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Types and Treatment of Peripheral Neuropathy

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

Peripheral Neuropathy

Peripheral Neuropathy

Nervous System Functions

The peripheral nervous system transmits messages to the brain and receives information for the rest of your body. Each peripheral nerve has a specific function. If you have peripheral nerve damage the symptoms will depend on the type of damaged peripheral nerve.

Classification of peripheral nerves include:

  1. Sensory nerves - They receive sensations that include pain, temperature, vibration or a touch to the skin.
  2. Motor nerves - These nerves control muscle movements.
  3. Autonomic nerves - They control various body functions that include your heart rate, blood pressure, digestion and the bladder.

Peripheral Nerve Damage Symptoms

Symptoms of peripheral nerve damage may include a gradual onset of numbness, tingling or prickling that occurs in the feet or hands. It may spread upward throughout your legs and arms.

The signs and symptoms of peripheral nerve damage depend on the type of nerves damaged and these symptoms include:

  • Throbbing, jabbing, burning and sharp pain
  • Pain that occurs while doing activities that should not cause pain
  • Muscle weakness
  • Extreme sensitivity to touch
  • Muscular weakness
  • Lack of coordination and falling occurs
  • Feeling like you are wearing gloves when you are not
  • Paralysis in extremities

Specific symptoms and signs of impairment to the autonomic nervous system may include:

  • Excessive sweating or no sweating at all
  • Intolerance to heat
  • Bladder, bowel and digestive problems
  • A change in the blood pressure that may cause dizziness or lightheadedness

If peripheral neuropathy affects one nerve it is called mononeuropathy and if it affects two cells it is called polyneuropathy. An example of mononeuropathy is carpal tunnel. It is more common for people to have polyneuropathy. It can result from a traumatic injury, a metabolic problem, an infection, an inherited effect or an exposure to toxins. Diabetes is one of the most common causes.

Sensory Nerve

types-and-treatment-of-peripheral-neuropathy

Peripheral Neuropathy Causes

There are several causes of nerve damage from peripheral neuropathy and they include:

  • Diabetes - Approximately one half of the people with diabetes will develop some type of neuropathy.
  • Autoimmune diseases - These diseases include lupus, rheumatoid arthritis, sjogren's syndrome, Guillain-Barre syndrome and chronic inflammatory demyelinating polyneuropathy and vasculitis.
  • Inherited disorders - Charcot-Marie-Tooth disease is an example of an inherited disease causing neuropathy.
  • Infections - Infections that may cause peripheral neuropathy include: Epstein-Barr virus, shingles, Lyme disease, hepatitis B and C, diphtheria, HIV and leprosy.
  • Tumors - Growths that are noncancerous (benign) or cancerous (malignant) can grow and press on a nerve. Polyneuropathy may occur as a result of a cancer that is related to the body’s immune response.
  • Bone marrow disorders - An abnormal protein (monoclonal gammopathies) in the blood, lymphoma, a form of bone cancer (myeloma) or a rare disease called amyloidosis.

Other possible causes - Kidney disease, connective tissue disorders, liver disease and a poorly functioning thyroid (hypothyroidism) are possible causes.

Other causes of peripheral neuropathy are alcoholism, poison exposure, vitamin deficiencies, trauma or pressure on the nerve and certain medications, particularly chemotherapy meds.

Diagnosis of Peripheral Neuropathy

A doctor can diagnose diabetic neuropathy with a thorough physical exam and by a review of your medical history and your symptoms.

A doctor will examine you for:

  • Your tendon reflexes
  • Your muscle strength and tone
  • You sensitivity to vibration and touch

The American Diabetes Association recommends that a doctor check the feet of a diabetic patient annually

There are several tests a doctor can also order, including:

  1. Filament test - A soft nylon fiber (monofilament) is rubbed over suspected damaged nerves to test your sensitivity to touch.
  2. Nerve Conduction Study - The is a measure of the arm and leg nerves and how quickly the nerves can conduct electrical signals.
  3. Quantitative Sensory testing - This is a noninvasive test that measures how well your nerves respond to vibration and a change in temperature.
  4. The Electromyography (EMG) - This is often ordered with the nerve conduction study to measure the electrical discharges produced in your muscles.
  5. Autonomic testing - This test may be ordered if you have symptoms of autonomic neuropathy as this test measures blood pressure changes when you are in different positions and if you sweat normally

Diabetes: Nerve Damage

Treatments for Peripheral Neuropathy

There is no known cure for peripheral neuropathy. There are medications to treat peripheral neuropathy, particularly if the condition that is causing the neuropathy is treatable.

Treatments are designed to slow the progression of nerve damage, to manage any complications and to relieve pain.There are medications for diabetic-related nerve pain, but they do not always work.

