What Is Neuropathy?
Peripheral neuropathy is a group of disorders affecting any of the nerves that connect the brain and spinal cord with other parts of the body, such as the internal organs, arms, legs, face and skin. When these nerves are damaged or destroyed, there is pain or numbness in the parts of the body the nerves usually serve.
Idiopathic neuropathy, with no known cause, is common in people over age 60. But there are also many well-known causes of neuropathy, including:
- Diabetes
- Alcohol abuse
- Kidney failure
- Autoimmune disorders, such as rheumatoid arthritis and celiac disease
- Carpal tunnel syndrome
- Medications — Neuropathy is an especially common side effect of chemotherapy and AIDS/HIV drugs.
- Inherited disorders — Two known inherited neuropathies are Charcot-Marie-Tooth disease and hereditary neuropathy with liability to pressure palsies.
- Infectious diseases — Some infectious diseases, such as Lyme disease, shingles, and hepatitis B and C, cause inflammation that can damage the peripheral nervous system.
- Malnutrition
- Vitamin B12 deficiency
- Toxins — Neuropathy can be a result of chemical abuse, such as sniffing glue; environmental or workplace exposure to toxins, particularly mercury, arsenic, lead and thallium; or taking any herbal medicines containing high levels of arsenic or mercury.
Symptoms
While some neuropathy only affects motor (muscle control), sensory (the ability to feel) or autonomic function (body processes that happen automatically, like digestion), most neuropathy affects all three functions to some extent.
The fingers and/or toes are usually the first places neuropathy manifests itself, with tingling or numbness. Over time, the discomfort increases to burning, freezing, throbbing, shooting or shock-like pain that spreads to the hands and/or feet. Other symptoms include:
- A dulling sensation in the hands or feet — Patients might feel like they’re wearing invisible gloves or socks.
- Sensitivity to touch — Things that normally aren’t painful cause discomfort.
- Discomfort that worsens at night — Pain or tingling in the feet and legs often interferes with sleep.
- Muscle weakness or cramping — Contractions or weakness in the muscles can develop.
- Autonomic neuropathy — The nerves control body functions like digestion, blood pressure, pulse, sweating, and bladder and bowel control, so when the nerves are affected, these functions can become irregular.
- Poor balance or coordination — Patients can experience trouble walking or moving their arms because they’ve lost sensation in the affected limbs.
Treatment Options
Because the severity of the symptoms of peripheral neuropathy can vary widely, there is also a wide range of treatment options, including:
- Over-the-counter pain relievers — Acetaminophen can reduce pain and non-steroidal anti-inflammatory drugs (NSAIDs) can reduce pain and inflammation.
- Topical medications — Analgesics, such as capsaicin, and local anesthetics, such as lidocaine, can be applied to the skin to relieve neuropathy pain.
- TENS — Transcutaneous electronic nerve stimulation uses small electrical impulses to block pain signals from certain nerves to the brain.
- Prescription medications — Prescription-strength NSAIDs, topical medications, antidepressants or anticonvulsants may be recommended.
- Corticosteroids — These anti-inflammatories can be taken orally or injected.
- Intravenous immunoglobulin — These medications help with neuropathy caused by autoimmune disorders.
- Anesthetic nerve blocks — Local anesthetics are injected close to the nerve to block pain.
- Alternative therapies — Treatments like acupuncture and biofeedback have been used to enhance the effects of traditional neuropathy treatment.
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