What Is Neuropathy?

Neuropathy Causes And

Treatments
Writer By: Peter Crosta M.A.
Neuropathy is a collection of disorders that occurs when nerves of the
peripheral nervous system (the part of the nervous system outside of the
brain and spinal cord) are damaged. The condition is generally referred
to as peripheral neuropathy, and it is most commonly due to damage to
nerve axons. Neuropathy usually causes pain and numbness in the hands
and feet. It can result from traumatic injuries, infections, metabolic
disorders, and exposure to toxins. ne of the most common causes of
neuropathy is diabetes.
Neuropathy can affect nerves that control muscle movement (motor
nerves) and those that detect sensations such as coldness or pain
(sensory nerves). In some cases ! autonomic neuropathy ! it can affect
internal organs, such as the heart, blood vessels, bladder, or intestines.
"ain from peripheral neuropathy is often described as a tingling or
burning sensation. There is no specific length of time that the pain exists,
but symptoms often improve with time ! especially if the neuropathy has
an underlying condition that can be cured. The condition is often
associated with poor nutrition, a number of diseases, and pressure or
trauma, but many cases have no #nown reason (called idiopathic
neuropathy).
In the $nited %tates, about &' million people suffer from neuropathy.
ver half of diabetes patients also suffer from the condition.
How is neuropathy classiied?
"eripheral neuropathy can be broadly classified into the following
categories(
)ononeuropathy ! involvement of a single nerve. *xamples include
carpal tunnel syndrome, ulnar nerve palsy, radial nerve palsy, and
peroneal nerve palsy.
)ultiple mononeuropathy ! two or more nerves individually affected.
"olyneuropathy ! generali+ed involvement of peripheral nerves.
*xamples include diabetic neuropathy and ,uillain!-arre syndrome.
Neurophathies may also be categori+ed based on a functional
classification (motor, sensory, autonomic, or mixed) or the type of onset
(acute ! hours or days, subacute ! wee#s or months, or chronic ! months
or years).
The most common form of neuropathy is (symmetrical) peripheral
polyneuropathy, which mainly affects the feet and legs on both sides of
the body.
What causes neuropathy?
.bout /'0 of neuropathy cases are considered idiopathic, which means
they are of un#nown cause. .nother /'0 of neuropathies are due to
diabetes. In fact, about 1'0 of people with diabetes develop some type
of neuropathy. The remaining cases of neuropathy, called ac2uired
neuropathies, have several possible causes, including(
Trauma or pressure on nerves, often from a cast or crutch or repetitive
motion such as typing on a #eyboard
Nutritional problems and vitamin deficiencies, often from a lac# of -
vitamins
.lcoholism, often through poor dietary habits and vitamin deficiencies
.utoimmune diseases, such as lupus, rheumatoid arthritis, and ,uillain!
-arre syndrome
Tumors, which often press up against nerves
ther diseases and infections, such as #idney disease, liver disease,
3yme disease, 4I56.I7%, or an underactive thyroid (hypothyroidism)
Inherited disorders (hereditary neuropathies), such as 8harcot!)arie!
Tooth disease and amyloid polyneuropathy
"oison exposure, from toxins such as heavy metals, and certain
medications and cancer treatments
9ho gets neuropathy:
;is# factors for peripheral neuropathy include several conditions and
behaviors. "eople with diabetes who poorly control their blood sugar
levels are very li#ely to suffer from some neuropathy. .utoimmune
diseases such as lupus and rheumatoid arthritis also increase one<s
chance of developing a neuropathy. "eople who have received organ
transplants, .I7% patients, and others who have had some type of
immune system suppression have a higher ris# of neuropathy. In
addition, those who abuse alcohol or have vitamin deficiencies
(especially - vitamins) are at an increased ris#. Neuropathy is also more
li#ely to occur in people with #idney, liver or thyroid disorders.
What are the symptoms o neuropathy?
Neuropathy symptoms depend on several factors, chiefly where the
affected nerves are located and which type of nerves are affected (motor,
sensory, autonomic). %everal types of neuropathy affect all three types of
nerves. %ome neuropathies suddenly arise while others come on
gradually over the course of years.
