Learning About Peripheral Neuropathy

What is peripheral neuropathy?

Peripheral neuropathy is a problem that affects the peripheral nerves. These nerves lead from the spinal cord to other parts of the body. They control your sense of touch, how you feel pain and temperature, and your muscle strength.

Most of the time the problem starts in the fingers and toes. As it gets worse, it moves into the limbs. It can cause pain and loss of feeling in the feet, legs, and hands.

What causes it?

Doctors don't always know what causes peripheral neuropathy. But it usually happens when your nerves are damaged. It is often caused by other health problems. It can also run in families.

Other things that can cause peripheral neuropathy include:

• Diabetes. This is the most common cause. If your blood sugar is too high for too long, it can damage the nerves. This is why some people with diabetes lose feeling in their feet.
• Kidney problems. These can lead to toxic substances in the blood that damage nerves.
• Low levels of thyroid hormone (hypothyroidism). This may cause swelling of the tissues around the nerves, which can put pressure on them.
• Infectious or inflammatory diseases. Examples are HIV, Guillain-Barré syndrome, and Lyme disease. These diseases can damage the nerves.
• Peripheral nerve injury. A physical injury can damage the nerves. Injuries can be from things like falls, car crashes, or playing sports.
• Overusing alcohol and not eating a healthy diet. These can lead to your body not having enough of certain vitamins, such as vitamin B-12 or vitamin E. This can damage nerves.
• Being exposed to toxic substances. This can include heavy metals such as lead and mercury or toxic chemicals.
• Certain medicines, such as those used for chemotherapy.

What are the symptoms?

Symptoms of peripheral neuropathy can occur slowly over time. The most common ones are:

• Numbness, tightness, and tingling. This most often happens in the legs, hands, and feet.
• A loss of feeling.
• Burning, shooting, or stabbing pain in the legs, hands, and feet. Often the pain is worse at night.
• Weakness and loss of balance.

What can happen if you have it?

If peripheral neuropathy gets worse, it can lead to a complete lack of feeling in your hands or feet. This can make you more likely to injure them. It may lead to calluses and blisters. It can also lead to bone and joint problems, infection, and ulcers.

For instance, small, repeated injuries to the foot may lead to bigger problems. This can happen because you can't feel the injuries. Reduced feeling in the feet can also change your step, leading to bone or joint problems.

If untreated, foot problems can become so severe that the foot or lower leg may have to be amputated. But treatment can slow down peripheral neuropathy. And it's a good idea to take care to avoid injury.

How is it diagnosed?

To diagnose peripheral neuropathy, your doctor will ask you about:

• Your symptoms.
• Your medical history. This may include your use of alcohol, risk of HIV infection, or exposure to toxic substances.
• Your family's medical history, including nerve disease.

Your doctor will check your nerves. The doctor may check your muscle strength and ability to feel touch, temperature, and pain.

Sometimes nerve tests are needed. These include electromyography and nerve conduction tests.

You may also have blood tests. These tests will help the doctor find out if you have conditions that can cause neuropathy. Examples are diabetes, vitamin deficiencies, thyroid disease, and kidney problems.

How is it treated?

Treatment for peripheral neuropathy can relieve symptoms. This is done by treating the health problem that's causing it. For example, if you have diabetes, keeping your blood sugar within your target range may help. Or maybe your body lacks certain vitamins caused by drinking too much alcohol. In that case, treatment may include eating healthy foods, taking vitamins, and stopping alcohol use.

You may have physical therapy. This can increase muscle strength and help build muscle control. Over-the-counter medicine can relieve mild nerve pain. Your doctor may also prescribe medicine to help with severe pain, numbness, tingling, and weakness. If you have neuropathy in your feet, it's a good idea to have them checked during each office visit. This can help prevent problems.

Some people find that physical therapy, gentle exercise, acupuncture, or transcutaneous electrical nerve stimulation (TENS) helps relieve pain.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.