Damaged motor nerves can affect your ability to control your muscles, therefore you may experience painful cramps, muscle spasms and muscle twitching. It may be hard to perform simple physical tasks, like buttoning your shirt. Exercise to maintain your muscles and strengthen them may help avoid further motor nerve damage.

There are several medications available to treat neuropathy, which include:

  1. Anti-seizure medications - pregabalin (Lyrica), Gabapentin (Gralise, Neurontin), carbamazepine (Carbatrol, Tegretol)
  2. Antidepressants - They disrupt the chemical processes that allow the brain to feel pain and you do not have to have depression for these medications to work. Two classes of antidepressants are used, tricyclics and serotonin and norepinephrine reuptake inhibitors that may have fewer side effects.
  3. Pain Medications - These may be prescribed when other types of treatment does not work.

Other options include:

  1. Capsaicin cream that is rubbed on painful areas.
  2. Alpha-lipoic acid, which is a vitamin that can be purchased over-the-counter and it is found in some food.
  3. Transcutaneous electrical nerve stimulation (TENS), which interrupts pain signals sent to the brain.
  4. Acupuncture may relieve pain without side effects.
types-and-treatment-of-peripheral-neuropathy

Peripheral Neuropathy Risk Factors

There are several possible risk factors that may cause peripheral neuropathy, which include:

  • Diabetes - This is particularly true when the blood sugar levels are not well controlled.
  • Alcohol abuse
  • Vitamin deficiency - particularly the B vitamins
  • Autoimmune diseases - rheumatoid arthritis, lupus
  • Infections - Lyme disease, hepatitis, Epstein-Barr virus, HIV, hepatitis B and C
  • Kidney, liver or thyroid disease
  • Toxin exposure
  • A family history of neuropathy
  • Repetitive motions - like those performed at a particular job

Complications of Peripheral Neuropathy

An infection of your feet or other areas of the body that lack sensation may become infected without your knowledge. It is important to check the areas without sensation on a regular basis.

Burns or skin trauma may also occur without your awareness due to the numbness.

Weakness, loss of sensation and falling may occur due to lack of balance. It is important to exercise, eat healthy, quit smoking, avoid repetitive motions and stay out of cramped positions that put extra pressure on areas where your nerves are damaged.

Peripheral Neuropathy

In Conclusion

An infection of your feet or other areas of your body that lack sensation may become infected without your knowledge. It is important to check the areas without sensation on a regular basis.

References

  1. https://www.neuropathytreatmentgroup.com/what-no-one-tells-you-about-neuropathy-muscle-control/?utm_source=mqc_facebook&utm_campaign=NrpthyArtcle-2&fbclid=IwAR3kz7zmHodgZMEtavQOgRcuRth7MkMUsqSfZ3lPus1qvSmDtzZhAoVchXs
  2. https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061
  3. https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/diagnosis-treatment/drc-20371587
  4. https://my.clevelandclinic.org/health/diseases/14737-neuropathy
  5. https://en.wikipedia.org/wiki/Peripheral_neuropathy

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2020 Pamela Oglesby

Comments

Pamela Oglesby (author) from Sunny Florida on February 10, 2020:

Hi Peggy, Our of control blood glucose will cause multiple problems. I appreciate your comments.

Peggy Woods from Houston, Texas on February 09, 2020:

Hi Pamela,

You continue to educate people about important topics such as this one that affects many people who have diabetes, among other diseases, especially if out of control.

Pamela Oglesby (author) from Sunny Florida on January 22, 2020:

Hi Robert, I appreciate your comments.

Robert Sacchi on January 21, 2020:

Another informative medical article. Thank you for posting.

Pamela Oglesby (author) from Sunny Florida on January 16, 2020:

Hi Alyssa, I don't think we could ever have enough information about health so I am happy thar you come away learning something new. Your comments are much appreciated.

Alyssa from Ohio on January 16, 2020:

Another interesting article. I appreciate these medical explanations and updates. I always come away learning something new. Thank you for sharing, Pamela!

Pamela Oglesby (author) from Sunny Florida on January 13, 2020:

Hi Maria, As a nurse educator and a friend I truly appreciate your comments. Have a great week Maria.

Love and hugs.

Pamela Oglesby (author) from Sunny Florida on January 13, 2020:

Hi Shwetha, Thank you so much for your very nice comments.

Shwetha bhat from Bengaluru on January 13, 2020:

Very interesting article. I heard this term in my graduation time, but your hub explains in detail. Thanks for sharing.

Maria Jordan from Jeffersonville PA on January 12, 2020:

Dear Pamela,

You have a gift of explaining medical issues, etiologies and interventions in an understandable and meaningful way for all.

Thanks for another valuable update.

