathy, also known as peripheral neuropathy - Only one nerve is affected
  • Multiple mononeuropathy - Two or more nerves are affected
  • Polyneuropathy - Multiple nerves are affected

Symptoms of peripheral neuropathy may include:

  • Gradual onset of tingling and numbness in the hands and feet - If you experience gradual tingling and numbness in your extremities, then chances are that you may be suffering from peripheral neuropathy.
  • Sharp pain - If you continue to experience sharp pain in your limbs (even at resting position), then you should consult with your doctor immediately and get your blood tested.
  • Extreme sensitivity to touch - Peripheral neuropathy is known to cause such extreme sensitivity to touch, that even the weight of a simple bed sheet may be agonizing.
  • Lack of coordination among body parts - If you find that you are developing a lack of coordination among your limbs, you may be suffering from peripheral neuropathy. However, kind in mind that there can be other causes for this symptom, so consult with your doctor and get your condition properly diagnosed as soon as possible.
  • Muscle weakness - High blood sugar levels are known to cause muscle weakness and even muscle atrophy. If you continue to experience muscle weakness, it may be time to see your doctor and seek treatment.
  • Heat intolerance - If you find that you are becoming increasingly intolerant to heat or cold, this may be an indication of several severe health conditions – one of which is peripheral neuropathy. In such instances, you may have difficulty in feeling whether an object is hot or cold to touch. Heat intolerance can be treated with the right medication, so schedule an appointment with your doctor for fast relief and effective treatment.
  • Digestion, bladder, and bowel problems - Peripheral neuropathy may be caused by several factors, ranging from infections to genetic conditions. The damage to your nerves can impact your digestion, cause a urinary tract infection or even obstruct your bowel movements.
  • Changes in blood pressure - Peripheral neuropathy can cause changes in blood pressure levels, so it is important that you undergo regular checkups and get your blood tested. Consult with a specialist for effective treatment.

If you start experiencing weakness and pain in your feet or hands or unusual tingling and lack of coordination, seek immediate medical care.

Make an appointment with your doctor to get your condition diagnosed and treated as soon as possible. Early diagnosis is vital in order to prevent further complications such as permanent nerve damage.

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3 Causes

Factors that may cause peripheral neuropathy include:

  • Alcoholism - Individuals suffering from alcoholism are prone to vitamin deficiencies, which in turn can lead to nerve damage. Alcohol is a form of toxin that can affect your body in many ways, including causing damage to your nerves. If you are suffering from such a disorder, it is extremely important that you consult with your doctor. Seek treatment for both your addiction and the peripheral neuropathy before it causes any permanent damage. Excessive high alcohol consumption can lead to erectile dysfunction and even sterility. Schedule an appointment with your doctor at your earliest convenience.
  • Autoimmune diseases - Diseases such as Sjogren’s syndrome, rheumatoid arthritis, lupus, chronic inflammatory demyelinating polyneuropathy, necrotizing vasculitis, and Guillain-Barre syndrome, are all diseases that may cause damage to the peripheral nerves. While these diseases can be managed and treated, diagnosing the underlying cause of peripheral neuropathy can be quite difficult. This is why it is essential to seek out a specialist to determine the exact cause and provide proper treatment.
  • Diabetes - More than 50% of individuals suffering from diabetes develop a certain type of neuropathy as a complication. Peripheral neuropathy is the most common form of neuropathy developed among diabetics. Seek out immediate medical care because if peripheral neuropathy is left untreated, it can result in muscle atrophy and perhaps even amputation.
  • Exposure to toxins - Exposure to poisonous or toxic substances such as chemicals and heavy metals can cause severe damage to the peripheral nerves. If you happen to work in a chemical plant or a site that involves heavy exposure to toxins on a daily basis, then your chances of developing peripheral neuropathy are rather high. Schedule regular checkups with your doctor and get your condition treated before it is too late.
  • Medications - Certain medications, such as chemotherapy drugs, can impact the peripheral nerves. This, in turn, may cause neuropathy. If you are undergoing treatment for any type of cancer, your chances of developing peripheral neuropathy may increase with chemotherapy. Consult with your specialist to better understand the risks associated with this procedure and to treat any nerve damage at an early stage.

