Peripheral Neuropathy
Peripheral neuropathy
is the general term that refers to disorders of peripheral nerves. The
peripheral nervous system is made up of the nerves that branch out of the spinal
cord to different parts of the body.
Peripheral neuropathy
is a relatively common neurological disorder that results from damage to the
peripheral nerves. It can be caused by a number of diseases of the nerves or be
the result of systemic illnesses. Many of the peripheral neuropathy's have a
well established cause such as diabetes, alcoholism, uremia, AIDs, or
nutritional deficiencies. Diabetes is, by far, one of the most common causes of
peripheral neuropathy. Other less common causes include exposure to cold or
radiation, a few medicines, toxic substances, vascular or collagen disorders,
systemic lupus erythematosus, scleroderma and rheumatoid arthritis.
Symptoms of peripheral
neuropathy:
The peripheral nervous system consists of
motor (to help move) nerves and sensory (to help feel) nerves. Either or
both sets of nerves can be affected in neuropathy.
If a sensory nerve is damaged, the
predominant symptoms are pain, numbness, tingling, burning or a loss of
feeling. They often begin gradually. There may be a tingling sensation or
numbness that starts in the toes and/or the balls of the feet and spreads
upward. Occasionally the skin may become so sensitive that the slightest
touch is agonizing. There may also may be a numbness, or a complete lack of
feeling in the feet. At times the symptoms may be barely noticeable and at
other times, especially at night, they may be almost unbearable. The
symptoms may also include a sensation that you're wearing an invisible glove
or sock; a burning or freezing pain; sharp, jabbing or electric pain; and an
extreme sensitivity to touch.
If the motor
nerves are damaged there may be a weakness or paralysis of the muscles
controlled by the affected nerve(s). In the foot their may be a 'wasting' of
the muscles as they do not work as well as before.
Diabetic peripheral neuropathy:
Diabetic
neuropathy deserves special mention as it is the most common type and can
lead to serious complications in those with diabetes. Diabetic peripheral
neuropathy means damage of nerve fibres in people with diabetes. The process
by which the nerves are damaged is not entirely clear but it is probably
related to high blood glucose changes that affect the metabolism of nerve
cells.
There are three types of
diabetic peripheral neuropathy:
Diabetic
peripheral neuropathy can result in two types of problems:
-
there can be a loss of ability to feel pain and other
sensations - this puts the foot at risk of being damaged and not knowing
about it
-
there can be symptoms of pain and burning leading to
discomfort (painful neuropathy).
Treatment of peripheral
neuropathy:
The treatment for
peripheral neuropathy will differ, depending on the cause. For example, if
it is caused by diabetes the therapy involves better control of the
diabetes. If it is caused by a vitamin deficiency, then supplementation will
help.
Medications, such as pain relievers and
tricyclic antidepressants are often helpful.
Generally, the
treatment for peripheral neuropathy is unsatisfactory and often only
symptomatic relief is available. Some of these include transcutaneous
electrical nerve stimulation, acupuncture and biofeedback.
Protection of the foot in
peripheral neuropathy:
As a loss of sensation (numbness) is
common in peripheral neuropathy, damage to the foot can go undetected and lead
to serious complications (especially in those who also have diabetes). It is
best to protect the foot with good fitting footwear and the foot should be
inspected daily for damage. Particular attention should be paid to corns and
calluses, as these may need treatment by a podiatrist.
