Peripheral Neuropathy: Information on Causes, Diagnosis & Treatments
Typically, peripheral neuropathy is caused by damage or injury to the peripheral nerves that results in pain, numbness, and weakness, usually in the feet and hands. The peripheral nervous system is and intricate network that is essential for sending information from the brain, through the central nervous system (spinal cord) out to every sold the body. The system can be affected by metabolic problems, infections, traumatic injury, exposure to toxins and inherited conditions.
Many individuals with diabetes mellitus also suffer from peripheral neuropathy involving a pain that can be described as tingling, burning or stabbing. With treatment, the symptoms can approve, and many drugs can reduce the pain associated with the condition. Usually, nerve damage will affect the dermatomes (connective tissue and skin) and interrupt communication between the body in the brain. This disruptive communication can impair the body's muscle movement and produce abnormal sensations, including pain, in the legs and arms.
- Who Is at Risk for Peripheral Neuropathy?
- Peripheral Neuropathy Types
- Common Symptoms
- Diagnosing Peripheral Neuropathy
- Peripheral Neuropathy Treatments
Peripheral Neuropathy Types
There are two types of peripheral neuropathic conditions that derive from various causes including carpal tunnel syndrome to nerve damage. Most commonly, individuals 55 years and older are at the greatest risk for developing the condition that is classified by its cause and the root of the damage.
- Mononeuropathy – This type of neuropathy traumatizes a single peripheral nerve. While the condition is usually caused by an accident, it can also occur from repetitive motions, sedentary positioning when lying in a bed or sitting in a chair or by carpal tunnel syndrome were nerves are injured by overuse strain. Many individuals who suffer from carpal tunnel syndrome are physical laborers, keyboard typists, and assembly-line workers.
When the body becomes weakened hands or feet, it can be the result of some form of mononeuropathy including ulnar nerve palsy, radial nerve palsy, or peroneal (foot drop) nerve palsy.
- Polyneuropathy – Most individuals that suffer from peripheral neuropathy are diagnosed with polyneuropathy where multiple peripheral nerves are malfunctioning at the same time. This condition has numerous causes including alcohol abuse, kidney failure, cancer, or exposure to specific toxins. Most diabetics with neuropathy are diagnosed with chronic polyneuropathy which is then referred to as diabetic neuropathy.
Who Is at Risk for Peripheral Neuropathy?
Anyone can suffer peripheral neuropathy when physical trauma causes injury to some portion of the nervous system. In addition to injury, the condition can also be acquired or inherited. The most common causes of peripheral neuropathy include:
- Physical Trauma – Sudden trauma or injury to one or more body parts caused by a sports-related activity, fall, accident, or surgical procedure can cause damage to the nervous system that was stretched, compress, crushed, or completely severed, leading to nerve damage. Additionally, dislocated or broken bones can exert enough pressure to damage surrounding nerves.
- Repetitive Stress – Compression injuries can lead to neuropathy. Usually, it is the cumulative damage to the nerve by repetition for prolonged periods that injure one or more groups of nerves. This type of peripheral neuropathy is usually caused by a forceful, awkward, or repetitive activity, leaving muscles, ligaments and tendons swollen and inflamed. This can constrict the narrow passageway where the nerve passes through, producing neuropathy.
- Disorders and Diseases – Independent metabolic disorders can cause nerve damage either by a hormonal imbalance or fluid retention that exerts pressure on the body's peripheral nervous system. Kidneys disorders can also cause neuropathy when the nerves are exposed to high levels of toxic substances in the bloodstream.
- Cancers – Malignant cells can infiltrate the fibers of the nervous system and compress the nerves.
- Infection – Many individuals with an infection will also suffer from neuropathy when bacteria and viruses attack nerve tissue. These can include Epstein-Barr virus, herpes simplex virus, shingles virus, and others.
- Heavy Alcohol Use – Peripheral neuropathy can be caused by excessive alcohol consumption that could lead to permanent damage of the affected peripheral nerves.
Some individuals suffer from peripheral neuropathy through a genetic mutation that was either inherited by a family member or developed in the body.
The most common symptoms associated with peripheral neuropathy include:
- Numbness and tingling sensations in the extremities
- A loss of sensation in the legs or arms
- A burning feeling in the hands or feet
- Thinning of the skin
- Routinely dropping things
- Stabbing, sharp pains
- The sensation like wearing a tight sock or glove
- Digestive difficulties
- Excessive perspiration (sweating)
- Shocking or buzzing sensations
- A heavy sensation in the legs and arms
Over time, individuals with chronic peripheral neuropathy will lose their capacity to sense pain or temperature. If the neuropathy reaches the internal organs, it can cause constipation, diarrhea, and loss of bladder and bowel function. There might also be sexual dysfunction or the development of abnormally low blood pressure.
Diagnosing Peripheral Neuropathy
To verify a diagnosis of peripheral neuropathy, the doctor will conduct a comprehensive physical examination and obtain a complete medical personal history. Other tests will likely include:
- Blood Tests – These tests can measure blood sugar levels and vitamins in the bloodstream to ensure that the thyroid is functioning properly.
- Imaging Tests – The doctor may order an MRI (magnetic resonance imaging) or CT (computerized tomography) scan that provides a visual image to identify a tumor, herniated disc, or nerve compression.
- Nerve Biopsy – Removing a small sample of nerve tissue during a minor surgical procedure allows the doctor to examine the problem under the microscope.
- Electromyography – Using probes with an attached needle inserted into the muscle can help determine if the body's nerve signals are working properly.
- Nerve Conduction Study – Using electrodes placed on the skin, the doctor can pulse minimally intensive electricity through the nervous system to ensure it is transmitting properly. While slightly uncomfortable, the test study provides valuable information on how the nerves are operating.
Peripheral Neuropathy Treatments
Most treatment options involve relieving symptoms, especially if no underlying condition of the cause can be determined. Many doctors perform "watchful waiting" to see if the neuropathic pain and discomfort improve without treatment. However, the doctor may recommend medication therapies and alternative methods for treating the condition.
- Medications – Certain drugs can treat peripheral neuropathy to relieve many of the symptoms associated with the condition. These include:
- Pain Relievers – many over-the-counter painkillers including NSAIDs (nonsteroidal anti-inflammatory drugs) Motrin and Aleve can alleviate mild symptoms associated with the condition. Doctors might also recommend tramadol or oxycodone. However, these drugs contain opioids that can lead to dependency and addiction.
- Anti-Seizure Drugs – Gabapentin and pregabalin that are often prescribed to treat epilepsy can also alleviate nerve pain. However, they can produce dizziness and drowsiness.
- Topical Treatments – the doctor may recommend capsaicin cream that can be applied to irritated or burning skin. However, some individuals do not tolerate the topical cream well.
- Antidepressants – Doxepin, amitriptyline, nortriptyline and other tricyclic antidepressants can alleviate pain by interfering with the brain's chemical processes associated with pain sensation.
Therapies including TENS (transcutaneous electrical nerve stimulation), physical therapy, plasma exchange, and surgical procedures are also effective at easing some of the symptoms associated with peripheral neuropathy. The doctor might also provide alternative treatments including acupuncture, herb supplementation, and amino asset supplements that are proven to be effective at alleviating many of the symptoms associated with the condition.