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Peripheral Neuropathy

What is peripheral neuropathy?

Peripheral neuropathy is a term used to describe problems with the nerves of the peripheral nervous system. It is also called nerve palsy. The peripheral nervous system is the term used for all of the nerves outside the brain and spinal cord. Peripheral nerves move information from the brain and spinal cord to every other part of the body. They connect your brain and spinal cord to your muscles and allow you to move your muscles. They also conduct sensations such as pain, temperature, and touch to your brain. The nerves connecting to internal organs that allow you to do things like breathe and digest food are also part of the peripheral nervous system.

How does it occur?

Peripheral neuropathy can have many causes. Anything that makes it hard for a nerve to work properly can lead to neuropathy. Some common causes are:

• direct injury to the nerve, such as a sports injury
• pressure on a nerve caused by repetitive use (such as carpal tunnel syndrome); improper use of crutches; or an abnormal growth, such as a tumor
• diseases such as diabetes, arthritis, lupus, or alcoholism
• infections (usually viral, for example, infections by the herpes virus)
• poisons and some medicines, such as some cancer medicines
• a lack of vitamins, such as vitamin B-12, or minerals

What are the symptoms?

The symptoms of peripheral neuropathy depend on which nerves are damaged.

• Nerves that help you move your muscles are called motor nerves. If motor nerves are damaged, you may have muscle weakness. You may not be able to move the muscles controlled by the damaged nerves.
• Nerves that conduct sensations, such as touch, are called sensory nerves. When these nerves are affected, you may have numbness, tingling, pain, or extreme sensitivity to touch.
• The nerves controlling internal organs are called autonomic nerves. Symptoms caused by damage to these nerves depend on what organs are affected. For example, you may have light-headedness, leaking of urine from the bladder, or digestion problems, such as constipation or diarrhea.

How is it diagnosed?

Your physician will ask about your symptoms and medical history. He or she will examine you. You may have a nerve conduction test. This test checks how well your nerves are working. You may have other tests.

How is it treated?

The treatment depends on the cause. For example:

• If the problem happens after an injury, the neuropathy may go away on its own and not need any specific treatment. It depends on severe the injury is.
• If the neuropathy is caused by a disease such as diabetes or lupus, you may need treatment that controls the disease better.
• If the cause is a lack of vitamins, your provider may prescribe vitamin supplements.

The symptoms of neuropathy can be treated with medicines, such as:

• nonprescription pain relievers such as acetaminophen, aspirin, or ibuprofen
• prescription NSAIDS (nonsteroidal anti-inflammatory drugs)
• medicines that can be put on the skin and numb the skin (lidocaine) or block pain (capsaicin)
• medicines originally developed to treat seizures, such as gabapentin (Neurontin), topiramate (Topamax), pregabalin (Lyrica), carbamazepine (Tegretol), and phenytoin (Dilantin).
• antidepressant medicines that can help relieve pain

Sometimes narcotic medicines are prescribed when nothing else works. These medicines can lead to dependence and addiction. They may cause constipation, dry mouth, dizziness, and sleepiness. In high doses they may cause trouble breathing and even cause death. For these reasons they are used only as a last resort.

Some other possible treatments for nerve pain are:

• biofeedback (a way to control your body's responses with your mind)
• relaxation methods
• electronic nerve stimulation devices
• shots of local anesthetics, steroids, or other medicines to block pain signals or decrease inflammation
• in severe cases, surgery to cut the nerve causing the pain

How long will the effects last?

Peripheral neuropathy caused by an injury usually lasts from a few days to several weeks, depending on the injury. Neuropathy due to diabetes and other chronic diseases tends to not go away completely, but it may improve with treatment of the disease. Neuropathy caused by a viral infection is less predictable. It may or may not go away with time.

How can I take care of myself?

If you have a disease such as diabetes, the best way to take care of yourself is to follow your physician's advice and take your medicines as prescribed. If the cause of your neuropathy is an injury, the best thing you can do is to try to protect against further injury.

How can I help prevent neuropathy?

Sometimes it is hard to avoid injuries that cause neuropathy. If the problem is caused by a disease, proper treatment of the disease is the best means of prevention. Follow your physician's advice and take your medicines as prescribed. Eat a healthy diet that includes fruits, vegetables, whole grains, and lean meat to give you enough vitamin B-12

Article provided by Relay Health