How to spell neuropathy?

Peripheral Neuropathy Natural Treatments

Treatment for peripheral neuropathy depends on the cause. Some common treatments involve physical therapy, surgery, and injections for increased nerve pressure. Other treatments focus on reducing pain and discomfort with over-the-counter painkillers such as ibuprofen or aspirin.

There are also a number of natural treatments to help reduce symptoms and peripheral neuropathy.

1. Vitamins

Some cases of peripheral neuropathy are related to vitamin deficiencies. Vitamin B is essential for your nerve health. A deficiency can lead to significant nerve damage.

While you can get vitamin B from your meals, your doctor may also recommend taking a supplement. Stick to the recommended dose to prevent toxicity and worsening symptoms.

Vitamin D can also help prevent nerve pain. Your skin typically produces vitamin D in response to sunlight. A deficiency can cause neuropathy pain. Taking a supplement can help reduce the symptoms of neuropathy.

2. Cayenne pepper

Cayenne pepper contains capsaicin, an ingredient in hot peppers that makes them spicy. Capsaicin has been used in topical creams for its pain relief properties. It decreases the intensity of pain signals sent through the body.

Incorporating cayenne pepper in your diet or taking a capsaicin supplement can help to reduce neuropathy pain.

Topical capsaicin ointments can also be used on the body. Although it may initially burn, continued use will gradually reduce neuropathy sensations.

Be sure to discuss this treatment method with your doctor before using it to prevent adverse symptoms.

3. Quit smoking

Smoking affects your blood circulation. The blood vessels narrow and less oxygenated blood can get through. Without proper blood circulation, you may experience increased numbness and pain from your peripheral neuropathy. Eliminating smoking habits can help to improve your symptoms. Let this motivate you to make positive changes.

4. Warm bath

Taking a warm bath can be soothing and can also alleviate pain symptoms from neuropathy. Warm water increases blood circulation throughout the body, decreasing pain symptoms from numbness.

If your sensory nerves are affected from peripheral neuropathy and you’re not as sensitive to temperature, be careful not to make your bath water too hot.

5. Exercise

Regular exercise can help to combat pain and improve your overall health. Being active can reduce your blood sugar, which, in turn, can reduce or slow down nerve damage. Exercise also increases blood flow to your arms and legs and reduces stress. These are all factors that help to reduce discomfort and pain.

6. Essential oils

Some essential oils, including chamomile and Roman lavender, help to increase circulation in the body. They also have pain-relieving and anti-inflammatory properties that could boost healing.

Dilute essential oils (a few drops) in 1 ounce of a carrier oil such as olive oil. Applying these diluted oils to the affected area can reduce stinging and tingling pains from peripheral neuropathy.

7. Meditation

Meditation techniques can help people struggling with neuropathy symptoms live through their pain. It can help to lower stress, improve your coping skills, and decrease your pain intensity. Taking a mind-body approach is a noninvasive technique that provides you with more control over your condition.

8. Acupuncture

Acupuncture promotes natural healing by stimulating the body’s pressure points. This technique triggers the nervous system to release chemicals that can change the pain experience or threshold. Acupuncture helps to provide an energy balance to the body that can affect your emotional well-being.

Nerve conduction testingThe nerve conduction test looks at the speed at which electrical signals pass through your nerves. Special electrodes are placed on your skin over the nerve being tested. They are a bit like the sticky electrodes used when you have a heart tracing (electrocardiogram, or ECG). These electrodes give off very small electrical impulses that feel a bit like a small electric shock which stimulate your nerve. Other electrodes record the electrical activity of the nerve. The distance that the impulses travel to the other electrodes and the time that this takes allows the speed of the nerve impulse to be calculated. In peripheral neuropathy, this speed is reduced.

Electromyography
This test looks at the electrical activity of your muscles. A very thin needle with an electrode attached is inserted through your skin into a muscle. This is connected up to a recording machine called an oscilloscope. You will then be asked to contract the muscle – for example, to bend your arm or your leg. The way that your muscle responds when it is stimulated by nerves can then be monitored using the oscilloscope and recorded. In peripheral neuropathy, the electrical activity will be abnormal.

