What Is Neuropathy Symptoms Causes Diagnosis Treatment And Prevention
Neuropathy, or nerve damage, can result from a wide range of conditions such as diabetes and even treatments like chemotherapy.
In fact, neuropathy, which is sometimes referred to as peripheral neuropathy, is not a single health condition but rather a term used to describe a range of health problems involving damage to the peripheral nerves, as well as the symptoms of those issues.
While the group of conditions is irreversible, you can take steps to help prevent neuropathy;or manage it through diet, lifestyle, and treatment.
Can Neuropathy Be Stopped
Your long-term outcome depends on what is causing your neuropathy. If your neuropathy is caused by a treatable condition, managing the condition might result in stopping the neuropathy or preventing it from getting worse. If the underlying cause of the neuropathy cant be treated, then the goal is to manage the symptoms of neuropathy and improve your quality of life.
Neuropathy rarely leads to death if the cause is determined and controlled. The sooner the diagnosis is made and treatment is started, the greater the chance that nerve damage can be slowed or repaired. Recovery, if its possible, usually takes a very long time — from months to even years. Some people live with a degree of neuropathy for the rest of their lives.
Trauma Repetitive Stress And Inflammation
Sometimes an injury or swelling can damage or put pressure on one or more nerves, disrupting its functioning and leading to neuropathy. If an individual, for instance, has some kind of trauma to the spine, then that can cause damage and injury to either peripheral nerves or the spinal cord and result in neuropathy, explains Vernon Williams, MD, a sports neurologist who is director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. If an individual has an injury to areas near the knee, then they may have a neuropathy that involves the peroneal nerve and develop pain, weakness, numbness or tingling in that particular nerve. Edema or swelling can affect nerve functioning as well, he adds.
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How Can I Prevent Neuropathy
The best treatment is prevention, and strategies for reducing injuries are highly effective and well tested. Since medical procedures ranging from casting fractures to injuries from needles and surgery are another cause, unnecessary procedures should be avoided. The new adjuvanted vaccine against shingles prevents more than 95 percent of cases and is widely recommended for people over 50, including those who have had previous shingles or vaccination with the older, less effective vaccine. Diabetes and some other diseases are common preventable causes of neuropathy. People with neuropathy should ask their doctors to minimize use of medications that are known to cause or worsen neuropathy where alternatives exist. Some families with very severe genetic neuropathies use in vitro fertilization to prevent transmission to future generations.
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Matthew Villani, doctor of podiatric;medicine at Central Florida Regional Hospital in Sanford, Florida, explains that these symptoms arise because the nerves are being encapsulated by the sugar, which causes the conductive properties of the nerves to slow down or be altered, so that the electrical impulses to the nerves arent functioning properly.
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Black And Hispanic People And Neuropathy
Determining which racial and ethnic groups experience neuropathy the most may be complicated by the type of neuropathy, as well as the differing ways that people communicate their pain to others, including their healthcare providers.
The FDA reports that American Indians/Alaska natives , Hispanics , Black people and Asian Americans have higher rates of diabetes than white people .
Yet in a December 2017 study of more than 1,900 people who had painful diabetic peripheral neuropathy symptoms, which was published in Clinical Diabetes and Endocrinology, Black and Hispanic participants were less likely than white participants to rate their pain as moderate or severe. Also, significantly fewer Black and Hispanic individuals reported having received a painful diabetic peripheral neuropathy diagnosis. However, higher proportions of those who were Black and Hispanic reported difficulty communicating with their healthcare provider about their pain symptoms, and feeling less comfortable about doing it. They were also younger, on average, than white participants. Researchers said more research in diverse populations is needed to understand the disparities.
However, a November 2015 study published in Clinical Cancer Research found that women of African descent being treated for breast cancer with specific chemotherapy drugs known as taxanes were more likely to report painful neuropathy symptoms than women of European descent.
Use A Capsaicin Cream
Hot peppers may leave your mouth on fire, but their active ingredient — capsaicin — might relieve some of the burning and pain of nerve damage. A study published in the journal Pain showed that wearing an 8% capsaicin patch reduced pain levels by 30% after 2 weeks.
Only your doctor can give you a higher-dose patch. But research shows that lower-dose, over-the-counter cream — about 0.1% capsaicin — may also help. It could reduce pain intensity by 11% more than a placebo cream.
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The Peripheral Nervous System
The;peripheral nervous system is the network of nerves that lie;outside the central nervous system .
It includes different types of nerves with their own specific functions, including:
- sensory nerves responsible for transmitting sensations, such as pain and touch
- motor nerves responsible for controlling muscles
- autonomic nerves responsible for regulating automatic functions of the body, such as blood pressure and bladder function
Joining A Neuropathy Support Group Can Help
They say that experience is the mother of all wisdom, so what better way to learn about neuropathy than to join others who have been living with it for years?
Joining a support group or online forum can give you insights into living with neuropathy that you might not find elsewhere.