Love,

Maria

Pamela Oglesby (author) from Sunny Florida on January 12, 2020:

Hi Lora, You are exactly right. These are painful consequences if you ignore the symptoms and do not get treated. I appreciate your very generous comments.

Lora Hollings on January 12, 2020:

An excellent and most informative article on peripheral neuropathy which most people probably never heard of. It is so important to see your doctor and get treatment if you have any of these symptoms and it can certainly have severe consequences. I learned a lot from your article about the causes of this disease and its treatments! Thanks for sharing.

Pamela Oglesby (author) from Sunny Florida on January 12, 2020:

Hi Devika, I think you are exactly right as this is often initially overlooked. Your comments are appreciaed.

Pamela Oglesby (author) from Sunny Florida on January 12, 2020:

Hi MG Singh, I am glad you found this article interesting. Thank you for your comments.

MG Singh emge from Singapore on January 12, 2020:

I didn't know anything about this and it was a revelation. Thank you for a very interesting hub.

Devika Primić from Dubrovnik, Croatia on January 12, 2020:

Pamela Oglesby

Thank you for the interesting, mot helpful hub that I came across concerning this health problem. Often it is ignored or overlooked and nobody knows until it becomes severe. Useful tips and one should be aware of the symptoms.

Pamela Oglesby (author) from Sunny Florida on January 12, 2020:

Hi Linda, I wish there was a cure also as living on pain meds for the rest of your life is not pleasant.

Thanks so much for your comments.

Pamela Oglesby (author) from Sunny Florida on January 12, 2020:

Hi Lorna, The feet in particular for diabetes is a problem over time. I see such advances in most helth problems, but I haven't seen much new for neuropathies.

I appreciate your ggenerous comments.

Lorna Lamon on January 12, 2020:

Another really informative article Pamela and in particular for those at risk.My Uncle has been a diabetic for most of his life and was diagnosed with Peripheral neuropathy due to an infection in his feet. I think he has tried most medications and is now on a cocktail of pain meds. Like most other conditions research needs to be ongoing and unfortunately this depends on funding. Great article.

Linda Crampton from British Columbia, Canada on January 11, 2020:

Thanks for sharing another educational article. I wish there was a cure for peripheral neuropathy.

Pamela Oglesby (author) from Sunny Florida on January 11, 2020:

Hi Lori, I do use a lot of sources to get the latest information as I retired from nursing quite a while ago. There is new research all the time. I am glad you found the article to be informative.

i certainly appreciate your generous comments always, Lori.

Lori Colbo from Pacific Northwest on January 11, 2020:

Pamela, your articles on health are so well done and thorough. It shows that you've done your research. They are not bogged down with lengthy minute details. And of course listing your sources is very good. Thanks once again for a very informative article.

Pamela Oglesby (author) from Sunny Florida on January 11, 2020:

Hi Susan, i hope you don't experience it either, especially as you have some health ailments already. It is very painful for sure. I appreciate your comments. Have a nice weekend, Susan.

Susan from Dover Delaware on January 11, 2020:

Very informative article. Hope I don't experience it, I think I have my share of ailments, and least I hope so. (:

Pamela Oglesby (author) from Sunny Florida on January 11, 2020:

Hi Bill, I'm glad this is new to you, which means you do not have this problem.

Thank you for your very nice comments and I wish you a weekend filled with blessings also.

Pamela Oglesby (author) from Sunny Florida on January 11, 2020:

Hi Rebecca, It is good to know the symptoms of any disorder and then hope you never have the problem. Your comments are appreciated.

Pamela Oglesby (author) from Sunny Florida on January 11, 2020:

Hi Flourish, Your description of your discomfort sounds exactly like nerve pain. I hope it doesn't increase in frequency. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on January 11, 2020:

Hi Mel, I'm glad you don't have any nerve damage but it is good to be aware of the symptoms just in care.

Thank you so much for your nice comments.

Mel Carriere from San Diego California on January 11, 2020:

Since I suffer from psoriatic arthritis this somewhat troubles me, but so far I haven't had any nerve damage such as this. It is fantastic you are raising awareness on this issue, keep up the great work!

FlourishAnyway from USA on January 11, 2020:

Omg I have had this for years in my feet. It doesn’t always affect me but randomly I will feel electric like shock that are sudden and strong, much more in one foot than the other. It feels almost like a cattle prod is so strong.

Rebecca Mealey from Northeastern Georgia, USA on January 11, 2020:

Good information to know. I hope never to have this disorder, but thanks for explaining so thoroughly!

Bill Holland from Olympia, WA on January 11, 2020:

Totally new to me, Pamela. I may have heard of it, but I sure didn't know what it was. Thank you for the very interesting article, and I hope your weekend is filled with blessings.