A nerve biopsy
This is the removal of a small part of a nerve so that it can be examined under a microscope. A nerve around your ankle or your wrist is most commonly biopsied. A local anaesthetic is given. A small cut is made in your skin and a small portion of your nerve is removed.

A skin biopsy
This is a technique to examine the peripheral nerves. It can be used to look for early peripheral neuropathy and also to monitor progression of neuropathy and response to treatment. It can be performed anywhere on the body. A local anaesthetic is used and an instrument takes a ‘punch’ biopsy from the skin (around 3 mm in diameter). No stitching is needed afterwards. The piece of skin is then examined under a microscope. Amongst other things, the density of nerve fibres in the area of skin is measured. In peripheral neuropathy, the density of the peripheral nerves is reduced.

Do I need any treatment?

The aims of treatment for peripheral neuropathy are:

  • To treat any underlying condition or cause for your peripheral neuropathy.
  • To control any symptoms that you may have.
  • To help you to achieve maximum independence.

Treatment of any underlying cause

Any underlying condition causing peripheral neuropathy, such as diabetes or vitamin B12 deficiency, should be treated. If you have diabetes, it is very important to try to get your blood sugar (glucose) levels under very good control so as to avoid any further nerve damage. If you have an injury causing peripheral neuropathy, this may need physiotherapy, surgery or other treatment so that the pressure on the nerve caused by the injury is relieved. If you have alcoholic neuropathy, reducing and stopping your alcohol intake will usually help to prevent any further nerve damage.

Control of any symptoms

Pain can be a problem for some people with peripheral neuropathy and can be difficult to treat. Various medicines are available that may help. These include medicines that are commonly used to treat epilepsy (anticonvulsant medicines) such as pregabalin, gabapentin and carbamazepine. A group of antidepressant medicines called tricyclic antidepressants may also be helpful. Amitriptyline is commonly used. In addition to having antidepressant effects, these medicines have also been found to be helpful in pain control. See separate leaflet called Neuropathic Pain.

Symptoms due to problems with your autonomic nerves may be more difficult to treat. Sometimes elastic stockings or a medicine called fludrocortisone (or other similar medicines) may be helpful if you have problems with low blood pressure. Various medicines may help your digestion if you have problems with this. Eating small frequent meals, sleeping with the head of your bed raised, or other measures may also help.

If you have problems with your bladder function, manual expression of urine – pressing over your bladder with your hands – may be necessary. Intermittent self-catheterisation is another method to help with bladder function. It means that you insert a thin plastic tube (a catheter) into your bladder, to enable your urine to flow out. There are also various medicines which may be needed to help with bladder function.

Medication and other treatment are also available to treat inability to get an erection (impotence).

Treatment to help you achieve maximum independence

If you have severe peripheral neuropathy, you may need some aids to help with your day-to-day activities. For example, if you have leg weakness you may need a walking stick, crutches, or a walking frame. Sometimes a wheelchair is needed. Foot braces may also be helpful if you have problems with foot drop. If you have weakness in your arms, a wrist splint may be helpful.

A physiotherapist may be the best person to help you with such aids. They may also be able to advise you about exercises to help to improve your muscle strength. An occupational therapist may be able to advise you about special utensils and home adaptations to help with muscle weaknesses.

Other things that may help

If you know that you have a peripheral neuropathy affecting your sensation, you are more prone to injuries. This is because pain usually helps to protect you against certain injuries. If you have numbness or loss of ability to detect hot or cold, you may not experience the pain when you step on a sharp object or when you pick up something too hot. Therefore, you should always make sure that you wear sensible and supportive shoes or boots. Don’t walk with bare feet. Examine your feet regularly to look for injuries. Untreated injuries can become infected. Visiting a podiatrist (previously called a chiropodist) regularly may also be helpful. Also, avoid using hot water bottles and take care that the water in your bath is not too hot – test it before you get in.

