Peripheral Neuropathy: Know the Signs
If you have diabetes, kidney disease or a hormone imbalance, you may also have peripheral neuropathy. Millions of people across the United States suffer from this nerve disorder and approximately 30-50% of people with diabetes are among those affected. Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system which is a large communications network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body.
“There are more than 100 types of peripheral neuropathy -- each with its own symptoms and likely course of progression,” said Ghassan Bejjani, MD, Chief of Neurosurgery at Penn Highlands Healthcare, who provides highly specialized care for neurosurgical conditions. “Symptoms vary depending on the type of nerves that are affected.”
There are three different classes of peripheral neuropathy including those that affect the motor, sensory and automatic nerves. The motor nerves impact the movement of muscles that we voluntarily control such as talking and walking. Sensory nerves carry signals related to physical feelings such as temperature or pain. The automatic nerves control involuntary muscle and organ function such as breathing, digestion and glandular function. Most neuropathies affect all three classes of nerve fibers and are length dependent which means that the nerves the farthest away from the brain (those in the feet) are where symptoms usually begin.
What are the causes?
While diabetes is the leading cause of peripheral neuropathy, other causes include:
- Injuries
- Arthritis
- Vascular and blood problems
- High blood pressure
- Autoimmune diseases
- Hormonal imbalances
- Kidney and liver disorders
- Tumors
- Chemotherapy drugs
- Vitamin deficiencies
- Alcohol abuse
- Exposure to toxins
What are the symptoms?
Two of the most common symptoms of peripheral neuropathy include pain and numbness. Symptoms may begin in the hands and feet with a feeling of tingling or prickling such as when people say their “hand fell asleep.” Other symptoms may include sharp, throbbing or burning pains; sensitivity to touch; muscle weakness; and lack of coordination and frequent falls. Some people simply cannot move. People whose autonomic nerves are impacted may experience dizziness due to low blood pressure; digestive issues; and heat intolerance.
How is peripheral neuropathy diagnosed?
“Since the symptoms can mimic other disorders, it is sometimes difficult to diagnose peripheral neuropathy,” said Dr. Bejjani. “However we have many diagnostic options such as physical and neurological exams, blood tests, medical imaging, nerve biopsies and ultrasound.”
What are the treatments?
There are three common approaches to treat peripheral neuropathy.
- Medications including over-the-counter pain relievers such as ibuprofen and topical patches and creams can be safely used. Also, prescription medications can be effective for moderate to severe pain and to manage diabetes (if the cause).
- Physical therapy and rehabilitation are common treatments including exercise such as walking or yoga because they help improve muscle strength and balance and can help relieve pain. Physical therapy is often prescribed to help with muscle weakness and to regain strength.
- Lifestyle Modifications such as foot care, diet, smoking cessation and stress management which also help contribute to a person’s overall health and well-being.
“It is important to address the underlying cause of the neuropathy to prevent further nerve damage,” said Dr. Bejjani, who advises people with chronic pain to seek medical attention.
Penn Highlands Neurosurgery offers an array of non-surgical and surgical options for nerve conditions causing pain, such as peripheral neuropathy and carpal tunnel syndrome. The board-certified neurosurgeons also treat brain conditions, such as brain aneurysms, and spinal conditions that cause back pain and neck pain.