They are also safe environments to ask questions and learn what experience others have had with various medications, treatments, and therapies.
To find a support group near you, the Neuropathy Support Network has a useful support group search tool. In addition to local support groups, there are a handful of online support groups or forums.
For finding information and support online, check out these 10 Resources Every Neuropathy Sufferer Should Bookmark.
Life with neuropathy can be painful, overwhelming and frustrating.
As with anything, the more experience one has the more wisdom and insight he or she will gain into how to better cope with the hand that has been dealt with.
For me, the process has been gradual and frustrating but Ive learned many things that have resulted in small yet meaningful changes to make the road a little smoother. What things do you wish you had known about neuropathy when you were first diagnosed?
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Diagnostic Criteria For Prediabetes And Mets
Prediabetes represents the earliest stage of glucose dysregulation, and precedes the development of overt type 2 diabetes. Prediabetes can be divided into impaired fasting glucose or impaired glucose tolerance . The American Diabetes Association defines prediabetes as a hemoglobin A1c of 5.76.4%. Prediabetes can be separated into IFG and IGT using a 2h oral glucose tolerance test . After measurement of a fasting plasma glucose early in the morning , the patient is given 75 g of oral anhydrous dextrose, and the glucose is repeated 2 h later. A fasting plasma glucose of 100125 mg/dL defines IFG, and a 2h oral glucose of 140199 mg/dL defines IGT. The diagnosis of diabetes requires a hemoglobin A1c of >6.5%, a fasting glucose >126 mg/dL or a 2h glucose of >200 mg/dL . It is worth noting, nevertheless, that the 2h OGTT has been noted to have reduced reproducibility in diagnosing patients with IGT as compared with diabetes patients and normoglycemic patients . Repeat testing should be considered to confirm the diagnosis. The prevalence of IFG and IGT varies internationally by ethnicity, with IFG being generally more common among men. It is expected that up to 472 million adults worldwide will have IGT by 2030, with the greatest anticipated rise in southeast Asia and the western Pacific.
Symptoms Of Diabetic Neuropathy
Symptoms of neuropathy usually appear gradually over a long period of time. The first type of nerve damage starts to occur in the nerves of the feet. This can lead to feelings of pain in the feet. The painful sensation often feels similar to the pain caused by âpins and needlesâ. Depending on the area affected by neuropathy, the symptoms of neuropathy can vary. Common symptoms and signs among the various types of Diabetic Neuropathy include:
- Sensitivity to Touch
- Muscle Weakness
- Loss of Balance
Wounds often take more time to heal due to the poor blood circulation of diabetes patients. Some people experience these symptoms at night more often than daytime.
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What Causes Nerve Damage
Nerve damage is the result of high levels of blood glucose over long periods of time. It isnt entirely clear why high glucose levels damage nerves.
A number of factors may play a role in nerve fiber damage. One possible component is the intricate interplay between the blood vessels and nerves, according to the Mayo Clinic.
Other factors include high blood pressure and cholesterol levels and nerve inflammation.
Diabetic peripheral neuropathy usually first appears in the feet and legs, and may occur in the hands and arms later.
Can Prediabetes Cause Neuropathy
Neuropathy can be found developing eventually in approximately 50% of all diabetes patients. What about in prediabetes?;
Diabetic polyneuropathy is the most common neuropathy in the Western world, developing eventually in approximately 50% of all diabetes patients. DPN is most commonly characterized by a progressive loss of distal sensation correlating with loss of sensory axons, followed, in severe cases, by motor weakness and motor axonal loss.
As with most complications of diabetes, duration and severity of hyperglycemia is directly correlated with degree of symptomatology. However, given that up to 18% of patients with newly diagnosed diabetes already have symptoms of pain in their lower extremities, is DPN occurring during the prediabetic stage?
When attempting to answer this question, its enlightening to look at the relationship between DPN and impaired glycemia . IG characterizes the prediabetic stage, and includes impaired fasting glucose and/or an abnormal oral glucose tolerance test . The correlation of DPN with IG is important for two reasons; it could potentially alter how the diagnosis of diabetes should be made and it would provide a reason to treat IG with medications versus the currently recommended approach of lifestyle change alone.
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You Often Forget To Check Your Sugar
Uncontrolled blood sugar is poison for peripheral nerves. Theres really no other way to put it. Although its not the;only;mechanism contributing to neuropathy, its a big one.
As a result, managing your diabetes and keeping your blood sugar within a healthy range is really critical for preserving nerve health. If you frequently forget to test your sugar or dont manage your diabetes well, your neuropathy is likely to get worse.
This process happens gradually over time, which is why so many people underestimate the danger until their nerves are in critical condition. Dont let this be you!
You Dont See Your Foot Doctor At Least Once Per Year
This is not so much a cause of worsening neuropathy as it is a failure to prevent it, but its definitely worth mentioning here because it is a huge mistake that many people make.