Lack of muscle control in motor neuropathy can also make you more prone to falling and other injuries. Remove loose objects or obstacles such as rugs in your home to reduce your chance of tripping.

What is the outlook?

The outlook (prognosis) for peripheral neuropathy depends on the underlying cause. In general, if a problem can be identified early and treated successfully, the prognosis is very good. However, in severe neuropathy, even if the underlying cause is found and treated, nerve damage can be permanent.

Can peripheral neuropathy be prevented?

Everyone can reduce their risk of peripheral neuropathy by having a sensible alcohol intake within medical guidelines. A healthy balanced diet is also important to prevent dietary deficiencies.

Type 2 diabetes is the most common cause of persistent (chronic) peripheral neuropathy. Diabetes is more common in people who are overweight or obese. Therefore, weight control may help to reduce your risk of developing diabetes. If you do develop diabetes or another medical problem that can cause peripheral neuropathy, good control of the condition may help to prevent neuropathy from developing.

Peripheral Neuropathy Fact Sheet

Autonomic testing

  • Several different types of autonomic testing can evaluate peripheral neuropathies, one of which is a QSART test that measures the ability to sweat in several sites in the arm and leg. Abnormalities in QSART are associated with small fiber polyneuropathies

Radiology imaging tests

  • Magnetic resonance imaging (MRI) of the spine can reveal nerve root compression (“pinched nerve”), tumors, or other internal problems. MRI of the nerve (neurography) can show nerve compression.
  • Computed tomography (CT) scans of the back can show herniated disks, spinal stenosis (narrowing of the spinal canal), tumors, bone and vascular irregularities that may affect nerves.

Muscle and nerve ultrasound is a noninvasive experimental technique for imaging nerves and muscles for injury such as a severed nerve or a compressed nerve. Ultrasound imaging of the muscles can detect abnormalities that may be related to a muscle or nerve disorder. Certain inherited muscle disorders have characteristic patterns on muscle ultrasound.

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What treatments are available?

Treatments depend entirely on the type of nerve damage, symptoms, and location. Your doctor will explain how nerve damage is causing specific symptoms and how to minimize and manage them. With proper education, some people may be able to reduce their medication dose or manage their neuropathy without medications. Definitive treatment can permit functional recovery over time, as long as the nerve cell itself has not died.

Addressing neuropathy’s causes. Correcting underlying causes can result in the neuropathy resolving on its own as the nerves recover or regenerate. Nerve health and resistance can be improved by healthy lifestyle habits such as maintaining optimal weight, avoiding toxic exposures, eating a balanced diet, and correcting vitamin deficiencies. Smoking cessation is particularly important because smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathic symptoms. Exercise can deliver more blood, oxygen, and nutrients to far-off nerve endings, improve muscle strength, and limit muscle atrophy. Self-care skills in people with diabetes and others who have an impaired ability to feel pain can alleviate symptoms and often create conditions that encourage nerve regeneration. Strict control of blood glucose levels has been shown to reduce neuropathic symptoms and help people with diabetic neuropathy avoid further nerve damage.

Inflammatory and autoimmune conditions leading to neuropathy can be controlled using immunosuppressive drugs such as prednisone, cyclosporine, or azathioprine. Plasmapheresis—a procedure in which blood is removed, cleansed of immune system cells and antibodies, and then returned to the body—can help reduce inflammation or suppress immune system activity. Agents such as rituximab that target specific inflammatory cells, large intravenously administered doses of immunoglobulins, and antibodies that alter the immune system, also can suppress abnormal immune system activity.

