The disorder is uncomfortable, but treatments can be very helpful. The most important thing to determine is whether the neuropathy is the result of a serious underlying condition. There are three types of nerves in the body.
Since there are so many types of peripheral neuropathy, doctors will diagnose your type by the group of nerves it affects. The three groups are:. Peripheral neuropathy can affect one nerve group, two groups, or all three. Symptoms can cause challenges in daily life, like trouble walking or sleeping because of pain in the feet and legs.
These symptoms can also indicate other conditions. Make sure you tell your doctor about all of your symptoms so they can find the right diagnosis and the best treatment. A variety of factors and underlying conditions can cause this condition. In rare cases, peripheral neuropathy is genetic, but most cases are acquired.
In most cases, doctors can connect the condition to one or more causes. Nerve damage caused by diabetes is one of the most common forms of neuropathy. This leads to numbness, pain, and a loss of sensation in the extremities. The American Diabetes Association recommends taking these steps to delay or prevent nerve damage:. According to the National Institutes of Health, 60 to 70 percent of people with diabetes have some sort of nerve damage.
Physical trauma is a common cause of injury to the nerves. This can include car accidents, falls, or fractures. Inactivity, or holding still too long in one position, can also cause neuropathy. Increased pressure on the median nerve , a nerve in the wrist that supplies feeling and movement to the hand, causes carpal tunnel syndrome.
This is a common type of peripheral neuropathy. Alcohol can have a toxic effect on nerve tissue, putting people with severe alcohol use disorder at a higher risk of peripheral neuropathy.
Exposure to toxic chemicals like glue, solvents , or insecticides , either through chemical abuse or in the workplace, can also cause nerve damage. Additionally, exposure to heavy metals such as lead and mercury can also cause this condition. Viruses such as herpes simplex , varicella-zoster virus which causes chickenpox and shingles , and Epstein-Barr virus damage sensory nerves and cause intense episodes of shooting pain.
Autoimmune diseases like rheumatoid arthritis and lupus affect the peripheral nervous system in various ways. Chronic inflammation and damage to tissues throughout the body, as well as pressure caused by inflammation, can all lead to severe nerve pain in the extremities.
First, your doctor will perform a physical exam and ask about your medical history. They might perform other tests, which include:. When they malfunction, complex functions can grind to a halt. Symptoms can range from mild to disabling and are rarely life-threatening.
The symptoms depend on the type of nerve fibers affected and the type and severity of damage. Symptoms may develop over days, weeks, or years. In some cases, the symptoms improve on their own and may not require advance d care. Unlike nerve cells in the central nervous system, peripheral nerve cells continue to grow throughout life. Some forms of neuropathy involve damage to only one nerve called mononeuropathy.
Neuropathy affecting two or more nerves in different areas is called multiple mononeuropathy or mononeuropathy multiplex. More often, many or most of the nerves are affected called polyneuropathy. Neuropathy is often misdiagnosed due to its complex array of symptoms.
More than types of peripheral neuropathy have been identified, each with its own symptoms and prognosis. Symptoms vary depending on the type of nerves—motor, sensory, or autonomic—that are damaged. Most neuropathies affect all three types of nerve fibers to varying degrees; others primarily affect one or two types. Doctors use terms such as predominantly motor neuropathy, predominantly sensory neuropathy, sensory-motor neuropathy, or autonomic neuropathy to describe different conditions.
In severe cases, such neuropathies can spread upwards toward the central parts of the body. In non-length dependent polyneuropathies, the symptoms can start more toward the torso, or are patchy. Motor nerve damage is most commonly associated with muscle weakness. Other symptoms include painful cramps, fasciculations uncontrolled muscle twitching visible under the skin and muscle shrinking. Sensory nerve damage causes various symptoms because sensory nerves have a broad range of functions.
Autonomic nerve damage affects the axons in small-fiber neuropathies. Common symptoms include excess sweating, heat intolerance, inability to expand and contract the small blood vessels that regulate blood pressure, and gastrointestinal symptoms. Although rare, some people develop problems eating or swallowing if the nerves that control the esophagus are affected. There are several types of peripheral neuropathies, the most common of which is linked to diabetes.
Common types of focal located to just one part of the body mononeuropathy include carpal tunnel syndrome, which affects the hand and the wrist, and meralgia paresthetica, which causes numbness and tingling on one thigh.
