What is peripheral neuropathy?
Peripheral neuropathy is a common condition caused by damage to the peripheral nerves of the nervous system. 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 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 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 peripheral neuropathy.
A very common cause of peripheral neuropathy (diabetic neuropathy) is diabetes. Peripheral 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 peripheral 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 peripheral neuropathy can be serious and include muscle wasting, paralysis, serious infections, and gangrene. Seek prompt medical care if you have symptoms of peripheral neuropathy, such as changes in sensation, difficulty moving, or other unusual symptoms. Prompt diagnosis and treatment of peripheral neuropathy and its underlying cause reduces the risk of permanent nerve damage and serious complications.
Some complications of peripheral 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 peripheral neuropathy?
Peripheral 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 with specialized functions that can be affected by peripheral neuropathy.
Symptoms that affect the limbs
Peripheral neuropathy commonly affects the arms and legs. Symptoms include:
Abnormal muscle reflexes
Muscle weakness and atrophy (wasting of muscle tissue)
Poor control of muscles and body movement
Poor coordination
Sores or lesions that do not heal
Unusual sensations, such as pain, numbness, pins and needles, tingling, or prickling that begin in the feet. In later stages of peripheral 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 peripheral neuropathy
Peripheral neuropathy can also affect the transmission of involuntary or partially voluntary nerve impulses from the brain and spinal cord to certain areas of the body, such as the bladder, intestine or stomach. These nerves are called autonomic nerves, and they carry signals that regulate bodily functions, such as sweating and blood pressure. Symptoms of autonomic neuropathy include:
Abdominal bloating
Drop in blood pressure, leading to dizziness and passing out
Heat intolerance due to impaired sweating
Impotence in men
Problems with swallowing
Problems with urination, such as incontinence and hesitancy with urination
Serious symptoms that might indicate a life-threatening condition
Over time peripheral neuropathy can lead to serious and possibly life-threatening complications, such as cardiac arrhythmias, a serious infection, or gangrene. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms:
Change in level of consciousness or alertness, such as passing out or unresponsiveness
Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations or delusions
Chest pain, tightness or pressure
Difficulty breathing or shortness of breath
Difficulty swallowing or inability to swallow
Severe dizziness that does not resolve
What causes peripheral neuropathy?
Peripheral neuropathy is caused by damage to the peripheral nervous system. The peripheral nerves carry motor signals for muscle movement and other functions from the brain and spinal cord to the rest of the body. The peripheral nerves also relay nerve impulses and sensory information back to the central nervous system (spinal cord and brain).
Widespread nerve damage can result from certain 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 interfere with adequate blood flow to nerves over time. Peripheral neuropathy can also be caused by long-term pressure on a particular nerve or nerves due to such conditions as a tight cast, long surgical procedures, or carpal tunnel syndrome.
A number of factors increase the risk for peripheral neuropathy. Risk factors include:
Alcoholism and alcohol abuse
Certain diseases, such as diabetes, cancer, lupus, Charcot-Marie-Tooth disease, rheumatoid arthritis, hepatitis, vasculitis, hypothyroidism, and HIV/AIDS
Certain medications including chemotherapy
Chronic degenerative nerve conditions (multiple sclerosis)
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, long surgical procedures, or carpal tunnel syndrome
Nerve trauma
Poor circulation
Vitamin B deficiency and vitamin E deficiency
Reducing your risk of peripheral neuropathy
You can lower your risk of peripheral neuropathy and permanent nerve damage by :
Avoiding exposure to toxins, such as insecticides, lead, mercury, glues, solvents and arsenic
Following your treatment plan for diabetes, hypothyroidism, and other diseases and conditions that can cause peripheral neuropathy
Not drinking alcohol or limiting alcohol intake to one drink per day for women and two drinks per day for men
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 jackhammer
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 peripheral neuropathy treated?
Treatment plans for peripheral neuropathy are individualized to the underlying cause, the presence of coexisting diseases and complications, the age of the patient, and other factors. Treatment generally involves a multifaceted plan that addresses the underlying cause of neuropathy, 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 peripheral neuropathy, treatment may include:
Medications to ease pain, inflammation, and other symptoms
Physical therapy and occupational therapy to maintain and increase strength and function
Surgery to relieve pressure on a nerve that is causing nerve damage
Walkers, canes, and other assistive devices, such as grab rails in the bathroom, to maintain independence and maximize safety
Complications associated with peripheral neuropathy can be progressive and vary depending on the underlying cause. Untreated peripheral neuropathy can lead to serious complications. You can help minimize complications of peripheral neuropathy by following the treatment plan you and your health care provider design specifically for you. Complications of peripheral neuropathy include:
