Definition

Peripheral neuropathy is a group of conditions in which damage to the peripheral nerves is caused, in turn triggering weakness, numbness and pain in the hands and feet. It can also affect other areas of the body.

The peripheral nervous system is a network of nerves that send information from the brain and spinal cord (central nervous system) to the rest of the body. While diabetes is the most common cause of peripheral neuropathy, other factors that can cause the condition include traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. Individuals with peripheral neuropathy generally experience symptoms such as stabbing or burning pain, as well as tingling.

Treatment options typically involve treating the underlying condition and taking medications to reduce pain and ease discomfort.   

 

Symptoms

Since the peripheral nervous system involves different types of nerves with their own specific function, symptoms depend on the type of nerves affected. Nerves are classified into:

·         Sensory nerves-responsible for  receiving sensation from the skin such as temperature, pain, vibration or touch

·         Motor nerves- responsible for  controlling how the muscles function and move

·         Autonomic nerves- responsible for controlling functions such as blood pressure, heart rate, digestion and bladder

 

Signs and symptoms of peripheral neuropathy may include:

·         Numbness and tingling in the feet and hands

·         Stabbing or burning pain

·         Extreme sensitivity to touch

·         Loss of balance and coordination

·         Muscle weakness or paralysis

 

If autonomic nerves are affected, signs and symptoms may include:

·         Inability to tolerate heat and altered sweating

·         Bowel, bladder or digestive problems

·         Dizziness due to changes in blood pressure levels

 

 

Causes

There are a number of factors that can cause neuropathies. The factors include:

·         Diabetes

·         Exposure to chemical toxins

·         Alcoholism

·         Autoimmune diseases

·         Certain medications

·         Viral or bacterial infections

·         Vitamin deficiencies

·         Trauma or pressure on the nerve from falls or sporting injuries

·         Tumors

·         Inherited disorders

·         Bone marrow disorders

·         Other diseases

 

 

 

Risk factors

Factors associated with the risk of developing peripheral neuropathy include:

·         Diabetes mellitus

·         High consumption of alcohol

·         Family history of peripheral neuropathy

·         Repetitive movements

·         Vitamin deficiencies

·         Exposure to chemical toxins

·         Infections (Lyme disease, shingles (varicella-zoster), Epstein-Barr virus, hepatitis C and HIV)

·         Autoimmune diseases (rheumatoid arthritis and lupus)

·         Kidney, liver or thyroid disorders

 

Complications

Complications of peripheral neuropathy may include the following:

·         Burns and skin trauma: inability to feel temperature changes or pain due to numbness in certain areas of the body

·         Infection

 

Treatment

Treatment options for peripheral neuropathy typically involve managing the condition and relieving symptoms. Such treatment options include:

·         Pain relievers: The use of nonsteroidal anti-inflammatory drugs to relieve mild symptoms.

·         Anti-seizure medications: The use of certain medications such as gabapentin (Gralise, Neurontin) and pregabalin (Lyrica) to treat epilepsy and relieve nerve pain.

·         Capsaicin: A cream containing the substance Capsaicin found naturally in hot peppers can cause modest improvements in peripheral neuropathy symptoms such as skin burning and irritation.

·         Antidepressants: The use of certain tricyclic antidepressants, such as amitriptyline, doxepin and nortriptyline (Pamelor) to help relieve pain by interfering with chemical processes in the brain and spinal cord that are the main cause.

 

 

There are a number of different types of therapies and procedures that can be used to help ease the signs and symptoms of peripheral neuropathy. These include:

·         Transcutaneous electrical nerve stimulation (TENS):  A procedure that uses adhesive electrodes that are placed on the skin to deliver a gentle electric current at varying frequencies.

·         Plasma exchange: A process that involves removal of blood from the body in order to remove antibodies and other proteins from it and replace it with a protein fluid called human albumin and then return it to the body.

·          Intravenous immune globulin: A type of therapy that involves receiving high levels of protein intake that work as antibodies (immunoglobulins)

·         Physical therapy: A program that uses specific exercises designed to improve muscle weakness and function

·         Surgery

 

 

 

 

 

 

Prevention

The best way to prevent peripheral neuropathy is to manage the underlying medical condition such as diabetes, alcoholism or rheumatoid arthritis. Making healthy lifestyle choices is also a great way to prevent occurrence of the condition. These include:

  • Eating a healthy, rich diet
  • Getting plenty of nutrients (Vitamin B -12 supplements)
  • Exercising regularly
  • Avoiding exposure to toxic chemicals
  • Quitting smoking