4 Making a diagnosis

A diagnosis of peripheral neuropathy is done by performing several tests and procedures.

Your general physician may refer you to a neurologist or a doctor who specializes in disorders affecting the central nervous system. Before going into your appointment, it would be best to make a list of questions that you would like to ask your doctor. You may even want to consider making a list of all your symptoms, as well as any medications, supplements, and vitamins you are currently taking.

A few examples of questions that may play an important role in your diagnosis include:

  • What is likely to be causing my symptoms?
  • Are there any tests that I need to undergo? What preparations should I do before undergoing these tests?
  • Will my symptoms have long term effects?
  • What are the possible treatment options? Which treatment option do you recommend for me?
  • Do the treatments have any side effects? If yes, what are they?
  • Will the treatments affect my health? In what way?
  • Are there any alternatives to the treatment option you are suggesting?

Never hesitate to ask questions. Only your doctor can recommend the best way to treat your symptoms.

He or she will also ask you a number of questions in order to make an accurate diagnosis.

Since peripheral neuropathy usually comes with underlying conditions, your doctor will have to find out its exact location and the exact cause of the nerve damage.

Your full medical history will be reviewed, including your symptoms, diet and lifestyle choices, possible exposure to any toxins, any family history of neurological diseases, as well as your drinking habits.

Physical examinations, such as blood tests and neurological examinations, will also be performed.

If necessary, your doctor may insist that you undergo imaging tests, such as a CT scan or MRI, in order to rule out tumors, herniated disks, and other abnormalities in the brain and spinal area.

Sometimes, a nerve function test known as an electromyogram may also be conducted. This test is used to measure the speed of your muscles’ electrical impulses.

Other important procedures, such as nerve and skin biopsies, are also effective ways to diagnose neuropathy.

5 Treatment

The goal of the treatment of peripheral neuropathy is to manage the condition and alleviate its symptoms.

If your test results show that your condition does not involve any other underlying health issue, the doctor may advise waiting until the neuropathy improves.

In the meantime, he or she may recommend taking certain medications to alleviate symptoms you may be experiencing. Such medications include the following:

  • Pain medications - Medications, such as over-the-counter pain relievers, can help relieve symptoms. If the symptoms are more severe, painkillers are typically prescribed. Opioids such as tramadol and oxycodone are only given to patients as a last resort, since they are known to be addictive. When taking painkillers, avoid consuming them yourself and only do so under the supervision of your doctor. Over-consuming pain killers is strictly prohibited. Even prolonged use of over-the-counter medications is powerful enough to cause several health complications, ranging from diarrhea to dizziness and lack of concentration.
  • Anti-seizure medications - Certain anti-epileptic medications, such as pregabalin and gabapentin, can help reduce nerve pain and discomfort associated with peripheral neuropathy. These medicines must be consumed only under the supervision of your doctor, as some of them may cause unwanted side effects.
  • Capsaicin cream - Capsaicin-infused creams are proven effective in improving some of the symptoms associated with peripheral neuropathy. Capsaicin is a hot pepper derivative, so it may cause skin irritation and minor burning sensations; however, these side effects usually subside over time. Your doctor may advise using the cream together with another form of treatment.
  • Antidepressants - Doxepin, amitriptyline, and nortriptyline are examples of tricyclic antidepressants. They are known to interfere with the chemical process that causes pain, hence relieving it from its root cause. Other antidepressants that are used to treat the symptoms of neuropathy are Cymbalta and Effexor XR. Antidepressants can help relieve pain and discomfort associated with peripheral neuropathy, however, prolonged use can cause your body to become immune. For this reason, it is important to consult with your doctor before any intake.

