Peripheral neuropathy

What is peripheral neuropathy? 

Peripheral neuropathy is a condition that impacts the nervous systems stemming from the brain and spinal cord when damaged. The name peripheral neuropathy can apply to any type of condition which impacts the nerves and is inclusive of various types of neuropathy. Peripheral nerves branch out from the central nervous system and send signals for many voluntary and involuntary muscle functions. Whereas your central nervous system sends signals from your brain through your spinal cord, your peripheral nerves serve every other area of the body. 

Often, peripheral neuropathy results from trauma to the brain or spinal cord or other medical conditions which cause the degeneration of the nervous system. While symptoms vary based on the type of neuropathy and the individual’s health, peripheral neuropathy typically causes weakness, pain, numbness, or a tingling sensation. The condition is treatable for many people, but treatment will vary for each person.  

What causes peripheral neuropathy?

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There are many causes of peripheral neuropathy, for different conditions, medicines, or traumas can contribute to it. Below are some known conditions and triggers that can cause peripheral neuropathy. This list is not inclusive of every cause. In fact, some cases of peripheral neuropathy have no identified cause. 

Diabetes: Around 50% of people with diabetes will experience nerve damage, making diabetes the most common cause of peripheral neuropathy. Diabetes causes nerve damage because of the high glucose levels in the bloodstream that cause damage to blood vessels. 

Infections and autoimmune disorders: Infections like HIV, Lyme disease, and shingles all can lead to nerve damage as can autoimmune diseases such as arthritis and lupus. These types of viruses can attack healthy nerves and cause inflammation that impacts your muscle tissue and nerves. 

Injury: Traumatic injuries can result in peripheral neuropathy. In addition, injuries that occur over time like carpal tunnel syndrome can leave the nerves damaged. 

Alcohol and toxins: Alcohol and toxins like glue or insecticides can all result in nerve damage and neuropathy with abuse or overuse. Whether you are intentionally or accidentally exposed to these toxins, they can be dangerous. 

Medicines: Nerve damage can result as a side effect to medications used to treat seizures, cancer, bacterial functions, and blood pressure. 

Other diseases: Conditions like kidney or liver disease can result in peripheral neuropathy without proper treatment.

What are the types of peripheral neuropathy?

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There are more than 100 types of peripheral neuropathy, so healthcare providers use the following classifications to identify the common symptoms and treatments for that type of neuropathy.  

  • Sensory neuropathy: Neuropathy of sensory nerves impacts what you feel in the event of certain stimuli like temperature, pain, or touch. These nerves work by transmitting signals from what is happening outside of the body, so peripheral sensory neuropathy can make it hard to communicate what senses you are experiencing with your brain.
  • Motor neuropathy: The motor nerves control how you move your limbs and muscles. Neuropathy of these motor nerves results in uncontrollable muscle twitches and the weakening of muscles. 
  • Autonomic nerve neuropathy: Automatic nerves operate your involuntary muscle movements and body functions, like your heartbeat and breathing. Impairment of these nerves tends to be more serious than other types of peripheral neuropathy. 
  • Combination neuropathies: Peripheral neuropathy can affect multiple types of nerves, resulting in a combination of neuropathies.

What are symptoms of peripheral neuropathy?

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Each type of peripheral neuropathy has its own symptoms which appear over time and occasionally in tandem with the symptoms of a different type of neuropathy. Symptoms may be limited to one area of the body or widespread among various parts of the body. It is best to separate the symptoms of peripheral neuropathy by the subcategory of neuropathy to understand the differences in type. 

Sensory neuropathy symptoms: Symptoms of sensory neuropathy are most noticeable in how you experience your senses and the sensitivities that may dull or heighten. 

  • Tingling 
  • Numbness
  • Imbalance 
  • Pain
  • Reduced sensations 

Motor neuropathy symptoms: Symptoms of motor neuropathy show up in your muscle movements and daily motions. Over time, you may notice a reduction in control of your muscles and limbs. 

  • Weakness or paralysis
  • Muscle atrophy
  • Uncontrollable muscle movements 
  • Foot drop 
  • Twitching 

Autonomic nerve neuropathy symptoms: Since autonomic nerve neuropathy impacts voluntary and involuntary muscle functions, the symptoms tend to be more serious and related to functions that typically occur without you having to think about them. 