Specific symptoms can usually be improved

  • For motor symptoms, mechanical aids such as hand or foot braces can help reduce physical disability and pain. Orthopedic shoes can improve gait disturbances and help prevent foot injuries. Splints for carpal tunnel problems can help position the wrist to reduce pressure of the compressed nerve and allow it to heal. Some people with severe weakness benefit from tendon transfers or bone fusions to hold their limbs in better position, or to release a nerve compression.
  • Autonomic symptoms require detailed management depending on what they are. For example, people with orthostatic hypotension (significant drop in blood pressure when standing quickly) can learn to prevent drops by standing up slowly and taking medications to improve blood pressure swings. Many people use complementary methods and techniques such as acupuncture, massage, herbal medications, and cognitive behavioral or other psychotherapy approaches to cope with neuropathic pain.
  • Sensory symptoms, such as neuropathic pain or itching caused by injury to a nerve or nerves, are more difficult to control without medication. Some people use behavioral strategies to cope with chronic pain as well as depression and anxiety that many may feel following nerve injury.

Medications recommended for chronic neuropathic pain are also used for other medical conditions. Among the most effective are a class of drugs first marketed to treat depression. Nortriptyline and newer serotonin-norepinephrine reuptake inhibitors such as duloxetine hydrochloride modulate pain by increasing the brain’s ability to inhibit incoming pain signals. Another class of medications that quiets nerve cell electrical signaling is also used for epilepsy. Common drugs include gabapentin, pregabalin, and less often topiramate and lamotrigine. Carbamazepine and oxcarbazepine are particularly effective for trigeminal neuralgia, a focal neuropathy of the face.

Local anesthetics and related drugs that block nerve conduction may help when other medications are ineffective or poorly tolerated. Medications put on the skin (topically administered) are generally appealing because they stay near the skin and have fewer unwanted side effects.

Lidocaine patches or creams applied to the skin can be helpful for small painful areas, such as localized chronic pain from mononeuropathies such as shingles. Another topical cream is capsaicin, a substance found in hot peppers that can desensitize peripheral pain nerve endings. Doctor-applied patches that contain higher concentrations of capsaicin offer longer term relief from neuropathic pain and itching, but they worsen small-fiber nerve damage. Weak over-the-counter formulations also are available. Lidocaine or longer acting bupivicaine are sometimes given using implanted pumps that deliver tiny quantities to the fluid that bathes the spinal cord, where they can quiet excess firing of pain cells without affecting the rest of the body. Other drugs treat chronic painful neuropathies by calming excess signaling.

Narcotics (opioids) can be used for pain that doesn’t respond to other pain-control medications and if disease-improving treatments aren’t fully effective. Because pain relievers that contain opioids can lead to dependence and addiction, their use must be closely monitored by a physician. One of the newest drugs approved for treating diabetic neuropathy is tapentadol, which has both opioid activity and norepinephrine-reuptake inhibition activity of an antidepressant.

Surgery is the recommended treatment for some types of neuropathies. Protruding disks (“pinched nerve”) in the back or neck that compress nerve roots are commonly treated surgically to free the affected nerve root and allow it to heal. Trigeminal neuralgia on the face is also often treated with neurosurgical decompression. Injuries to a single nerve (mononeuropathy) caused by compression, entrapment, or rarely tumors or infections may require surgery to release the nerve compression. Polyneuropathies that involve more diffuse nerve damage, such as diabetic neuropathy, are not helped by surgical intervention. Surgeries or interventional procedures that attempt to reduce pain by cutting or injuring nerves are not often effective as they worsen nerve damage and the parts of the peripheral and central nervous system above the cut often continue to generate pain signals (“phantom pain”). More sophisticated and less damaging procedures such as electrically stimulating remaining peripheral nerve fibers or pain-processing areas of the spinal cord or brain have largely replaced these surgeries.

Transcutaneous electrical nerve stimulation (TENS) is a noninvasive intervention used for pain relief in a range of conditions. TENS involves attaching electrodes to the skin at the site of pain or near associated nerves and then administering a gentle electrical current. Although data from controlled clinical trials are not available to broadly establish its efficacy for peripheral neuropathies, in some studies TENS has been shown to improve neuropathic symptoms associated with diabetes.

