Peripheral Neuropathy

What is peripheral neuropathy?

Peripheral neuropathy, the result of damage to nerves located outside the brain and spinal cord (peripheral nerves), often causes weakness, numbness, and pain, usually in the hands and feet. It can also affect other areas and body functions, such as digestion, urination, and circulation.

Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. Peripheral nerves also send sensory information to the central nervous system.

People with peripheral neuropathy usually describe the pain as stabbing, burning, or tingling. In many cases, symptoms improve, especially if they are caused by a treatable condition. Medicines can reduce the pain of peripheral neuropathy.

What does peripheral neuropathy feel like? (Symptoms)

Pain comes in many shapes and sizes, especially when it comes to peripheral neuropathy or nerve pain. It is common to experience pain in the arms, hands, legs, or feet and to feel a tingling, burning, or stabbing sensation that does not stop.

However, there are many other symptoms of nerve pain that can trigger the onset of chronic pain. First, let’s take a closer look at peripheral neuropathy.

Each person has a series of peripheral nerves that start in the brain and spinal cord and descend to our hands and feet. These nerves also extend to our internal organs, mouth, and face. Unfortunately, it is our hands and feet that are the first to experience the relentless signs of nerve pain.

Signs and symptoms of peripheral neuropathy may include:

• Gradual onset of numbness, itching, or tingling in the feet or hands, which may spread to the legs and arms
• Sharp, stabbing, throbbing, or burning pain
• Extreme sensitivity to touch
• Pain during activities that shouldn’t cause pain, such as pain in the feet when putting weight on them or when they’re under a blanket
• Lack of coordination and falls.
• Muscular weakness
• Feeling like you’re wearing gloves or socks when you’re not
• Paralysis if the motor nerves are affected

If autonomic nerves are affected, signs and symptoms may include:

• heat intolerance
• Excessive sweating or not being able to sweat
• Bowel, bladder, or digestive problems
• Drops in blood pressure, causing dizziness or lightheadedness

Peripheral neuropathy can affect one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy), or many nerves (polyneuropathy). Carpal tunnel syndrome is an example of mononeuropathy. Most people with peripheral neuropathy have polyneuropathy.

Causes

Peripheral neuropathy is nerve damage caused by a number of different conditions. Health conditions that can cause peripheral neuropathy include:

• Autoimmune diseases. These include Sjogren’s syndrome, lupus, rheumatoid arthritis, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and vasculitis.
• Diabetes. This is the most common cause. Among people with diabetes, more than half will develop some form of neuropathy.
• infections. These include certain viral or bacterial infections, such as Lyme disease, shingles, Epstein-Barr virus, hepatitis B and C, leprosy, diphtheria, and HIV.
• hereditary disorders Disorders such as Charcot-Marie-Tooth disease are inherited types of neuropathy.
• Tumors. The growths, both cancerous (malignant) and noncancerous (benign), can develop on or press on nerves. Also, polyneuropathy can arise as a result of some cancers related to the body’s immune response. These are a form of a degenerative disorder called paraneoplastic syndrome.
• Bone marrow disorders. These include an abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (myeloma), lymphoma, and the rare disease amyloidosis.
• Other diseases. These include kidney disease, liver disease, connective tissue disorders, and an underactive thyroid (hypothyroidism).

Other causes of neuropathies include:

• Alcoholism. Poor dietary choices made by people with alcoholism can lead to vitamin deficiencies.
• Exposure to poisons. Toxic substances include industrial chemicals and heavy metals like lead and mercury.
• Medications Certain medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy.
• Injury or pressure on the nerve. Injuries, such as those caused by car accidents, falls, or sports injuries, can damage or damage peripheral nerves. Pressure on the nerves can be the result of having a cast or using crutches or repeating a movement such as typing many times.
• Vitamin deficiencies. B vitamins, including B-1, B-6 and B-12, vitamin E and niacin are crucial for nerve health.
• In several cases, the cause cannot be identified (idiopathic).

What are the warning signs of neuropathy?

Unfortunately, not all cases of peripheral neuropathy are symptomatic in the early stages. This can make early detection even more difficult.