  • Changes in blood pressure 
  • Irregular sweating 
  • Bladder and bowel incontinence 
  • Sexual dysfunction 
  • Bloating 
  • Faintness or dizziness 

Are there any risk factors or groups for peripheral neuropathy?

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Peripheral neuropathy is a relatively common condition. The condition affects people of all ages, sexes, races, and medical history. While anyone can be at risk of developing peripheral neuropathy, there are some groups that are at a higher risk than others for the condition. 

The most common risk factors that increase your likelihood of getting the condition are the following: 

  • Alcoholism: Misuse of alcohol puts people at a higher risk for nerve damage.
  • Age: While people of all ages can develop nerve damage, the risk tends to get higher as you get older and potentially develop other age-related conditions. 
  • Diabetes: Because diabetes is the most common cause of peripheral neuropathy, having the condition puts you at a higher likelihood of having some type of nerve damage. 
  • Nutritional deficiencies: If you have poorly regulated levels of vitamins like B-12, you are more likely to have nerve damage. 
  • Autoimmune diseases and infections: Infections like shingles, HIV, hepatitis B, and Lyme disease and autoimmune diseases like arthritis and lupus are frequent causes of peripheral neuropathy. Having these conditions increases your risk. 

How is peripheral neuropathy diagnosed?

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To confirm a peripheral neuropathy diagnosis, your doctor will use a review of your medical history, a physical exam, and lab tests. Your medical history will help show your potential risk for the condition if you have any preexisting conditions that often cause peripheral neuropathy or are at a higher risk because of your lifestyle. Following a medical history review, your doctor may conduct various physical and neurological exams to test your reflexes, muscle strengths, and sensations. All of these physical tests can help measure how well your nerves are sending signals to your brain and vice versa. 

In addition to a medical review and physical exams, lab tests can help confirm the root cause of the neuropathy and confirm the type. 

  • Blood test: Blood tests help measure nutritional deficiencies and toxins, which could be causing the neuropathy, in addition to other indicators of disease. 
  • Nerve conduction tests and electromyography: These tests measure how well your nerves are communicating within your body by recording electrical activity within the muscles. 
  • Nerve biopsy: In some cases, your doctor will remove part of a sensory nerve to identify what is causing the neuropathy. 
  • Imaging tests: Imaging tests like MRIs help locate where there might be pinched or compressed nerves affecting nerve function. 

How is peripheral neuropathy treated?

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Treatment for peripheral neuropathy aims to relieve pain, limit damage to the nerves, and treat the underlying cause of the neuropathy. Often, the best treatment plan is a combination of a few treatment options. 

Medicine: Over-the-counter pain medications are useful for moderate pain management. In addition, topical pain creams can help dull areas of muscle pain that can result from sensory neuropathy. 

Surgery: Surgery can help repair damaged nerve connections and relieve pressure on the nerves. Your doctor may also want to remove any dead or severely damaged nerves to help restore better nerve function.  

Physical therapy: Physical therapy is effective at helping people adapt to the changes in their body and movements caused by nerve damage. Therapy can also help you strengthen your muscles and improve your coordination in light of the impaired nerve function. 

Should you see a doctor for peripheral neuropathy?

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You should see a doctor if you notice any changes in your nerves or muscle functionality. Certain symptoms like tingling, pain in your hands, or new weakness are cause for concern, and you should seek medical attention. Your doctor can review your symptoms with you and start you on a treatment plan to help limit nerve damage and diagnose the underlying cause.

What is the outlook for people living with peripheral neuropathy?

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With the right treatment, peripheral neuropathy can be a temporary condition that improves or goes away over time. However, some cases of peripheral neuropathy are chronic and will last. The outlook of someone living with neuropathy is generally positive, as nerve damage does not typically pose a greater risk to your health. While some types of neuropathy are cause for concern when they impact your involuntary muscle functions, many types of neuropathy simply affect how you feel pain and sensation. 

There are concerns for complications such as falls, infection, or injuries to numb areas. Since your nerves do not function as well with neuropathy, it can be hard to detect an injury in areas you cannot see as well, mainly your feet. If you have neuropathy, it is important to frequently check for injuries to avoid infection.