Complex regional pain syndrome is a class of lingering neuropathies where small-fibers are mostly damaged. Acquired neuropathies are either symptomatic the result of another disorder or condition; see below or idiopathic meaning it has no known cause. Genetically-caused polyneuropathies are rare. Genetic mutations can either be inherited or arise de novo , meaning they are completely new mutations to an individual and are not present in either parent.
Some genetic mutations lead to mild neuropathies with symptoms that begin in early adulthood and result in little, if any, significant impairment. More severe hereditary neuropathies often appear in infancy or childhood. Treatment for peripheral neuropathy may include treating any underlying cause or any symptoms you're experiencing.
Treatment may be more successful for certain underlying causes. For example, ensuring diabetes is well controlled may help improve neuropathy or at least stop it getting worse. There are many different possible causes of peripheral neuropathy , some of which can be treated in different ways. For example:. Unlike most other types of pain, neuropathic pain doesn't usually get better with common painkillers, such as paracetamol and ibuprofen and other medications are often used.
These should usually be started at the minimum dose, with the dose gradually increased until you notice an effect, because the ideal dose for each person is unpredictable. Higher doses may be better at managing the pain, but are also more likely to cause side effects. The most common side effects are tiredness, dizziness or feeling "drunk". If you get these, it may be necessary to reduce your dose.
Don't drive or operate machinery if you experience drowsiness or blurred vision. You also may become more sensitive to the effects of alcohol. The side effects should improve after a week or two as your body gets used to the medication. However, if your side effects continue, tell your GP as it may be possible to change to a different medication that suits you better. Many of these medications may also be used for treating other conditions, such as depression, epilepsy, anxiety or headaches.
If you're given an antidepressant , this may treat pain even if you're not depressed. This doesn't mean your doctor suspects you're depressed. There are also some additional medications that can be used to relieve pain in a specific area of the body or to relieve particularly severe pain for short periods.
These are described below. If your pain is confined to a particular area of your body and you can't, or would prefer not to, take the medications above, you may benefit from using capsaicin cream. Capsaicin is the substance that makes chilli peppers hot and is thought to work in neuropathic pain by stopping the nerves sending pain messages to the brain.
A pea-sized amount of capsaicin cream is rubbed on the painful area of skin three or four times a day. Side effects of capsaicin cream can include skin irritation and a burning sensation in the treated area when you first start treatment.
Don't use capsaicin cream on broken or inflamed skin and always wash your hands after applying it. This is a large sticking plaster that contains a local anaesthetic.
It's useful when pain affects only a small area of skin. It's stuck over the area of painful skin and the local anaesthetic is absorbed into the skin that's covered. Tramadol is a powerful painkiller related to morphine that can be used to treat neuropathic pain that doesn't respond to other treatments your GP can prescribe.
Like all opioids, tramadol can be addictive if it's taken for a long time. It will usually only be prescribed for a short time.
Tramadol can be useful to take at times when your pain is worse. In addition to treating pain, you may also require treatment to help you manage other symptoms you're experiencing as a result of peripheral neuropathy. For example, if you have muscle weakness, you may need physiotherapy to learn exercises to improve your muscle strength. You may also need to wear splints to support weak ankles or use walking aids to help you get around.
In some cases, you may need more invasive treatment, such as botulinum toxin injections for hyperhidrosis or urinary catheterisation if you have problems emptying your bladder. Peripheral neuropathy can sometimes cause other medical problems, such as foot ulcers and heart rhythm changes, and blood circulation problems.
A diabetic foot ulcer is an open wound or sore on the skin that's slow to heal. These are common in people with diabetic polyneuropathy. An ulcer can also occur if you unknowingly develop a blister caused by badly fitting shoes.
If you don't feel any pain, you may continue walking without protecting the blister. If the cut or blister gets worse, it may develop into an ulcer. High blood sugar can damage your blood vessels, causing the blood supply to your feet to become restricted.
A reduced blood supply to the skin on your feet means it receives a lower number of infection-fighting cells, which can mean wounds take longer to heal and can lead to gangrene. Peripheral neuropathy has many different causes. One of the most common causes of peripheral neuropathy in the U.
The most common type of peripheral neuropathy is diabetic neuropathy, caused by a high sugar level and resulting in nerve fiber damage in your legs and feet. Symptoms can range from tingling or numbness in a certain body part to more serious effects, such as burning pain or paralysis.
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. 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.
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.
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