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How can I prevent neuropathy?

The best treatment is prevention, and strategies for reducing injuries are highly effective and well tested. Since medical procedures ranging from casting fractures to injuries from needles and surgery are another cause, unnecessary procedures should be avoided. The new adjuvanted vaccine against shingles prevents more than 95 percent of cases and is widely recommended for people over 50, including those who have had previous shingles or vaccination with the older, less effective vaccine. Diabetes and some other diseases are common preventable causes of neuropathy. People with neuropathy should ask their doctors to minimize use of medications that are known to cause or worsen neuropathy where alternatives exist. Some families with very severe genetic neuropathies use in vitro fertilization to prevent transmission to future generations.

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What research is being done?

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.

NINDS-funded research ranges from clinical studies of the genetics and the natural history of hereditary neuropathies to discoveries of new cause and treatments for neuropathy, to basic science investigations of the biological mechanisms responsible for chronic neuropathic pain. Together, these diverse research areas will advance the development of new therapeutic and preventive strategies for peripheral neuropathies. Understanding the causes of neuropathy provides the foundation for finding effective prevention and treatment strategies.

Genetic mutations have been identified in more than 80 distinct hereditary neuropathies. NINDS supports studies to understand the disease mechanisms of these conditions and to identify other genetic defects that may play roles in causing or modifying the course of disease. The Inherited Neuropathies Consortium (INC)—a group of academic medical centers, patient support organizations, and clinical research resources dedicated to conducting clinical research in Charcot-Marie-Tooth disease and improving the care of people with the disease—seeks to better characterize the natural history of several different forms of neuropathy and to identify genes that modify clinical features in these disorders. Knowing which genes are mutated, and what their normal function is, permits precise diagnosis and leads to new therapies that prevent or reduce nerve damage. INC is also developing and testing biomarkers (signs that can indicate the diagnosis or progression of a disease) and clinical outcome measures that will be needed in future clinical trials to determine whether individuals respond to candidate treatments.

Rapid communication between the peripheral nervous system and the central nervous system often depends on myelination, a process through which special cells called Schwann cells create an insulating coating around axons. Several NINDS-funded studies focus on understanding how myelin protein and membrane production and maintenance in Schwann cells is regulated and how mutations in genes involved in these processes cause peripheral neuropathies. Schwann cells play a critical role in the regeneration of nerve cell axons in the peripheral nervous system. By better understanding myelination and Schwann cell function, researchers hope to find targets for new therapies to treat or prevent nerve damage associated with neuropathy.

Other efforts focus on immune system peripheral nerve damage. In inflammatory peripheral neuropathies such as Guillain-Barre Syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP), the body’s immune system mistakenly attacks peripheral nerves, damaging myelin and weakening signaling along affected nerves. NINDS-supported researchers hope to better understand how antibodies to cell membrane components cause peripheral nerve damage and how the effects of these antibodies can be blocked. Researchers are also studying how mutations in the Autoimmune Regulator (AIRE) gene in a mouse model of CIDP cause the immune system to attack peripheral nerves. NINDS research has helped discover that some types of small-fiber polyneuropathy appear to be immune-caused, particularly in women and children.

NINDS-supported researchers are also exploring the use of tissue engineered from the cells of humans with peripheral neuropathy as models to identify specific defects in the transport of cellular components along axons and the interactions of nerves with muscles. Such tissue engineering approaches may eventually lead to new therapeutics for peripheral neuropathies.

In addition to efforts to treat or prevent underlying nerve damage, other NINDS-supported studies are informing new strategies for relieving neuropathic pain, fatigue, and other neuropathy symptoms. Researchers are investigating the pathways that carry pain signals to the brain and are working to identify substances that will block this signaling.

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Where can I get more information?

