What is Neuropathy?

What is neuropathy?

Neuropathy is damage or dysfunction of one or more nerves that typically results in numbness, tingling, muscle weakness, and pain in the affected area. Neuropathies frequently start in your hands and feet, but other body parts can also be affected.

Neuropathy, often called peripheral neuropathy, indicates a problem within the peripheral nervous system. Your peripheral nervous system is the network of nerves outside your brain and spinal cord.

How does neuropathy feel?

If you have neuropathy, the most commonly described feelings are sensations of numbness, tingling (“pins and needles”), and weakness in the area of the body affected. Some people also say sharp, lightning-like pain; or a burning, throbbing, or stabbing pain.

What are the symptoms of neuropathy?

Common signs and symptoms of neuropathy include:

• Tingling (“pins and needles”) or numbness, especially in the hands and feet. Sensations can spread to the arms and legs.
• Sharp, burning, throbbing, stabbing, or electric-like pain.
• Changes in sensation. Severe pain, especially at night. Inability to feel pain, pressure, temperature, or touch. Extreme sensitivity to touch.
• Falling, loss of coordination.
• Not being able to feel things in your feet and hands – like wearing socks or gloves when you’re not.
• Muscle weakness, difficulty walking or moving your arms or legs.
• Muscle twitching, cramps, and spasms.
• Inability to move a part of the body (paralysis). Loss of muscle control, loss of muscle tone, or dropping things out of your hand.
• Low blood pressure or abnormal heart rate causes dizziness when standing up, fainting, or lightheadedness.
• Sweating too much or not enough with the temperature or degree of exertion.
• Problems with bladder (urination), digestion (including bloating, nausea/vomiting), and bowels (including diarrhea and constipation).
• Sexual function problems.
• Weight loss (unintentional).

What causes neuropathy?

A single disease does not cause neuropathy. Many conditions and events that impact health can cause neuropathy, including:

• Diabetes
• Trauma: Injuries from falls, car accidents, fractures, or sports activities can result in neuropathy. Compression of the nerves due to repetitive stress or narrowing of the space through which nerves run are other causes.
• Autoimmune disorders and infections
• Other health conditions: Neuropathy can result from kidney disorders, liver disorders, hypothyroidism, tumors (cancer-causing or benign) that press on nerves or invade their space, myeloma, lymphoma, and monoclonal gammopathy.
• Medications and poisons: Some antibiotics, some anti-seizure medications, and some HIV medications, among others, can cause neuropathy. 
• Vascular disorders
• Abnormal vitamin levels and alcoholism: Proper levels of vitamins E, B1, B6, B12, and niacin are essential for healthy nerve function. Chronic alcoholism, which typically results in a lack of a well-rounded diet, robs the body of thiamine and other essential nutrients needed for nerve function.
• Inherited disorders: Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuropathy. CMT causes weakness in the foot and lower leg muscles and can also affect the muscles in the hands. Familial amyloidosis, Fabry disease, and metachromatic leukodystrophy are other inherited disorders that can cause neuropathy.
• No known cause

How is it diagnosed?

• History and physical exam
• Neurologic exam
• Blood work and imaging tests
• Genetic testing
• Electrodiagnostic assessment (EDX): Your doctor might send you to a nerve specialist for an EDX to find the location and degree of nerve damage. EDX includes two tests:
  • Nerve conduction study (NCS)
  • Needle electromyography (EMG)
• Tissue biopsies
• Other tests: Other tests include a test to measure your body’s ability to sweat (called a QSART test) and other tests to check the sensitivity of your senses (touch, heat/cold, pain, vibration).

Is there treatment for neuropathy?

Treatment begins by identifying and treating any underlying medical problem, such as diabetes or infections.

Some cases of neuropathy can be easily treated and sometimes cured. Not all patients with neuropathy can go back to normal; however, treatment aims to manage symptoms and prevent further nerve damage. Treatment options include the following:

• Medicines
• Physical therapy
• Occupational therapy
• Surgery
• Mechanical aids, such as braces and specially designed shoes, casts, and splints, can help reduce pain by providing support or keeping the affected nerves in proper alignment.
• Proper nutrition
• Adopting healthy living habits

Other treatments

• Transcutaneous electrical nerve stimulation (TENS)
• Immune suppressing or immune modulating treatments (IV infusion treatments is an example)
• Complementary therapies: (Acupuncture is an example)

What does City Health Services have to offer neuropathy patients?

We have a tailored treatment protocol for each person. Neuropathy isn’t a “one-size-fits-all.” Learn more about our protocol and the list of treatments we integrate.