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Signals from your peripheral nerves the nerves located outside of the brain and spinal cord are responsible for a host of functions, from perceiving sensations to allowing movements and supporting balance. But sometimes these signals get disrupted for various reasons. The result is a condition known as peripheral neuropathy.
The network of nerves in your body serves as a messaging highway, constantly carrying impulses to and from your brain. These messages tell your body to use muscles, digest food, breathe, and feel pain, among countless other things.
Peripheral neuropathy develops when this highway becomes disrupted, and nerves become compressed or damaged. It usually affects the legs, feet, arms, and hands. Peripheral neuropathy can happen at any age but is more common after age 50.
More than 100 types of peripheral neuropathy have been identified. Each type has its own causes, symptoms, and treatment options. Some types affect only one or a few nerves, while others affect many nerves in the body.
Some types of peripheral neuropathy result from inherited conditions. Others result from conditions or circumstances that arise over the course of someone's life.
In some people, the cause of peripheral neuropathy can't be pinpointed, which can make treatment more challenging. These cases are called idiopathic peripheral neuropathy.
While it is rarely life-threatening, peripheral neuropathy can greatly interfere with your ability to work, sleep, stay active, socialize, and enjoy your life.
Peripheral neuropathy can be caused by health conditions such as diabetes, rheumatoid arthritis, lupus, kidney disease, Lyme disease, shingles, and hepatitis. Other conditions that can cause peripheral neuropathy include having poor blood flow to the legs (often caused by peripheral arterial disease, or PAD), an underactive thyroid gland (hypothyroidism), metabolism problems, nutritional deficiencies, and growths or tumors that press on nerves.
Factors that can also cause peripheral neuropathy include heavy alcohol use, exposure to toxic chemicals, long-term exposure to cold, side effects of certain medications, nerve injuries from an accident, and pressure on a nerve (as with carpal tunnel syndrome), a cast, a brace, or crutches.
Inherited conditions causing peripheral neuropathy include Charcot-Marie-Tooth disease, which affects nerves in the arms, hands, legs, and feet; Friedreich ataxia, which slowly damages the nervous system; and a rare gene disorder known as giant axonal neuropathy, or GAN.
In the U.S., diabetes is the most common cause of peripheral neuropathy, eventually affecting about half of all people with this condition. It happens when high blood sugar levels the hallmark of diabetes damage nerves and the small blood vessels that nourish them.
People with diabetes need to be especially careful about managing their blood sugar, blood pressure, and cholesterol. Good management can help prevent or slow the progression of peripheral neuropathy, which mainly affects the feet and legs of people with diabetes.
Nerve damage in the feet can lead to falls, blisters, and sores. Diabetes can also interfere with the body's ability to heal, which may necessitate amputation of a toe, foot, or part of a leg.
Diabetic neuropathies can happen in both type 1 and type 2 diabetes.
Symptoms of peripheral neuropathy include:
Symptoms of peripheral neuropathy can range from mild to severe. In most cases, symptoms develop slowly over a period of time, and are often worse at night.
Because peripheral neuropathy causes a wide variety of symptoms, it isn't always easy for a doctor to diagnose. Your doctor will start by asking you about details of your symptoms, your medical and family history, and by performing a physical examination.
The doctor also may order blood tests to check for diabetes, thyroid problems, vitamin deficiencies, or liver or kidney problems. Genetic tests to check for inherited neuropathy conditions also may provide some clues.
In some cases, additional testing is helpful. For example, electromyography, or EMG, can tell how well your nerves are working. It can be done with either a nerve conduction study, which measures impulses along large nerves, or a needle exam, in which tiny needles are inserted into muscles to record their activity.
Other tests to help diagnose peripheral neuropathy include a biopsy of nerve or skin tissue, which involves removing a tiny bit of skin after a numbing injection, and a CT or MRI scan to check for a pinched nerve or growth that may be pressing on your nerves.
A muscle and nerve ultrasound is a noninvasive technique to look for severed or compressed nerves and abnormalities that may be related to a muscle or nerve disorder.
Treatment for peripheral neuropathy depends on your symptoms and what is causing the nerve damage. Treatment is often twofold: treating pain and other symptoms and treating the underlying cause.
Your doctor may prescribe medication to relieve pain and tingling. Different types of antidepressants including selective serotonin and norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) and tricyclic antidepressants such as amitriptyline (Elavil), as well as certain antiseizure medications including gabapentin (Neurontin) and pregabalin (Lyrica), can ease these symptoms.
Over-the-counter skin patches or creams that contain lidocaine also may help. Other pain management techniques include electrical stimulation and relaxation therapy.
Although these medications and techniques can help ease symptoms, they do not heal the nerve damage. If the underlying cause of the neuropathy is treated, symptoms sometimes can resolve as nerves recover and regrow.
Tightly controlling diabetes by keeping blood sugar levels in check may help reduce or even eliminate symptoms in people with diabetes. Lifestyle changes, including quitting smoking, avoiding drugs and excess alcohol, healthy eating, and maintaining a healthy weight, may also help to relieve symptoms.
Surgery sometimes is necessary to ease pressure on a nerve, such as carpal tunnel surgery for the hands or surgery to remove a growth or tumor.
You can take steps to prevent peripheral neuropathy by:
To reduce the risk of shingles-related nerve damage, adults 50 years and older should get two doses of the Shingrix shingles vaccine. This has been shown to greatly reduce the risk of shingles and its complications, including peripheral neuropathy.
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Peripheral neuropathy: Causes, symptoms, treatment, and prevention
Sponsored: Say goodbye to neuropathy with help from NexGenEsis Healthcare KHOU.com
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