FAQs on Peripheral Neuropathy

It is estimated that 20 million Americans suffer with some type of peripheral neuropathy. This condition develops as a result of damage to the peripheral nervous system. A vast communication network transmits information between the central nervous system (CNS) and other parts of the body. The CNS is composed of the spinal cord and brain. When nerve disease (neuropathy) develops, the patient feels pain and other sensations in the hands, arms, shoulders, and other body regions.

What are the symptoms of peripheral neuropathy?

Areas of the body become abnormally sensitive with peripheral neuropathy. A distorted experience of touch is called allodynia, and pain occurs in response to a stimulus, such as mild touch, clothing, or wind. Severe symptoms include:

  • Burning pain
  • Muscle wasting
  • Organ/gland dysfunction
  • Paralysis

What is the difference in motor nerve damage and sensory nerve damage?

Motor nerve damage is associated with muscle weakness, uncontrolled muscle twitching, muscle atrophy, decreased reflexes, and painful cramps. Sensory nerve damage is associated with pain to light touch, vibration, and position sense. Damage to the sensory fibers impairs the general sense of sensation, and this is felt in the hands and feet.

What causes peripheral neuropathy?

Peripheral nerves transfer sensory information back to the spinal cord and brain, which are messages that the feet are cold, hot, or sore. The peripheral nerves carry messages from the brain and down the spinal cord to allow for movement. The peripheral nervous system interferes with these connections. Peripheral neuropathy will distort and interrupt these messages.

With autonomic nerve damage, the symptoms include ability to sweat normally, loss of bladder control, and trouble with contraction and expansion of blood vessels. Patients with this type of damage often have dizziness, fainting, lightheadedness, and orthostatic hypotension.

What conditions are associated with peripheral neuropathy?

Peripheral neuropathy is either inherited or acquired through various disease processes, injuries, or trauma. Conditions associated with this condition include:

  • Injury/sudden trauma – From falls, sport-related activities, accidents, and surgical procedures.
  • Repetitive stress – From awkward, repeated, and forceful activities.
  • Metabolic and endocrine disorders – These impair the body’s ability to transform food into energy and process bodily wastes. Nerve damage occurs from high levels of circulating glucose, hormone imbalances, and other problems.
  • Autoimmune diseases – Neuropathy occurs when the body’s immune system attacks its own body tissues. This include Lupus, Sjogren’s syndrome, and rheumatoid arthritis.
  • Kidney disorders – Kidney dysfunction leads to high amounts of toxins in the blood, which causes nerve tissue damage.
  • Cancers – Cancer will infiltrate nerve fibers and exert a damaging force on nerves.
  • Infections – Viruses and bacteria attack nerve tissues and cause lasting damage.
  • Neuromas – Benign tumors resulting from an overgrowth of nerve tissue develop after a penetrating injury.

How is peripheral neuropathy diagnosed?

  • Nerve conduction velocity tests measure the degree of large nerve fiber damage.
  • Electromyography (EMG) is used to assess electrical activity of the muscles.
  • Magnetic resonance imaging (MRI) shows muscle size and quality, rules out tumors, confirms herniated tests, and checks for other abnormalities.
  • Nerve biopsy – This test confirms a nerve problem.

How is peripheral neuropathy treated?

Treatment options include:

  • Immunosuppressive drugs – Prednisone and azathioprine are used for reducing inflammatory and autoimmune conditions.
  • Antidepressants – These are used for neuropathic pain. Examples are nortriptyline and amitriptyline.
  • Anticonvulsants – These are used for nerve pain, and include gabapentin, topiramate, and pregabalin.
  • Topical agents – These include capsaicin and menthol. These drugs block local pain signal transmission are help with nerve-related pain.
  • Transcutaneous electrical nerve stimulation (TENS) – This non-invasive intervention is used to relieve pain. Small electrodes attach to the spine and mild electrical current is sent to interfere with pain signals.