Neuropathy is a condition that has a multitude of causes and symptoms, and it can greatly impact a person’s quality of life. Alla Al-Habib, M.D., a neurologist at Texas Neurology and Stroke Center in Allen, breaks down what exactly neuropathy is, its causes, and how it can affect someone diagnosed with it.
What is neuropathy?
“Neuropathy is a general term that is used for a peripheral nerve injury,” Al-Habib explains.
The peripheral nerves are located outside the brain and spinal cord.
“The peripheral nerves are particularly susceptible to injuries,” she adds. “These injuries can cause pain and motor or sensory deficits.”
In the U.S., neuropathy is fairly common—around 25% to 30% of people will develop it.
And who’s most at risk? Anyone can be affected, but it’s more common in older folks—those 65 and older.
Depending on the type of neuropathy someone has, it could develop slowly over time or it might come on quickly and intensely.
“For neuropathy, there are a wide variety of causes,” says Al-Habib. But the most common are diabetes and vitamin deficiencies.
Another common cause of peripheral nerve injury is from toxins like alcohol or chemical/poison exposure.
Physical injuries to the body (like from a car accident or a fall) can cause damage to nerves.
Infections such as HIV or Lyme disease may cause neuropathy, and inflammation from other conditions may contribute as well.
Patients who remain in the ICU for long periods of time are at a higher risk of developing neuropathy.
Certain autoimmune disorders like Guillain-Barre and rheumatoid arthritis are known to cause damage to the nerves, thus resulting in neuropathy.
Some less common causes of nerve damage include genetic and hereditary degenerative nerve diseases, like Charcot-Marie-Tooth disease.
The Neuropathy Action Foundation (NAF) states that sometimes an exact cause of neuropathy is not found. This type would be considered idiopathic and occurs in about 30% of patients.
Symptoms will vary depending on the cause of the neuropathy.
“Most commonly patients present with numbness and loss of balance, tingling and pain,” Al-Habib says.
According to the NAF, some individuals experience burning sensations and aching or stabbing pains in their limbs. Feelings of an electric current or shock may radiate through the legs and feet.
The NAF explains how some people with neuropathy experience what are called altered sensations. This can be defined as increased sensitivity to pressure—meaning small pain or light sensations hurt worse than they should or cause great discomfort.
Al-Habib describes how symptoms typically start in the toes and feet and become worse at night. As symptoms progress, the pain and tingling may move to the calves, and then eventually to the hands and forearms.
Sometimes neuropathy can cause symptoms elsewhere in the body other than the limbs. For example, some people experience urinary or gastrointestinal problems. Sweat glands can be affected by damaged nerves as well, leading to changes in how much sweat the body produces and how often.
“A neuropathy diagnosis needs a thorough history and a physical exam that usually gives guidance for what work up, labs, images, and electrodiagnostic studies might be needed,” Al-Habib states.
Electrodiagnostic tests are specific tests that show electrical activity within the body. Any activity that shows up on these tests can help your provider see the function of the nerves in the arms, legs, and feet.
Needles are used for these tests, and while they may cause discomfort for some people, they are completely safe. Your provider will instruct you on how to be the most comfortable during these tests.
The treatment prescribed will depend on the cause of neuropathy.
Al-Habib reveals a good place to start is by ensuring vitamin levels are within a proper range, focusing on nutrition, and avoiding toxins as much as possible.
Some medications like antidepressants and antiepileptics are helpful for reducing symptoms of neuropathy.
Physical and occupational therapies can aid in reducing symptoms and can teach new ways of movement that are more comfortable.
The NAF emphasizes exercise as a great treatment option. Choosing low-impact exercises like swimming or biking can minimize pain and improve your overall quality of life.
For those individuals whose neuropathy is localized to a small area, topical ointments can provide symptom relief.
Al-Habib adds that sometimes other treatments may be used like transcutaneous electrical nerve stimulation (TENS) or immune modulation therapy.
TENS uses electrical currents to treat pain. Immune modulation therapy uses a product containing antibodies and is administered through an IV to stimulate the immune system. It’s a beneficial treatment for neuropathy that’s caused by autoimmune disorders.
“[Some] patients show improvement with yoga, acupuncture, and massage therapy,” Al-Habib concludes.