Understanding Peripheral Neuropathy: Symptoms, Causes, Diagnosis & Treatment

Understanding Nerves and Neuropathy

The nervous system is a complex network of cells, tissues, and organs that helps to regulate and control many vital bodily functions. The building blocks of the nervous system are nerve cells, also known as neurons. Neurons transmit signals between different parts of the body through threadlike projections called axons and dendrites. Groups of axons bundled together form nerves. Nerves act like information superhighways, quickly transmitting electrochemical signals between the brain and spinal cord (central nervous system) and the rest of the body (peripheral nervous system).

Key Terminology Related to Nerves

There are many terms used to describe nerves and conditions related to nerve damage or dysfunction:

• Neuron: A nerve cell that transmits nerve signals.
• Axon: The long threadlike part of a nerve cell that transmits signals to other cells.
• Myelin sheath: A fatty protective coating around axons.
• Nerves: Bundles of axons routed throughout the body to communicate signals.
• Ganglion: A group of neuron cell bodies bundled together outside the central nervous system.
• Neuropathy: Damage or dysfunction of one or more nerves.

Types of Neuropathy

There are several ways to categorize the different types of neuropathy, including:

• Sensory, motor, and autonomic: Neuropathy can affect different kinds of nerves in the body that sense stimuli, stimulate muscle movement, or control involuntary functions.
• Focal and peripheral: Focal neuropathies affect a single nerve or group of nerves; peripheral neuropathies affect the outer sensory and motor nerves.
• Acute and chronic: Acute neuropathies come on suddenly, while chronic ones develop over time.

Some specific examples include:

• Diabetic neuropathy: High blood sugar levels from diabetes can injure peripheral nerves.
• Chemotherapy-induced peripheral neuropathy (CIPN): Anti-cancer medications may damage peripheral nerves.
• Neuralgia: Nerve pain often described as sharp or stabbing.
• Carpal tunnel syndrome: Compression of the median nerve running through the wrist.

What Causes Nerve Damage?

There are many potential causes of neuropathy, including:

Metabolic Conditions

• Diabetes can cause elevated blood sugar levels to injure nerve fibers.
• Kidney disease disrupts fluid balance and mineral levels, which can impair nerve function.
• Hypothyroidism leads to a deficiency of thyroid hormone, potentially altering chemical signaling.

Toxins and Medications

• Chemotherapy drugs designed to kill cancer cells may also damage healthy nerves.
• Toxic metals like arsenic, lead, mercury, and thallium can harm nerve tissue.
• Drugs and alcohol leading to vitamin deficiencies or direct nerve damage.

Infections and Immune System Diseases

• Bacterial and viral infections like Lyme disease, shingles, hepatitis B, and HIV.
• Autoimmune disorders like Guillain-Barre syndrome or chronic inflammatory demyelinating polyneuropathy (CIDP).

Inherited Conditions

• Charcot-Marie-Tooth disease and other genetic neuropathies affecting myelin sheath or axons.

Injuries and Compression

• Trauma from motor vehicle accidents, falls, sports injuries, etc.
• Repetitive stress like carpal tunnel syndrome.
• Pinched spinal nerves (radiculopathy).

Other Factors

• Vitamin deficiencies
• Alcoholism
• Tumors applying pressure to nerves
• Idiopathic causes (no known reason)

Neuropathy Symptoms

Symptoms of neuropathy depend on the type, location, and severity of the nerve damage but may include:

Sensory Disturbances

• Tingling, prickling or burning sensations
• Sharp, jabbing, throbbing, or stabbing pains
• Extreme sensitivity to touch
• Lack of sensation (numbness)
• Feeling of wearing socks/gloves when not
• Uncoordinated movements
• Problems walking or balances
• Dizziness or vertigo

Autonomic Dysfunction

• Urinary/bowel incontinence
• Sexual dysfunction
• Abnormal blood pressure and heart rate
• Reduced/excessive sweating
• Gastrointestinal issues (nausea, vomiting, diarrhea, constipation)

Symptoms may develop slowly and worsen over time, temporarily remit, or resolve entirely depending on severity and underlying cause.

Clinical Diagnosis

Since neuropathy symptoms can vary tremendously, diagnosis involves testing and evaluation to determine extent and location of nerve damage. Steps include:

Medical History

Information about symptoms, family history, medication use, other conditions, lifestyle factors.

Neurological Exam

Assessment of muscle strength, reflexes, gait, and physical sensation.

Diagnostic Testing

• Nerve conduction studies - Small electric shocks determine nerve signal speed.
• Electromyography - Records muscle electrical activity.
• Quantitative sensory testing - Measures response to stimuli like touch/temperature.
• Blood tests - Evaluate vitamin levels, proteins, blood sugar, thyroid, etc.

Results help determine type of nerves affected and guide appropriate treatment.

Neuropathy Treatment

Treatment focuses on relieving pain, regrowing damaged nerves, and addressing underlying condition causing neuropathy. Options may include:

Pain Management Medications

• Over-the-counter pain relievers (acetaminophen, NSAIDs)
• Topical anesthetics and creams
• Antidepressants and anticonvulsants
• Opioid medications for severe pain

Alternative Therapies

• Physical therapy and exercise
• Transcutaneous electrical nerve stimulation (TENS)
• Biofeedback, acupuncture, massage
• Relaxation techniques

Disease-Modifying Treatments

• Tight blood sugar control for diabetes
• Immunotherapy drugs for autoimmune neuropathy
• Vitamin supplements for deficiencies

Treatment also aims to limit progression and avoid additional nerve injury through lifestyle changes like improved diet, exercise, and avoiding toxins like alcohol.

Preventing Neuropathy

It’s not always possible to prevent neuropathy, but key strategies include:

• Carefully managing diseases like diabetes and kidney disorders
• Maintaining healthy lifestyle habits regarding diet, exercise, sleep, etc.
• Avoiding neurotoxic medications when possible
• Limiting or abstaining from alcohol consumption
• Preventing/treating vitamin deficiencies
• Avoiding infection through vaccination, protective equipment, etc.

Early detection is also vital, allowing for treatment before extensive nerve damage occurs. Be alert for potential neuropathy symptoms and talk to your doctor promptly about evaluation.

The Takeaway

Neuropathy can severely impact quality of life, but better understanding this complex condition helps patients and doctors work together more effectively. Accurate diagnosis guides appropriate treatment to manage symptoms and improve outcomes when possible. While nerve damage may not always be reversible, a multi-pronged approach can often substantially reduce neuropathy signs and disability.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.