Other forms of treatment include:

  • Intravenous immunoglobulin
  • TENS or Transcutaneous electrical nerve stimulation
  • Plasma exchange
  • Physical therapy
  • Surgery

Weigh your options by asking your doctor for vital information such as - the pros and cons of each treatment course, the possible complications and side effects, as well as other questions concerning the available treatments (price, duration, etc.).

6 Prevention

The best possible way to prevent peripheral neuropathy from occurring is to treat any condition that might put you at risk.

Medical conditions such as diabetes, rheumatoid arthritis, and alcoholism are all factors that may cause peripheral neuropathy.

Maintaining a healthy lifestyle by eating well-balanced meals, exercising on a regular basis, and avoiding factors that may result in nerve damage, can greatly help prevent this disabling condition from occurring.

7 Alternative and homeopathic remedies

Several individuals suffering from peripheral neuropathy try alternative remedies to relieve their symptoms. While there haven’t been enough studies conducted to prove that these methods are effective, the following remedies are still becoming the most sought-out complementary treatments for peripheral neuropathy:

  • Acupuncture - This procedure involves inserting special, thin needles into key spots on your body. Acupuncture is generally safe, given that it is done with sterile needles and by a certified acupuncturist. After a few sessions, acupuncture is believed to help reduce the symptoms of peripheral neuropathy. It is known for its effectiveness in treating nerve damage and alleviating nerve pain. Moreover, acupuncture comes with no side effects, which is why it is often prescribed by doctors as an effective treatment option for peripheral neuropathy.
  • Alpha-lipoic acid - Alpha-lipoic acid is a well-known antioxidant that is used to treat peripheral neuropathy. For many years now, it has been used in parts of Europe for certain types of nerve damage.
  • Herbal medicine - Certain herbal concoctions, such as evening primrose oil, are known to minimize the pain brought on by peripheral neuropathy in diabetics. Herbal medicine may not cause side effects; however, some individuals are known to develop allergic reactions. Make sure to consult with your specialist about which herbal medicine is right for you.
  • Amino acids - Acetyl-L-carnitine, a type of amino acid, can help alleviate the symptoms of peripheral neuropathy - especially in diabetics and individuals undergoing chemotherapy. Amino acids can actually help you deal with nerve damage from chemotherapy and alleviate pain.
  • Fish oil - Fish oil is an omega 3-rich supplement derived mainly from fish liver. It can help improve blood pressure, reduce inflammation, and improve the symptoms of neuropathy in diabetics. Make sure to include fish, especially salmon, as part of your regular diet. Likewise, eat foods rich in omega-3.

Before considering any of these alternative treatments, you need to speak with your doctor first and discuss the benefits / risks associated with each treatment method.

8 Lifestyle and coping

Lifestyle modifications are necessary in order to cope with peripheral neuropathy. These include:

  • Taking good care of your feet - If you have diabetes, it is important that you take good care of your feet and wear comfortable shoes. Peripheral neuropathy tends to affect the arms and legs, so it is vital that you check for any cuts, blisters, rashes, calluses, and open wounds that are not healing quickly. With proper treatment, you can protect your arms and legs all the while managing your condition.
  • Exercising on a regular basis - Performing regular and light exercises, such as walking, can help reduce the pain associated with neuropathy. A simple routine, such as walking at least three times a week, can improve muscle strength and keep blood sugar at a normal level. Physical activity helps keep the blood flowing and lessens residual pain from peripheral neuropathy.
  • Quitting smoking - The risk of foot problems and other complications is higher if you are a smoker. Smoking can impact your nerves and cause nerve damage. Try your best to quit.
  • Eating healthy, well-balanced meals - A diet consisting of low-fat protein and milk products, combined with lots of fruits and vegetables, will keep your blood sugar at a normal level and give you the vitamins and minerals you need to stay fit.
  • Avoiding excessive alcohol intake - Alcohol can greatly impact your nerve functions and cause your blood sugar level to rise.

9 Risks and complications

The risk factors of peripheral neuropathy include:

  • Diabetes mellitus
  • Vitamin B deficiency
  • Infection
  • Alcohol abuse
  • Autoimmune diseases
  • Repetitive motion
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