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Peripheral Neuropathy

 

What is peripheral neuropathy?

Peripheral neuropathy occurs when the nerves that are located outside the brain and spinal cord are damaged. This condition often causes weakness, numbness, and pain, usually in the hands and feet. It can also affect other functions of the body, like digestion and urination.

The peripheral nervous system is responsible for sending information from the brain and spinal cord to the rest of the body through motor nerves. They also send sensory information to the central nervous system through sensory nerves. When these nerves are affected, communication throughout the body becomes interrupted.

What causes peripheral neuropathy?

In some cases, there may not be a cause of someone’s peripheral neuropathy, which is referred to as idiopathic peripheral neuropathy. However, there are certain conditions that can cause it, including:

  • Autoimmune diseases
  • Diabetes and metabolic syndrome
  • Infections
  • Inherited disorders
  • Tumors
  • Bone marrow disorders
  • Other diseases, such as kidney or liver disease or hypothyroidism.

Other common causes of peripheral neuropathy include:

  • Alcoholism
  • Exposure to poisons
  • Certain medications
  • Injury or pressure on the nerve
  • Low vitamin levels

What are symptoms of peripheral neuropathy?

Every nerve in the peripheral system has a specific job, so symptoms will vary depending on whether the sensory (temperature, pain, touch), motor (controls muscle movement), or autonomic (controls functions like blood pressure, sweating, heart rate) nerves are affected.

Sometimes, peripheral neuropathy can affect more than one nerve, called mononeuropathy. If it affects two or more kinds of nerves in different areas, it is referred to as multiple mononeuropathy. If it affects many nerves, it is called polyneuropathy.

The most common symptoms of peripheral neuropathy include:

  • Gradual onset of numbness, prickling or tingling in the feet or hands that spread up to your legs and arms.
  • Sharp, jabbing, throbbing, or burning pain.
  • Extreme sensitivity to touch.
  • Pain during activities that normally don’t or shouldn’t cause pain.
  • Lack of coordination and falling.
  • Muscle weakness.
  • If motor nerves are affected, the inability to move.

If autonomic nerves are affected, symptoms may include:

  • Heat intolerance.
  • Excessive sweating or the inability to sweat.
  • Bowel, bladder, or digestive problems.
  • Sudden drops in blood pressure resulting in dizziness or lightheadedness.

How is peripheral neuropathy diagnosed?

Your provider will perform a physical exam and examine your full medical history. This will include your symptoms, lifestyle, exposure to toxins, drinking habits and family history. They will also perform a neurological exam to check tendon reflexes, muscle strength, ability to detect certain sensations, and balance. Other tests that your provider may order include:

  • Blood tests -- which can be useful to detect low levels of vitamins, diabetes, signs of inflammation or metabolic issues that may be associated.
  • Imaging tests – CT or MRI scans can look for possible herniated discs, pinched nerves, growths, or other problems affecting the blood vessels and bones.
  • Electromyography (EMG) -- measures and records the electrical activity in your muscles to determine the location of nerve damage.
  • Autonomic reflex screen – tests to see how your autonomic nerve fibers work.
  • Nerve biopsy – involves removing a small portion of a nerve to find the cause.
  • Skin biopsy – involves removing a small portion of skin to look at the number of nerve endings.

What are treatment options for peripheral neuropathy?

Treatment of peripheral neuropathy aims to manage the condition causing the neuropathy and improve your symptoms. Medicine and therapy are the most common treatment forms.

Medicine is commonly used to treat conditions associated with peripheral neuropathy and improve symptoms. These medicines can include pain relievers, anti-seizure medications, topical treatments, and antidepressants.

Various therapies and procedures have also proven to be effective to help with the symptoms of peripheral neuropathy, including:

  • Scrambler therapy – involves using electrical impulses to send non-pain messages to the brain. These messages replace the pain messages the nerves send to the brain and retrains it to think there is no pain.
  • Spinal cord stimulation – devices are places throughout the body that send small electrical impulses that block pain signals from reaching the brain.
  • Plasma exchange – used if inflammation or autoimmune conditions are causing neuropathy with weakness, numbness or imbalance.
  • Physical therapy – can help improve your ability to move, balance, or muscle weakness.
  • Surgery – in some cases, neuropathies caused by pressure on nerves, such as tumors, may require surgery.

How can I manage peripheral neuropathy?

There are several things you can do at home to help manage your peripheral neuropathy:

  • Take care of your feet, especially if you have diabetes.
  • Exercise regularly to lower neuropathy pain, improve muscle strength and help control blood sugar levels.
  • Quit smoking to help with circulation and decrease the risk of foot problems and other neuropathy complications.
  • Eat healthy meals.
  • Avoid excessive alcohol.
  • Monitor your blood sugar levels.