That said, be on the lookout for any of the following symptoms, especially if you have any of the common risk factors for neuropathy (which we’ll talk about in the next section):

Tingling in the feet. Most people recognize the feeling that their foot is “numb,” usually after sitting cross-legged or putting pressure on a limb. However, if you notice that the tingling or numbness is more frequent, more intense, or does not go away after changing positions, it may be a sign of systemic nerve damage.

Other unexplained sensations or pains. In addition to (or instead of) prickling or “pins and needles” sensations, you may notice symptoms such as burning sensations, sudden “electric shock” pain, itching, hypersensitivity to touch or temperature, or other unusual sensory issues that do not appear to have an obvious external cause.

Weakness or balance problems. Sensory nerves are not the only type of nerves that can be affected by neuropathy. The motor nerves, which control the muscles and movement of the feet and legs, may also be affected. Also, if you have trouble feeling your feet make contact with the ground, you’re less likely to remain stable.

Cuts, sores, or sores that you don’t notice or that don’t get better. Neuropathy can reduce your ability to feel pain, so you may not notice cuts or injuries until after you’ve walked on them for a while. Also, because neuropathy is often caused by the same factors that suppress circulation and immune health, those cuts and injuries may take longer to heal and are more likely to become infected.

Even though you may have these symptoms, they may not be related to neuropathy. However, it’s always wise to get a full checkup if you suspect a problem, especially if you have any known risk factors for neuropathy.

What does peripheral neuropathy in the feet feel like?

Sensory symptoms of peripheral neuropathy in the feet include:

Gradual onset of numbness, itching, or tingling in the feet or hands, which may spread to the legs and arms

Pain during activities that shouldn’t cause pain, such as pain in the feet when putting weight on them or when they’re under a blanket

Seek immediate medical attention if you experience unusual tingling, weakness, or pain in your hands or feet. Early diagnosis and treatment offer the best chance to control your symptoms and prevent further damage to your peripheral nerves.

What does peripheral neuropathy feel like in the hands?

Sensory symptoms of peripheral neuropathy in the hands include:

• Numbness and tingling in the hands
• Burning or stabbing pain
• Loss of coordination
• Muscular weakness

These symptoms are usually constant, but can come and go.

Diabetes with peripheral neuropathy

Diabetic neuropathy is a type of nerve damage that can happen if you have diabetes. High blood sugar (glucose) can damage nerves throughout the body. Diabetic neuropathy most often damages the nerves in the legs and feet.

Depending on which nerves are affected, symptoms of diabetic neuropathy include pain and numbness in the legs, feet, and hands. It can also cause problems with the digestive system, urinary tract, blood vessels, and heart. Some people have mild symptoms. But for others, diabetic neuropathy can be quite painful and disabling.

Diabetic neuropathy is a serious complication of diabetes that can affect up to 50% of people with diabetes. But you can often prevent diabetic neuropathy or slow its progress with consistent blood sugar control and a healthy lifestyle.

What causes diabetic peripheral neuropathy?

Over time, high blood glucose levels, also called blood sugar, and high levels of fats, such as triglycerides, in the blood from diabetes can damage nerves. High blood glucose levels can also damage the small blood vessels that supply the nerves with oxygen and nutrients. Without enough oxygen and nutrients, your nerves can’t function properly.

Can diabetic peripheral neuropathy recover?

There is no cure for diabetes-related neuropathy. You can control nerve pain with medication, exercise, and proper nutrition.

Treatment of diabetes with peripheral neuropathy

Physicians should carefully consider the goals and functional status of the patient and the possible adverse effects of medication when choosing a treatment for painful diabetic peripheral neuropathy.

Pregabalin and duloxetine are the only medications approved by the US Food and Drug Administration to treat this disorder. According to current practice guidelines, these medications, with gabapentin and amitriptyline, should be considered for initial treatment.

Second-line therapy includes opioid-like drugs (tramadol and tapentadol), venlafaxine, desvenlafaxine, and topical agents (lidocaine patches and capsaicin cream). Isosorbide dinitrate spray and transcutaneous electrical nerve stimulation may provide relief in some patients and may be considered at any time during therapy.

Opioids and selective serotonin reuptake inhibitors are optional third-line medications. Acupuncture, traditional Chinese medicine, alpha lipoic acid, acetyl-l-carnitine, evening primrose oil, and the application of electromagnetic fields lack high-quality evidence to support their use.

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