)otor nerve damage usually leads to symptoms that affect muscles such
as muscle wea#ness, cramps, and spasms. It is not uncommon for this
type of neuropathy to lead to a loss of balance and coordination. "atients
may find it difficult to wal# or run, feel li#e they have heavy legs,
stumble, or tire easily. 7amage to arm nerves may ma#e it difficult to do
routine tas#s li#e carry bags, open jars, or turn door #nobs.
%ensory nerve damage can cause various symptoms, such as an impaired
sense of position, tingling, numbness, pinching and pain. "ain from this
neuropathy is often described as burning, free+ing, or electric!li#e, and
many report a sensation of wearing an invisible =glove= or =stoc#ing=.
These sensations tend to be worse at night, and can become painful and
sever. n the contrary, sensory nerve damage may lead to a lessening or
absence of sensation, where nothing at all is felt.
.utonomic nerve damage affects internal organs and involuntary
functions and can lead to abnormal blood pressure and heart rate,
reduced ability to perspire, constipation, bladder dysfunction, diarrhea,
incontinence, sexual dysfunction, and thinning of the s#in.
How is neuropathy dia!nosed?
"eripheral neuropathy is often not easy to diagnose. It is not a single
disease, but a symptom with often several potential causes. The standard
diagnostic process begins with a full medical history with physical and
neurological exams that will examine tendon reflexes, muscle strength
and tone, the ability to feel sensations, and posture and coordination.
-lood tests are also common in order for doctors to measure levels of
vitamin -!>&. ther common tests include urinalysis, thyroid function
tests, and a nerve conduction study that includes electromyography (to
measure electrical discharges produced in muscles). "hysicians may also
recommend a nerve biopsy, where a small portion of nerve is removed
and examined under a microscope.
How is neuropathy treated?
There are a variety of treatments available for peripheral neuropathy.
They range from traditional pills and creams to special diets and
therapies that stimulate the nervous system. .ntidepressants, especially
tricyclics and selective serotonin!norepinephrine re!upta#e inhibitors
(%N;I<s), are a favored treatment for neuropathies. They will relieve
neuropathic pain in non!depressed persons.
In ?une &'>&, researchers from the $niversity of )ichigan %chool of
Nursing reported that 8ymbalta (duloxetine), an antidepressant, can
relieve the symptoms of chemotherapy!induced peripheral neuropathy.
.nother class of medicines commonly prescribed for neuropathy is that
of anticonvulsants. These medicines bloc# calcium channels on neurons
to limit pain. pioid narcotic treatments for neuropathy are used as well
to treat the condition, but are less favored because of the ris# of
dependency. 4owever, opioids have been the most consistently effective
in reducing pain.
@or some types of neuropathy, such as post!herpes neuralgia, physicians
recommend treatment with a topical anesthetic such as lidocaine. Topical
applications of capsaicin (the chemical that ma#es peppers hot) has also
been used to treat neuropathic pain.
.lternative therapies for peripheral neuropathy include cannabinoids (an
class of chemicals found in marijuana), -otulinum Toxin Type . (better
#nown as -otox), N)7. antagonists (such as #etamine), dietary
supplements (such as alpha lipoic and benfotiamine), chiropractic
massages, yoga, meditation, cognitive therapy, and accupuncture.
. final class of therapies for neuropathy are called neuromodulators.
These include both implantable and non!implantable technologies
(electrical and chemical) such as spinal cord stimulators, implanted
spinal pumps, electrodes that stimulate the motor cortex of the brain, and
methods called deep brain stimulation.
How can neuropathy "e mana!ed and pre#ented?
There are several ways to manage neuropathy and prevent its symptoms.
,ood foot health is important, especially for diabetics. "atients should
chec# feet for blisters, cuts, or calluses and avoid tight fitting shoes and
soc#s. 7octors can recommend an exercise plan that will reduce
neuropathy pain and control blood sugar levels. "atients should also 2uit
smo#ing and eat healthful meals. )assages of hands and feet may also
aid neuropathy management by stimulating nerves and temporarily
relieving pain. @inally, it is advised to avoid prolonged pressure on #nees
or elbows in order to prevent new nerve damage.