For more information on neurological disorders or research programs funded by NINDS, contact the Institute’s Brain Resources and Information Network (BRAIN) at:

BRAIN
P.O. Box 5801
Bethesda, MD 20824
800-352-9424

Information also is available from the following organizations:

Foundation for Peripheral Neuropathy
485 Half Day Road
Suite 200
Buffalo Grove, IL 60089
877-883-9942

Charcot-Marie-Tooth Association (CMTA)
P.O. Box 105
Glenolden, PA 19036
610-499-9264
800-606-2682

Muscular Dystrophy Association
2200 S. Riverside Plaza, Suite 1500
Chicago, IL 60606
520-529-2000
800-572-1717

American Diabetes Association
2451 Crystal Drive, Suite 900
Arlington, VA 22202
703-549-1500
800-342-2383

National Diabetes Information Clearinghouse (NDIC)
National Institute of Diabetes and Digestive and Kidney Diseases
National Institutes of Health
1 Information Way
Bethesda, MD 20892-3560
800-860-8747

NeuropathyCommons.org
(information for patients, professionals, and researchers hosted by Harvard University)

“Peripheral Neuropathy Fact Sheet”, NINDS, Publication date: August 2018.

NIH Publication No. 18-NS-4853

Back to Peripheral Neuropathy Information Page

See a list of all NINDS disorders

Publicaciones en Español

Neuropatía Periférica

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

Additional Types of Neuropathy

Additional Types of Neuropathy

Charcot’s Joint, also called neuropathic arthropathy, occurs when a joint breaks down because of a problem with the nerves. This type of neuropathy most often occurs in the foot.

In a typical case of Charcot’s Joint, the foot has lost most sensation. The person no longer can feel pain in the foot and loses the ability to sense the position of the joint. Also, the muscles lose their ability to support the joint properly. The foot then becomes unstable, and walking just makes it worse.

An injury, such as a twisted ankle, may make things even worse. Joints grind on bone. The result is inflammation, which leads to further instability and then dislocation. Finally, the bone structure of the foot collapses. Eventually, the foot heals on its own, but because of the breakdown of the bone, it heals into a deformed foot.

People at risk for Charcot’s Joint are those who already have neuropathy. They should be aware of symptoms such as:

  • swelling
  • redness
  • heat
  • strong pulse
  • insensitivity of the foot.

Early treatment can stop bone destruction and aid healing.

Cranial neuropathy

Cranial neuropathy affects the 12 pairs of nerves that are connected with the brain and control sight, eye movement, hearing, and taste.

Most often, cranial neuropathy affects the nerves that control the eye muscles. The neuropathy begins with pain on one side of the face near the affected eye. Later, the eye muscle becomes paralyzed. Double vision results. Symptoms of this type of neuropathy usually get better or go away within 2 or 3 months.

Compression mononeuropathy

Compression mononeuropathy occurs when a single nerve is damaged. It is a fairly common type of neuropathy. There seem to be two kinds of damage. In the first, nerves are squashed at places where they must pass through a tight tunnel or over a lump of bone. Nerves of people with diabetes are more prone to compression injury. The second kind of damage arises when blood vessel disease caused by diabetes restricts blood flow to a part of the nerve.

Carpal tunnel syndrome is probably the most common compression mononeuropathy. It occurs when the median nerve of the forearm is compressed at the wrist. Symptoms of this type of neuropathy include numbness, swelling, or prickling in the fingers with or without pain when driving a car, knitting, or resting at night. Simply hanging your arm by your side usually stops the pain within a few minutes. If the symptoms are severe, an operation can give complete relief from pain.

Femoral neuropathy

Femoral neuropathy occurs most often in people with type 2 diabetes. A pain may develop in the front of one thigh. Muscle weakness follows, and the affected muscles waste away. A different kind of neuropathy that also affects the legs is called diabetic amyotrophy. In this case, weakness occurs on both sides of the body, but there is no pain. Doctors do not understand why it occurs, but blood vessel disease may be the cause.

Focal neuropathy

Focal Neuropathy affects a nerve or group of nerves causing sudden weakness or pain. It can lead to double vision, a paralysis on one side of the face called Bell’s palsy, or a pain in the front of the thigh or other parts of the body.

