Neuropathy

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What is neuropathy?

Neuropathy is a common condition caused by damage to the peripheral nerves of the nervous system. Neuropathy is also known also peripheral neuropathy.

The peripheral nerves spread out from the brain via the spinal cord. The peripheral nerves relay nerve impulses and sensory information from the body to the spinal cord, where they are then carried to the brain. The peripheral nerves also carry motor signals for muscle movement and other functions, such as organ function, from the brain and spinal cord to the rest of the body, including the organs.

Damage to the peripheral nerves interferes with normal functioning of the peripheral nervous system. Typical symptoms of neuropathy include unusual or abnormal sensations of the extremities, which commonly occur in the feet. A wide variety of other symptoms can occur as well because there are many types of peripheral nerves with specialized functions that can be affected by neuropathy. For example, peripheral nerves control the autonomic nervous system, which is responsible for involuntary functions including:

  • Blood pressure

  • Breathing

  • Contraction of the smooth muscles of organs, such as the heart and bladder

  • Digestion

  • Sexual functions

A very common cause of neuropathy is diabetes. This is called diabetic neuropathy. Neuropathy can also result from certain metabolic disorders, infections, malignancy, inflammation, vitamin deficiencies, toxins, inherited conditions, and other abnormal processes. The goal of the clinical evaluation is to identify the root cause for peripheral neuropathy.

Treatment of neuropathy involves diagnosing and treating the underlying disease, disorder or condition. Some conditions can be successfully treated and cured, while others may require more intensive treatment.

Complications of untreated neuropathy and its underlying causes can be serious and include permanent loss of nerve function, muscle wasting, paralysis, serious infections, and gangrene. Seek prompt medical care if you have symptoms of neuropathy, such as changes in sensation, difficulty moving, or any other unexplained or persistent symptoms. Prompt diagnosis and treatment of neuropathy and its underlying cause reduces the risk of permanent nerve damage and serious complications.

Some complications of neuropathy can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have chest pain, difficulty breathing, or a change in alertness or passing out.


What are the symptoms of neuropathy?

Neuropathy generally develops slowly, over a period of months, as peripheral nerves are progressively damaged. A wide variety of symptoms can occur because there are many types of peripheral nerves that have many specialized functions that can be affected by neuropathy.

Symptoms of neuropathy that affect the nerves of the limbs and muscles

Common symptoms of neuropathy often affect the sensory or motor functioning of the arms and legs. Symptoms include:

  • Abnormal muscle reflexes

  • Muscle twitching or cramps

  • Muscle weakness and atrophy (wasting of muscle tissue)

  • Poor coordination and balance, leading to falls

  • Poor muscle control and body movement

  • Problems with swallowing

  • Sores or lesions that do not heal, leading to infections

  • Unusual sensations, such as pain, numbness, pins and needles, tingling, burning, or prickling, that begin in the feet. In later stages of neuropathy, the hands can be affected as well. In some cases, the abnormal sensations can extend to the arms, legs and trunk.

Other symptoms of neuropathy

Neuropathy can also affect the transmission of involuntary or partially voluntary nerve impulses from the central nervous system (brain and spinal cord) to certain areas of the body, such as the bladder, intestines or stomach. Called autonomic nerves, these nerves carry signals that regulate bodily functions, such as sweating, digestion, breathing, and blood pressure. Symptoms of autonomic neuropathy include:

Serious symptoms that might indicate a life-threatening condition

Over time, neuropathy can lead to serious and possibly life-threatening complications, such as cardiac arrhythmias and gangrene. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms:

  • Change in alertness or consciousness, such as passing out, lethargy or unresponsiveness

  • Chest pain or palpitations

  • Difficulty breathing or shortness of breath

  • Difficulty or inability to swallow

  • Hot, dry skin and a lack of sweat

  • Severe dizziness that does not resolve

What causes neuropathy?

Neuropathy is caused by damage to the peripheral nervous system. The peripheral nerves are responsible for relaying messages from the brain and spinal cord to the rest of the body. Widespread nerve damage can result from nerve compression, metabolic disorders, infections, malignancy, inflammation, vitamin deficiencies, toxins, inherited conditions, and other abnormal processes.

A common cause of neuropathy is diabetes. Uncontrolled diabetes causes high blood sugar levels that interferes with adequate blood flow to nerves over time. Neuropathy can also be caused by long-term pressure or compression of a nerve or nerves.

What are the risk factors for neuropathy?

A number of factors increase your risk of nerve damage and neuropathy. Risk factors include:

  • Exposure to certain toxins, such as insecticides, lead, mercury, glues, solvents and arsenic
  • Long-term pressure on a nerve due to such conditions as a tight cast, a long surgical procedure, or carpal tunnel syndrome
  • Nerve trauma
  • Poor circulation
  • Vitamin B deficiency and vitamin E deficiency

Reducing your risk of neuropathy

You can lower your risk of neuropathy and permanent nerve damage by :

  • Avoiding exposure to toxins, such as insecticides, lead, mercury, glues, solvents and arsenic

  • Not drinking alcohol or limiting alcohol intake to one drink per day for women and two drinks per day for men

  • Seeking regular medical care throughout your life and following your treatment plan for diseases and disorders, such as diabetes, hypothyroidism, vasculitis, and other diseases and conditions that can cause neuropathy

  • Taking frequent breaks and using proper techniques for repetitive activities that can cause pressure or compression of a nerve, such as keyboarding or using a jack hammer

  • Using proper technique when using crutches and notifying your health care provider if a cast is too tight or if other orthopedic devices cause discomfort

How is neuropathy treated?

Treatment plans for neuropathy are individualized to the underlying cause and the presence of coexisting diseases and complications. Treatment generally involves a multifaceted plan that addresses the underlying cause, minimizes the pain and abnormal sensations, and reduces the risk of complications, such as gangrene. The ultimate goal is to help you achieve and maintain an independent and active life.

In addition to treating the underlying cause of neuropathy, treatment may include:

  • Medications to relieve pain, inflammation, and other symptoms

  • Physical therapy and occupational therapy to maintain and increase your strength and function

  • Surgery to relieve pressure on a damaged nerve

  • Walkers, canes, and other assistive devices, such as grab rails in the bathroom, to maintain your independence and maximize safety

What are the potential complications of neuropathy?

Untreated neuropathy can lead to serious complications. Following the treatment plan you and your health care provider develop specifically for you will minimize the risk of complications including:

  • Adverse effects of treatment for neuropathy
  • Choking due to problems with swallowing
  • Difficulty breathing
  • Falls
  • Gangrene and amputation
  • Incontinence of urine and feces
  • Passing out
  • Permanent loss of nerve function
  • Permanent physical disability
  • Poor wound healing and infection
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    Medical Reviewer: William C. Lloyd III, MD, FACS
    Last Review Date: 2020 Nov 23
    THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
    1. About Peripheral Neuropathy: Facts. The Neuropathy Association. http://www.neuropathy.org/site/PageServer?pagename=About_Facts.
    2. Peripheral Neuropathy. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000593.htm.
    3. Peripheral Neuropathy. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001619/.
    4. Peripheral Neuropathy Fact Sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm.
    5. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.