Peripheral Neuropathy: What it is, Symptoms & Treatment
Peripheral neuropathy is a condition in which nerves are damaged. It is a problem of the nervous system that affects the nerves outside the brain and spinal cord.
Peripheral neuropathy is damage or dysfunction of the peripheral nerves, that is, the nerves outside the brain and spinal cord. It may affect:
Sensory nerves (sensation)
Motor nerves (movement)
Autonomic nerves (uncontrolled body functions)
Peripheral Neuropathy Symptoms
These are the typical symptoms of peripheral neuropathy, listed by the type of nerve involved:
Sensory Nerve Symptoms (most frequent)
Numbness or decreased sense of feeling (particularly in hands or feet)
Tingling or "pins and needles" feeling
Burning, stabbing, or shooting pain
Heightened sensitivity to touch (even slight touch may hurt)
Loss of coordination or balance
Feeling like you're wearing gloves or socks when you're not
Motor Nerve Symptoms
Weakness of muscles
Cramping or spasms
Paralysis (in extreme cases)
Difficulty with fine motor tasks (e.g., dressing)
Autonomic Nerve Symptoms
Dizziness or fainting (particularly when rising from a lying down position)
Abnormal sweating (excessive or insufficient)
Digestive problems (bloating, nausea, diarrhea, or constipation)
Bladder difficulties (incontinence or retention)
Heat intolerance
Peripheral Neuropathy Treatment
Treatment for peripheral neuropathy is aimed at symptom management, addressing the underlying cause, and preventing additional nerve damage. Below is a summary of options available:
Diabetes Management: Blood sugar control can prevent additional nerve damage and potentially improve symptoms.
Vitamin Deficiencies: B vitamin (particularly B12), vitamin E, and others as appropriate supplementation.
Autoimmune Conditions: Treatment may involve immunosuppressive therapies.
Medications for Symptom Relief:
Pain Relievers:
Over-the-counter (OTC): Mild pain may be eased with acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
Prescription: For greater pain, more potent drugs such as tramadol might be dispensed.
Anti-seizure Medications: Gabapentin and pregabalin are prescribed to relieve pain due to the nerves.
Antidepressants: Tricyclic antidepressants (amitriptyline) and serotonin-norepinephrine reuptake inhibitors (duloxetine) will ease neuropathic pain.
Topical Treatments: Topical lidocaine patches or capsaicin cream will ease local pain.
Therapies and Procedures
Physical Therapy: Enhances strength, coordination, and balance of muscles.
Transcutaneous Electrical Nerve Stimulation (TENS): Could alleviate pain by providing mild electrical impulses to nerves.
Surgical Intervention: When there is nerve compression, interventions such as nerve decompression surgery may be advised.
Peripheral Neuropathy Causes
Peripheral neuropathy has numerous potential causes. It results when peripheral nerves are disrupted or damaged, causing weakness, numbness, and pain. The following is a listed and categorized array of the most significant and common causes:
Hereditary sensory and autonomic neuropathies (HSANs)
Trauma or Nerve Compression
Carpal tunnel syndrome
Herniated disc
Sustained pressure on a nerve (e.g., during surgery, cast, or immobilization)
Accidents or injuries
Other Causes
Cancer or tumors compressing nerves
Paraneoplastic syndromes (immune responses to tumors)
Idiopathic neuropathy – no known cause (most common in older adults)
Peripheral Neuropathy Diagnosis
Diagnosing peripheral neuropathy includes determining the type, cause, and extent of nerve injury. This is how physicians normally proceed:
Medical History and Physical Exam
Review of symptoms: Time of onset, location (hands, feet), character of pain, numbness, etc.
Family history: Presence of inherited conditions such as Charcot-Marie-Tooth
Lifestyle factors: Alcohol consumption, exposure to toxins, medications
Underlying medical conditions: Diabetes, autoimmune conditions, infections
Blood Tests
Used to test for:
Diabetes (HbA1c, fasting glucose)
Vitamin deficiencies (B12, B6, E)
Thyroid function (TSH)
Kidney and liver function
Autoimmune markers (ANA, RF)
Infections (HIV, Hepatitis B/C, Lyme disease)
Nerve Function Tests
a. Nerve Conduction Study (NCS)
Measures how quickly electrical impulses travel through your nerves.
Helps detect damage in large myelinated fibers.
b. Electromyography (EMG)
Tests electrical activity in muscles.
Identifies muscle weakness due to nerve damage.
Imaging Tests
MRI/CT scan: Eliminate herniated discs, tumors, or nerve compression.
Ultrasound: Occasionally used to see swelling of nerves.
Nerve or Skin Biopsy (Rare)
A tiny sample of nerve or skin is removed for microscopic examination.
Assists in the diagnosis of small fiber neuropathy or vasculitis.
Lumbar Puncture (Spinal Tap) (Occasionally)
Tests cerebrospinal fluid for infection or inflammation.
Peripheral Neuropathy Supplements
Some supplements can help control peripheral neuropathy, particularly when the condition is due to vitamin deficiencies, diabetes, or oxidative stress. Nevertheless, always see a healthcare professional before taking supplements since improper use can exacerbate symptoms (e.g., excessive vitamin B6).
Best Supplements for Peripheral Neuropathy
Vitamin B12 (Methylcobalamin): Nerve regeneration support; deficiency is a frequent cause of neuropathy
Acetyl-L-Carnitine: Enhances nerve function and pain relief
Vitamin B1 (Benfotiamine): Enhances glucose metabolism; can decrease neuropathic pain
Vitamin B6 (Pyridoxine): Enhances nerve function
Vitamin D: Deficiency associated with nerve pain and inflammation
Magnesium: Can relax nerves and decrease cramping
Omega-3 Fatty Acids (Fish Oil/Algal oil): Anti-inflammatory; can aid in nerve repair
Curcumin (Turmeric extract): Anti-inflammatory and antioxidant
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