What is peripheral neuropathy?
If you have peripheral neuropathy, you have nerve damage in your peripheral nervous system (PNS). Your PNS transmits all the impulses from the brain and spinal cord to the rest of the body. For example: you accidentally touch the hot burner of your stove. Immediately the heat from the burner activates the nerve receptors in your skin and a message is sent to the spinal cord. In a nanosecond the message is interpreted and a message is sent back to your hand to remove it from the source of heat. So, in a knee jerk reaction, you touch the burner, it is hot and you remove your hand. The peripheral nervous system is different than your central nervous system (CNS). Your CNS has to do with your brain and spinal cord, and your peripheral nervous system has to do with everything outside of your CNS.
There are more than one hundred types of peripheral neuropathies, and each type has their own set of symptoms. The peripheral nerves have three types: motor, sensory, and autonomic. The motor nerves have to do with movement of muscles. Sensory nerves have to do with touch. The symptoms the patient experiences depends on what nerves are impaired. If motor nerves are impaired the patient may have problems moving, there may be weakness of muscles or paralysis. If sensory nerves are impaired the patient may complain of tingling or burning pain, or the patient may not feel sensations such as hot and cold. If the autonomic nerves are impaired there may be any number of problems regulating temperature, breathing, heart rate, blood pressure, organ and hormone functions.
What causes peripheral neuropathy?
Peripheral neuropathy is either acquired or inherited. Acquired peripheral neuropathy can be caused by an injury to a nerve, an autoimmune response as in rheumatoid arthritis or lupus, alcoholism, tumors, toxins, nutritional deficiencies, metabolic disorders as in diabetes mellitus, and vascular diseases. Inherited peripheral neuropathy is caused by genetic mutations, in which a mistake is made in the genetic code.
How is peripheral neuropathy treated?
There is no medical treatment that will eliminate the inherited form of peripheral neuropathy. For the patient with the acquired form of the disease, he/she should maintain a healthy lifestyle with a balanced diet and adequate exercise. The patient should avoid or limit alcohol consumption, and should not smoke. In general most peripheral neuropathies are non-fatal, but they do become chronic and worsen over time.
Peripheral neuropathy is quite common in patients with diabetes, rheumatoid arthritis, lupus, HIV, AIDS, vitamin B-1 and B-12 deficiencies, alcohol addictions, and side effects of medications.
Pain and antiseizure medications are prescribed to alleviate the discomfort of the disorder. Neuontin, Tegretol, and Dilantin were originally used to treat epilepsy, but are prescribed for the stabbing pain associated with peripheral neuropathy. The side effects of these drugs are dizziness and drowsiness. In some patients the doctor may order a topical lidocaine patch that is worn at the site of pain. There are no side effects, other than some patients reported a slight rash at the application site.
Many patients are treated with antidepressants because these drugs offer mild relief of nerve pain. In severe cases that do not respond to the other medicines, opiates are prescribed, but should only be used intermittently because of the risk of addiction.
Are there other ways to treat peripheral neuropathy?
1)
Transcutaneous electrical nerve stimulation (TENS)-this electrical unit blocks pain signals from reaching your brain by delivering tiny electrical impulses to the painful area. TENS is safe and painless, but doesn’t work for everyone.
2)
Biofeedback-you are taught to use a special machine to help control your responses that reduce pain.
3)
Acupuncture-can be effective to treat chronic pain.
4)
Hypnosis-is helpful if you are motivated and believe you can be helped. You will be given suggestions to decrease your perception of pain.
5)
Relaxation techniques-are helpful because tension is released through muscle relaxation and deep breathing exercises.
When should you see your doctor?
If you have diabetes or an autoimmune disease you should see your doctor on a regular basis to detect any possible problems before they become serious. If you have an injury that doesn’t seem to be healing well, or is getting worse, you should get it checked promptly. If you notice numbness, tingling, or weakness in your hands or feet, getting medical help quickly can prevent further nerve damage, and it will be your best chance at recovery.
How is peripheral neuropathy diagnosed?
Your doctor will examine you, and take a full medical history. He/she will check your reflexes, muscle strength, as well as your ability to feel sensations-such as hot and cold, rough and smooth-as well as your over all appearance. Your physician will also request blood tests, check your vitamin B-12 level, do a urinalysis, as well as an electromylograph (EMG), and thyroid function tests.
Getting medical care on regular checkup visits and when you are aware of a potential problem is the best way to prevent peripheral neuropathy. Take care of yourself by eating healthy meals, get adequate exercise, if you smoke-quit, abstain from or reduce alcohol consumption, message your hands and feet regularly, and avoid prolonged pressure on your elbows and knees. If you cross your legs, uncross them from time to time. For more information on peripheral neuropathy click on the link at the end of this article.
Source: Mayo Clinic webpage
