Peripheral Neuropathy

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Peripheral Neuropathy

What is peripheral neuropathy?

Peripheral neuropathy is a nerve disorder which may cause numbness, tingling, weakness and pain. Symptoms usually affect the feet first and later the hands, which is also called the 'stocking-glove' pattern. The symptoms usually spread slowly and evenly up the legs and arms. Other body parts might also be affected. Most people who develop peripheral neuropathy are over the age of 55 but people can be affected at any age.

What causes peripheral neuropathy?

Common causes include:

  • Diabetes
  • Alcohol abuse
  • Poor nutrition
  • Autoimmune processes (where the body’s own immune system attacks parts of the nerves)
  • Hereditary
  • Exposure to certain drugs or toxins
  • Direct pressure or compression of a single nerve like in carpal tunnel syndrome

What are the symptoms?

Early symptoms of peripheral neuropathy include:

  • Tingling
  • Burning
  • Pricking, stabbing or shock-like pain
  • Muscle cramping
  • Numbness
  • Sensitivity to touch

Late symptoms can include:

  • Weakness
  • Loss of muscle mass
  • Digestive problems
  • Erectile dysfunction in men
  • Dizziness
  • Balance and walking problems
  • Increased risk of ulcers or infections in the feet

Most types of neuropathy develop and progress slowly, but some types come on quickly.

For instance, with Guillain-Barré syndrome, a disorder in which the body's immune system attacks the nerves, neuropathy symptoms appear suddenly and progress rapidly. Then they slowly get better as the damaged nerves heal.

How is peripheral neuropathy diagnosed?

Peripheral neuropathy is often first recognised because of the characteristic symptoms. A physician will look for medical conditions associated with neuropathy or medications that commonly cause neuropathy. A neurological examination can confirm the diagnosis. Sometimes electrical tests of the nerves and muscles (electromyography and nerve conduction studies) help to confirm and classify the neuropathy. More tests may be needed to determine the cause of the neuropathy. Sometimes a specific cause is not identified.

What are the treatment options?

  • For most types of neuropathy, no treatment is available that can cure or modify the disease. In these cases, symptomatic treatment especially for pain is available.
  • Physical therapy can help with balance problems and safety issues. Assistive devices, such as canes or walkers can also be useful.
  • For some types of neuropathy, treatments are available that can help control the disease or prevent further nerve damage.
  • For people with neuropathy caused by diabetes, controlling blood sugar levels may prevent further nerve damage.
  • Medications that alter the immune system can be used to treat autoimmune neuropathies.
  • Identification of a treatable, associated medical cause such as a vitamin deficiency or imbalance of thyroid hormone may arrest or partially reverse the neuropathy.
  • Exercise may reduce nerve pain and improve overall health and mood. Daily walking, housework, gardening and other daily chores all count as exercise.
  • Transcutaneous electric nerve stimulation (TENS) can help reduce the pain for some people.
  • Talk to your physician about which treatments may be best for you.

Living with peripheral neuropathy

Lifestyle changes may also help relieve symptoms.

  • Stop smoking. Nicotine has been found to increase pain perception.
  • Limit alcohol consumption.
  • Eat a healthy diet.
  • Avoid excessive consumption of vitamin B6 which can cause neuropathy at levels of more than 100 mg daily.