One of the most insidious things about neuropathy is that, for some people, it can be almost asymptomaticuntil it isnt. By the time you even start to notice something might be wrong, it could already be really wrong, and you may have already missed your ideal window to stop and reverse it.
But when you check in regularly with a foot doctor who specializes in diabetic foot care and neuropathy screening, they can often help you detect the early signs of nerve damage faster than you could on your own, and that can buy you a lot of precious time to sidestep the most severe complications before its too late.
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How To Manage Numbness Tingling And Other Sensory Symptoms Of Ms
Across a wide range of causes, the symptoms of neuropathic pain tend to be similar, says;Vernon Williams, MD, a sports neurologist and director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles.
The character and quality of neuropathic pain tends to be pain thats burning or electric in character,” says Dr. Williams.
Additionally, he says, the pain will often be associated with other symptoms, such as:
- Paresthesia
- Allodynia
- Hyperalgesia .
Why Is Foot Care So Important
Peripheral neuropathy makes the foot incredibly vulnerable hence foot care and general;skin care is very important.
Because one of the signs of neuropathy is a loss of feeling, feet should be checked daily for cuts, sores, blisters, bruises and cracked or dry skin. If you notice anything unusual, get to your doctor as soon as possible.
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Neuropathy Can Affect Autonomic Functions
Another group of nerves that can be affected by neuropathy is the autonomic nerves.
The autonomic nervous system is a division of the peripheral nervous system that influences various internal organs such as the heart, stomach, liver, adrenal gland and more.
Damage to the autonomic nerves disrupts the signals sent from the brain and spinal cord to these various organs sometimes resulting in a disruption to the involuntary functions these organs are involved in.
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Here are the most common organs affected by damage to the autonomic nerves and the symptoms generally associated with them:
Treating The Underlying Cause
There are many different possible causes of peripheral neuropathy, some of which can be treated in different ways. For example:
- diabetes can sometimes be controlled by lifestyle changes, such as stopping smoking, cutting down;on alcohol, maintaining a healthy weight and exercising regularly
- vitamin B12 deficiency can be treated with B12 injections or tablets
- peripheral neuropathy caused by a medication you’re taking may improve if the medication is stopped
Some less common types of peripheral neuropathy may be treated with medication, such as:
- corticosteroids; powerful anti-inflammatory medication
- immunosuppressants; medications that reduce the activity of the immune system
- injections of immunoglobulin; mixture of blood proteins called antibodies made by the immune system
However, the underlying cause may not always be untreatable.
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How Is Neuropathy Diagnosed
There are a number of ways in which neuropathy can be diagnosed, says Williams. Generally the process will start with your physician taking down a patient history that includes a description of your complaints, as well as a physical examination to check the functioning of the area in question.
After that, tests may be ordered. Williams and the Foundation for Peripheral Neuropathy describe the following types of common tests:
Electrodiagnostic Testing;These include electromyography and nerve conduction testing, where nerves are stimulated and their responses are recorded and analyzed for abnormalities.
Needle Examinations;Small needles are inserted into individual muscles to get audio and visual information on how the nerves supplying that muscle are functioning.
Blood Tests;These can be ordered to check for elevated blood sugar , toxins, vitamin deficiencies, hereditary disorders, and evidence of an abnormal immune response.
Skin Biopsies;A small incision is made to remove a sample of skin for examination. It may help to distinguish certain disorders affecting the small nerve fibers, such as painful sensory neuropathies affecting nerve fibers called axons.
Quantitative Sensory Testing ;Used to assess damage to the nerve endings involved in sensing temperature and vibrations, QST uses computer testing to measure how the nerves in question react to these stimuli.
Common Ways You May Be Making Your Neuropathy Worse
The lifestyle changes you need to make in order to slow or stop the progression of your neuropathy arent necessarily difficult, but you do need to go about them in a comprehensive and disciplined way. There are many potential pitfalls, and if you want to avoid them, you need to know what they are in the first place. The last thing you want is to unwittingly put your feet at risk simply because you didnt know any better!
The rest of this blog post will go over some of the most common mistakes people make when managing their neuropathy, but first an important caveat: it is not a substitute for seeking a professional evaluation! If you are experiencing the symptoms of neuropathy and havent yet visited our office for a comprehensive evaluation and treatment plan, please contact us today.
Now, without further ado, heres what to watch out for.
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What Are The Most Common Signs Of Neuropathy
It is important to be on the lookout for common, early signs of neuropathy, particularly if you suffer from a condition that has been tied to nerve damage. Some of those at highest risk are those who have or have suffered from:
- Diabetes, both type-1 and type-2
- HIV
- Chemotherapy
- Certain cancers
Accidents, trauma, infections, and vitamin deficiencies can also lead to nerve damage. Additionally, if you are a smoker or heavy drinker, your chances of developing neuropathy are higher than that of the average population.