Peripheral neuropathy generally occurs because damage to the nerve axons has occurred. The nerve axon is what conducts the electrical impulses to different places. For example, if damage occurs within the axon of a sensory neuron, then a person’s sense of touch and warmth will be impaired. Generally, neuropathy creates pain, numbness and tingling in the extremities (hands and feet). There are several different causes of this condition, including:
- The most common: diabetes
- Traumatic injury
- Metabolic Disorders
Types of Neuropathy
- Sensorimotor polyneuropathy: affects the sensory and motor nerves
- Autonomic neuropathy: affects nerves that control processes such as breathing, heartbeat, perspiration, etc.
Peripheral neuropathy often creates painful sensations described as tingling, burning and prickling. With a condition such as this, a specific duration of pain varies but generally improves in time. There is a better chance of improving the symptoms if proper treatment for an underlying condition is received. It is common to see the condition correlating with several life factors, such as poor nutrition, various diseases, trauma or pressure on the nerves. In some cases, there is an unknown cause. This is referred to as idiopathic neuropathy.
Causes of Neuropathy
There is not a single underlying cause for neuropathy. In fact, there may be no known cause which is referred to as idiopathic and makes up nearly 40% of all neuropathies. Also, nearly 35% of the remaining Americans suffering from neuropathy have diabetes. In fact, almost 70% of Americans with diabetes have developed a form of neuropathy due to the disease.
The remaining percent of neuropathies is composed of a group called acquired neuropathies. This group consists of causes such as: Alcoholism, Poor nutrition and nutritional deficiencies, Trauma, Pressure on nerves, Repetitive movements for extended periods of time, Various autoimmune diseases, Rheumatoid Arthritis, Lupus, Toxins, Heavy metal poisoning, Various medications, Certain cancer treatments, Hereditary neuropathies (from inherited disorders), Tumors and Other diseases, including but not limited to: HIV/AIDS, Lyme disease, Liver disease, Kidney disease and Hypothyroidism.
Diagnosis of Neuropathy
This condition is generally not a simple diagnosis to make. It is difficult because it is not often that it is a disease present alone rather a symptom of an underlying disease. There is a process that occurs before the diagnosis is made. The process may consist of:
- Full medical history
- Physical exam
- Neurological exam
- Tendon reflexes
- Muscular strength
- Muscular tone
- Sensory tests
- Postural analysis
- Coordination analysis
- Blood tests (check vitamin B-12)
- Thyroid function tests
- Nerve conduction test
In some cases a nerve biopsy may be requested by a physician.
Other Neuropathy Treatment Options
Anticonvulsants are another choice of treatment used for neuropathies. This type of medication is used because it blocks the incoming calcium within a neuron which ultimately inhibits the transmission of pain. A less favorable medication used is opioid narcotics. These are not used very often because of the chance the patient may become addicted and dependent although they are they usually the most effective for alleviating the pain. Topical creams that may be used are lidocaine or capsaicin.
There are also alternative therapies available. Some of that have been used are: Cannabinoids, Botox, Ketamine, Dietary supplements, Therapeutic massage, Yoga and Acupuncture.
Neuropathy may be treated with a class of therapy known as neuromodulators. This may require surgical implantation of electrical or chemical implants. These include:
- Spinal cord stimulators
- Spinal pumps
- Electrodes – used to stimulate the motor cortex
- Deep brain stimulation
As always remember that if you have questions you can call the team at Superior Health Centers for help.