Are you struggling with neuropathy or peripheral neuropathy? Neuropathy is defined as a group of disorders that begins due to damage of the peripheral nervous system. The peripheral nervous system is a part of the nervous system excluding the brain and spinal cord. This means that this is the collection of nerves that is connects your limbs and organs to the central nervous system. This condition is also known as peripheral neuropathy and generally occurs because damage to the nerve axons has occurred. The nerve axon is what conducts the electrical impulses to different places. For example, if damage occurs within the axon of a sensory neuron, then a person’s sense of touch and warmth will be impaired. Generally, neuropathy creates pain, numbness and tingling in the extremities (hands and feet). There are several different causes of this condition, including:
- The most common: diabetes
- Traumatic injury
- Metabolic Disorders
Types of Neuropathy
- Sensorimotor polyneuropathy: affects the sensory and motor nerves
- Autonomic neuropathy: affects nerves that control processes such as breathing, heartbeat, perspiration, etc.
Peripheral neuropathy often creates painful sensations described as tingling, burning and prickling. With a condition such as this, a specific duration of pain varies but generally improves in time. There is a better chance of improving the symptoms if proper treatment for an underlying condition is received. It is common to see the condition correlating with several life factors, such as poor nutrition, various diseases, trauma or pressure on the nerves. In some cases, there is an unknown cause. This is referred to as idiopathic neuropathy.
According to the Neuropathy Association, more than 20 million Americans are suffering from a form of neuropathy. That means that more people suffer from this one condition than Alzheimer’s, Epilepsy, Rheumatoid Arthritis, HIV, Parkinson’s Disease, and Multiple Sclerosis combined. Of those 20 million Americans suffering from neuropathy, an estimated 15-18 million of those people have this condition due to a form of diabetes.
There are over 100 different types of neuropathy, but peripheral neuropathy can be further categorized into one of the following groups. The group is defined according to how many nerves are involved.
- A single nerve involved would be classified as mononeuropathy. When this occurs, conditions like carpel tunnel syndrome and bell’s palsy may manifest.
- Two or more individual nerves involved would be classified as multiple mononeuropathy.
- Involvement of a board range of peripheral nerves would be classified as polyneuropathy. When is occurs, conditions like diabetes may be associated.
There are several other ways to categorize these conditions, including:
- Functional classification: motor, sensory, autonomic or a combination
- Type of onset: hours, days, weeks, months, years
Peripheral neuropathy, affecting the extremities like the arms, wrists, hands, legs, ankles and feet, is the most common.
Causes of Neuropathy
There is not a single underlying cause for neuropathy. In fact, there may be no known cause which is referred to as idiopathic and makes up nearly 40% of all neuropathies. Also, nearly 35% of the remaining Americans suffering from neuropathy have diabetes. In fact, almost 70% of Americans with diabetes have developed a form of neuropathy due to the disease. The remaining percent of neuropathies is composed of a group called acquired neuropathies. This group consists of causes such as:
- Poor nutrition and nutritional deficiencies
- Pressure on nerves
- Repetitive movements for extended periods of time
- Various autoimmune diseases
- Rheumatoid Arthritis
- Heavy metal poisoning
- Various medications
- Certain cancer treatments
- Hereditary neuropathies (from inherited disorders)
- Other diseases, including but not limited to:
- Lyme disease
- Liver disease
- Kidney disease
Who can Develop Neuropathy?
Neuropathy can affect all people of all ages. It is more commonly found in men and Caucasians as well as those who have jobs consisting of a lot repetitive movements. There are several risk factors ranging from lifestyle choices, behaviors and conditions. As previously stated, those who have poor nutrition are likely to develop Type II Diabetes which will cause neuropathy. If a person suffers from an autoimmune disease, they have a predisposition for the development of various types of neuropathy. If a person has a compromised immune system (organ transplant recipient, HIV/AIDS patients, or due to medication), they are at an increased risk for developing a type of neuropathy. If a person suffers from alcoholism or has a vitamin deficiency, they are likely to develop a form of neuropathy. Also, if a person has kidney disease, liver disease or a thyroid disorder they are more susceptible to developing neuropathy.
Diagnosis of Neuropathy
This condition is generally not a simple diagnosis to make. It is difficult because it is not often that it is a disease present alone rather a symptom of an underlying disease. There is a process that occurs before the diagnosis is made. The process may consist of:
- Full medical history
- Physical exam
- Neurological exam
- Tendon reflexes
- Muscular strength
- Muscular tone
- Sensory tests
- Postural analysis
- Coordination analysis
- Blood tests (check vitamin B-12)
- Thyroid function tests
- Nerve conduction test
In some cases a nerve biopsy may be requested by a physician.
Neuropathy Treatment Options
There have been several treatments developed for the treatment of neuropathies. Treatment options range from medications, creams, special diets and therapies. All of these treatments are designed to assist in nervous system function. The most common course of treatment is prescription antidepressants to relieve pain in non-depressed patients. Research has also found that antidepressants can alleviate peripheral neuropathy induced from chemotherapy treatments.
Anticonvulsants are another choice of treatment used for neuropathies. This type of medication is used because it blocks the incoming calcium within a neuron which ultimately inhibits the transmission of pain. A less favorable medication used is opioid narcotics. These are not used very often because of the chance the patient may become addicted and dependent although they are they usually the most effective for alleviating the pain. Topical creams that may be used are lidocaine or capsaicin.
There are also alternative therapies available. Some of that have been used are:
- Dietary supplements
- Chiropractic adjustments
- Therapeutic massage
Neuropathy may be treated with a class of therapy known as neuromodulators. This may require surgical implantation of electrical or chemical implants. These include:
- Spinal cord stimulators
- Spinal pumps
- Electrodes – used to stimulate the motor cortex
- Deep brain stimulation
Proper nutrition is very important in preventing and managing neuropathy. This is especially true about diabetics. An exercise plan is highly recommended. If you are currently a smoker, it is advised to quit. For relief at home, massaging your hands and feet will stimulate the nerves and relieve pain. It is also extremely important to avoid spending extensive periods of time on your knees or elbows in order to prevent further damage.
As always remember that if you have questions you can call the team at Access Health Centers for help.