Peripheral neuropathy notions towards a problem with the peripheral nerves. These nerves are responsible for sending messages from the central nervous system (CNS) to the spinal cord and the rest of the body.
The peripheral nerves form part of the hypothalamus and tell the body regarding its temperature in various parts, sometimes leading to different feelings such as tingling, numbness, muscle weakness, etc.
Peripheral neuropathy can impact a single nerve or several nerves in various areas of the body in various ways. Peripheral neuropathy can also be said to have an association with various underlying medical conditions. In worst cases, even the cause cannot be identified.
Peripheral neuropathy affects 20 million people in the U.S. alone. Below are some highlighted facts regarding peripheral neuropathy:
Among other medical conditions, neuropathy is somewhat a common complication.
Sensory nerves, motor nerves, autonomic nerves; can all be involved in neuropathy.
It can affect an individual nerve or nerve sets, for instance, in Bells’ Palsy, which can affect a facial nerve.
Some possible causes include physical trauma, infection, repetitive injury, metabolic problems, toxin exposure, and some drugs.
Diabetic people are at a greater risk of neuropathy.
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Targeting the underlying cause or providing symptomatic pain relief while preventing further damage is what the treatment is expected to do. Addressing the high blood sugars can prevent any further nerve damage in patients with diabetic neuropathy.
If the underlying cause was toxic exposure, stopping a drug or avoiding the suspected toxin can prove to be fruitful. However, medicines can aid in mollifying pain and reducing burning.
Drug treatment to deal with neuropathic pain
Below are some effective medicines for such conditions:
- Epilepsy-related drugs, e.g. carbamazepine
- antidepressants, e.g. venlafaxine
- opioid painkillers, for example, tramadol or oxycodone
Opioid painkillers are often inclusive of safety risk warnings. People subject to chemotherapy-induced neuropathy might find Duloxetine helpful. Doctors can also prescribe skin patches such as Lidoderm as a source of temporary relief.
The patches are similar to bandages, can be cut to size, and contain lidocaine, a local anesthetic.
Non-steroidal anti-inflammatory drugs (NSAIDs), for instance, ibuprofen, might aid in controlling the pain and are extensively available in the market. Topical ointments/creams/patches that contain chili pepper can also cause pain relief.
If an individual nerve’s compression causes neuropathy, the treatment is somewhat the same regardless of the specific nerve. The only variation in approach might be caused if the compression is transient or fixed.
An example of a transient and reversible approach is palsy of the ulnar, radial, or peroneal nerve. The cure is as simple as avoiding the cause of the compression. For instance, a person with ulnar nerve palsy is advised not to lean on the affected elbow. Rest, and short-term anti-inflammatory medicines might also be advised.
Conservative therapy for carpal tunnel syndrome includes splinting the wrist, oral or injected corticosteroid drugs, and an ultrasound.
If in a single-nerve neuropathy, these measures are not seen responsive, then surgery might be the final option. Besides, if the nerve compression is fixed, for example, it might be caused by a tumor, then surgery becomes necessary.
Specialist pain services or clinical assistance shall be opted at any stage if:
- Pain becomes severe
- Pain hinders routine activities
- Worsening of underlying health condition
The symptoms might be different concerning the type of neuropathy.
The person might have:
- Numbness and tingling
- Hypersensitivity and pins and needles
- The ability to feel pain lost or heightened
- Loss of thermal sensitivity
- Loss of coordination and proprioception
- Shooting pains, inflammation, stabbing, etc. might increase at night
Foot and leg ulcers, infections, and gangrene can also be caused.
This usually affects the muscles. Symptoms include:
- Fatigued muscles causing hindrance in daily life movements
- Muscle wasting
- Muscle twitching and cramps
- Muscle paralysis
If the autonomic nerves were affected, the person would feel sweating, heat intolerance, blood pressure changes, and bowel or bladder problems that might lead to dizziness.
Neuropathies are “idiopathic,” meaning that their cause is unknown, but certain conditions might trigger it. Among the common reasons of chronic peripheral neuropathy, diabetes is the most common. It occurs when high blood sugar levels start to damage the nerves.
Other medical conditions and injuries include:
- Chronic kidney disease: When the kidneys function abnormally, an imbalance of salts and chemicals might cause peripheral neuropathy and you might need peripheral neuropathy treatment but do ask for suggestions from your physician.
- Injuries: Pressure on nerves can also be caused by tight plasters or broken bones.
- Infections: Nerve damage can also be caused by HIV infection, Lyme disease, shingles, and others.
- Guillain-Barre syndrome: This specific type of peripheral neuropathy is triggered by
- Some autoimmune disorders: These include systemic lupus erythematosus (SLE) and rheumatoid arthritis.
Some other causes:
- Excessive alcohol consumption
- A few types of drug, e.g., HIV treatment, chemotherapy
- Deficiencies; B12 or folate vitamins
- Poisons, e.g., solvents, insecticides
- Cancers of some kind; such as lymphoma and multiple myeloma
- Chronic liver disease
Disorders in small blood vessels reduce blood supply to the nerves, hence, damaging the nerve tissue. Neuromas, benign tumors that affect nerve tissue, also lead to neuropathic pain.
Diabetes is one of the most common cause of peripheral neuropathy. Of all the people with diabetes, 60-70% have some sort of neuropathy.
The walls of the tiny blood vessels responsible for supplying oxygen and other nutrients to the nerves in the ends of various areas of the body, such as the hands, feet, and vital organs, are damaged by high blood sugar levels.
Resultantly, loss of sensation and skin damage is faced. Around half of all people with diabetes are believed to have diabetic neuropathy in the U.S., and it is also the cause of foot ulcers, etc.
The CNS comprises various types of nerves; however, peripheral neuropathy solely relates to peripheral nerves.
Neuropathy can affect the:
- Sensory nerves: Control sensation and any damage can cause pain, numbness, tingling, or weakness in the feet and hands.
- Motor nerves: These nerves enable mobility and strength, and damage can result in weak hands and feet.
- Autonomic nerves: These nerves are responsible for controlling body systems such as the digestive or cardiovascular system. The damage will affect the heart rate, blood pressure, and other functions.
Mononeuropathiesmong involves an individual nerve, whereas, in polyneuropathy, several nerves are affected.
Examples of neuropathy include:
- Ulnar nerve palsy refers to an injury to the elbow
- Bell’s palsy, a single-facial-nerve neuropathy
- Carpal tunnel syndrome, a compression of nerves in one’s wrist
Non-drug measures are:
- Wear non-irritating fabrics, e.g., cotton
- Cover sensitive areas with plastic covering/cling film
- If not affected by temperature, use warm/cold packs.
Meditation, relaxation, acupuncture, etc., are yet other sources of relief. The transcutaneous electrical nerve stimulation (TENS) machine uses electric currents to interrupt nerve messages. It is thought useful but has not been proven yet. Any supplements shall be discussed primarily with the doctor.
We can conclude here by saying that conditions for many patients can vary. If it gets treated on a timely basis, the problem will go away over time; otherwise, it might stay permanently or worsen.