Thoracic/lumbar radiculopathy

Thoracic or lumbar radiculopath is another common mononeuropathy. It is like femoral neuropathy, except that it occurs in the torso. It affects a band of the chest or abdominal wall on one or both sides. It seems to occur more often in people with type 2 diabetes. Again, people with this neuropathy get better with time.

Unilateral foot drop

Unilateral foot drop is when the foot can’t be picked up. It occurs from damage to the peroneal nerve of the leg by compression or vessel disease. Foot drop can improve.

Peripheral Neuropathy Risk Factors + Facts

Immune system disorders

  • Guillian-Barré syndrome & Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
    Anyone can develop GBS; however, it is more common among older adults. The incidence of GBS increases with age, and people older than 50 years are at greatest risk for developing GBS. In the United States, for example, an estimated 3,000 to 6,000 people develop GBS each year on average.
  • Charcot-Marie Tooth
    Charcot-Marie Tooth disease is the most common inherited disorder that involves the peripheral nerves, affecting an estimated 150,000 people in the United States. It occurs in populations worldwide with a prevalence of about 1 in 2,500 individuals.

Other autoimmune disorders can include but not limited to:

  • Celiac disease
  • Lupus
  • Rheumatoid arthritis
  • Shingles

Repetitive Stress

A job or hobby that puts stress on one nerve for long periods of time increases the chances for development of peripheral neuropathy. Playing certain sports or musical instruments and/or using vibrating power tools even crutches can put pressure on peripheral nerves and cause nerve irritation and damage.

Alcohol abuse

Excessive drinking of alcohol can affect the nervous system, causing numbness of the hands and feet.

Vitamin deficiency

A lack of certain vitamins, especially B-1 (thiamin) and B-12 makes peripheral neuropathy more likely. Pernicious anemia, which occurs when the body cannot absorb B-12 properly, often leads to peripheral neuropathy. Learn more

Other health problems

Medical conditions, including certain types of kidney disease and liver disease, or those with family history of genetic diseases that produce peripheral neuropathic pain symptoms and conditions put an individual at risk of developing peripheral nerve damage. Learn more

Toxic substances

Exposure to some toxic substances can make one susceptible to peripheral nerve damage. These substances include heavy metals, such as lead, mercury, arsenic and organic solvents; and certain medications, such as those used to treat cancer or AIDS.

Peripheral Neuropathy

  • Causes

  • Types

  • Symptoms

  • Diagnosis

  • Treatment

  • Prevention

  • Management

Peripheral neuropathy is a type of damage to the nervous system. Specifically, it is a problem with your peripheral nervous system. This is the network of nerves that sends information from your brain and spinal cord (central nervous system) to the rest of your body.

Peripheral Neuropathy Causes

Peripheral neuropathy has many different causes. Some people inherit the disorder from their parents. Others develop it because of an injury or another disorder.

In many cases, a different type of problem, such as a kidney condition or a hormone imbalance, leads to peripheral neuropathy. One of the most common causes of peripheral neuropathy in the U.S. is diabetes.

Peripheral Neuropathy Types

There are more than 100 types of peripheral neuropathy, each with its own set of symptoms and prognosis. To help doctors classify them, they are often broken down into the following categories:

  • Motor neuropathy. This is damage to the nerves that control muscles and movement in the body, such as moving your hands and arms or talking.

  • Sensory neuropathy. Sensory nerves control what you feel, such as pain, temperature or a light touch. Sensory neuropathy affects these groups of nerves.

  • Autonomic nerve neuropathy. Autonomic nerves control functions that you are not conscious of, such as breathing and heartbeat. Damage to these nerves can be serious.

  • Combination neuropathies. You may have a mix of 2 or 3 of these other types of neuropathies, such as a sensory-motor neuropathy.

Peripheral Neuropathy Symptoms

The symptoms of peripheral neuropathy vary based on the type that you have and what part of the body is affected. Symptoms can range from tingling or numbness in a certain body part to more serious effects such as burning pain or paralysis.

  • Muscle weakness

  • Cramps

  • Muscle twitching

  • Loss of muscle and bone

  • Changes in skin, hair, or nails

  • Numbness

  • Loss of sensation or feeling in body parts

  • Loss of balance or other functions as a side effect of the loss of feeling in the legs, arms, or other body parts

  • Emotional disturbances

  • Sleep disruptions

  • Loss of pain or sensation that can put you at risk, such as not feeling an impending heart attack or limb pain

  • Inability to sweat properly, leading to heat intolerance

  • Loss of bladder control, leading to infection or incontinence

  • Dizziness, lightheadedness, or fainting because of a loss of control over blood pressure

  • Diarrhea, constipation, or incontinence related to nerve damage in the intestines or digestive tract

  • Trouble eating or swallowing

  • Life-threatening symptoms, such as difficulty breathing or irregular heartbeat

The symptoms of peripheral neuropathy may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

Peripheral Neuropathy Diagnosis

The symptoms and body parts affected by peripheral neuropathy are so varied that it may be hard to make a diagnosis. If your healthcare provider suspects nerve damage, he or she will take an extensive medical history and do a number of neurological tests to determine the location and extent of your nerve damage. These may include:

  • Blood tests

  • Spinal fluid tests

  • Muscle strength tests

  • Tests of the ability to detect vibrations

Depending on what basic tests reveal, your healthcare provider may want to do more in-depth scanning and other tests to get a better look at your nerve damage. Tests may include:

  • CT scan

  • MRI scan

  • Electromyography (EMG) and nerve conduction studies

  • Nerve and skin biopsy

Peripheral Neuropathy Treatment

Usually a peripheral neuropathy can’t be cured, but you can do a lot of things to prevent it from getting worse. If an underlying condition like diabetes is at fault, your healthcare provider will treat that first and then treat the pain and other symptoms of neuropathy.

In some cases, over-the-counter pain relievers can help. Other times, prescription medicines are needed. Some of these medicines include mexiletine, a medicine developed to correct irregular heart rhythms; antiseizure drugs, such as gabapentin, phenytoin, and carbamazepine; and some classes of antidepressants, including tricyclics such as amitriptyline.

Lidocaine injections and patches may help with pain in other instances. And in extreme cases, surgery can be used to destroy nerves or repair injuries that are causing neuropathic pain and symptoms.

Peripheral Neuropathy Prevention

Lifestyle choices can play a role in preventing peripheral neuropathy. You can lessen your risk for many of these conditions by avoiding alcohol, correcting vitamin deficiencies, eating a healthy diet, losing weight, avoiding toxins, and exercising regularly. If you have kidney disease, diabetes, or other chronic health condition, it is important to work with your healthcare provider to control your condition, which may prevent or delay the onset of peripheral neuropathy.

Peripheral Neuropathy Management

Even if you already have some form of peripheral neuropathy, healthy lifestyle steps can help you feel your best and reduce the pain and symptoms related to the disorder. You’ll also want to quit smoking, not let injuries go untreated, and be meticulous about caring for your feet and treating wounds to avoid complications, such as the loss of a limb.

In some cases, non-prescription hand and foot braces can help you make up for muscle weakness. Orthotics can help you walk better. Relaxation techniques, such as yoga, may help ease emotional as well as physical symptoms.

New thinking on peripheral neuropathy

Nerve damage might be causing everything from low blood pressure to gastrointestinal distress without your knowing it.

Published: September, 2019

Doctors have long known peripheral neuropathy as a nerve condition that causes reduced sensation, tingling, weakness, or pain in the feet and hands. But those symptoms may be just the tip of the iceberg. Doctors are now learning that neuropathy can cause many more problems.

What is peripheral neuropathy?

Peripheral neuropathy refers to damage to the peripheral nerves throughout the body. These nerves carry messages to and from the brain.

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