What is Peripheral Neuropathy?
The peripheral nerves are long and cylindrical wire-shaped structures that help connect your brain and spinal cord (the central nervous system) to your muscles and skin in the periphery. This connection enables conduction of information from the central nervous system to the muscles to produce desired movements and actions virtually everywhere in the body, whilst also enabling transfer of information such as pain signals to the central nervous system.
Peripheral neuropathy is the result of some injury or trauma to the peripheral nerves, which could be due to various causes, leading to the malfunction of the nerves.
What are the symptoms and signs of peripheral neuropathy?
This depends on the type of peripheral nerve affected, whether it is a motor nerve (that controls the movement of muscles) or a sensory nerve (that controls sensitivity to pain, heat, touch and vibration) or an autonomic nerve (which controls skin temperature, color and sweating).
Some of the most common symptoms include:
- Burning pain in the feet or hands.
- Numbness in the feet or hands.
- Tingling sensation in the affected area
- Extreme sensitivity to touch
- Lack of coordination in the legs and falling.
- Coldness, discoloration and/or excessive sweating in the feet
- Muscle weakness in the feet or hands.
What are the common causes of Peripheral Neuropathy?
Some of the commonest causes include:
- This is the most common cause of peripheral neuropathy in the world
- Vitamins deficiency, including B1, B6, and B12
- Nerve entrapments such as Carpal tunnel syndrome.
- Metabolic disorders such as kidney disease.
- Autoimmune diseases, including Guillain-Barre syndrome, lupus, rheumatoid arthritis, and some types of vasculitis.
- Infections such as Lyme disease, leprosy, HIV.
- Medications, like chemotherapy treatments.
How is Peripheral Neuropathy diagnosed?
After eliciting your full medical history and conducting a proper neurological examination, your physician/neurologist will usually request some tests to confirm your condition and explore the possible underlying cause. Some of such tests will include:
- Nerve conduction study. This is usually one of the foremost tests that clarify the nature of your nerve disease and direct subsequent tests. This test is also useful for monitoring progress of treatment and progression of nerve disease over time. During this test, small amounts of electricity is applied to the skin overlying certain nerves and the responses are recorded over a distant muscle or area of skin.
- Electromyography (EMG). This test is usually performed in addition to nerve conduction study if the examiner considers that it would provide additional information to the information that has already been gathered during nerve conduction study. It involves inserting a tiny needle electrode through your skin into selected muscles to evaluate the electrical activity of your muscles both at rest and during contraction.
- Blood tests. These help to detect vitamin deficiencies, diabetes, infections, toxins or an abnormal immune system functioning that may underlie your condition.
What are the treatment options for Peripheral Neuropathy
The most important treatment goal is to mitigate the underlying condition causing peripheral neuropathy while also alleviating the associated symptoms.
Different medication options are available to your physician to choose from to treat disabling symptoms of pain, tingling, burning, etc. These range from oral medications to topical patches, creams and targeted injections such as nerve blocks.
A physical therapist will teach you some exercises to stretch your nerves/muscles and help relieve your pain. Also, you may be given splints to use at night especially in the case of carpal tunnel syndrome. Useful instructions will also be given to improve your posture avoid some physical activities that might otherwise make your condition worse.
Cases of nerve entrapments such as carpal tunnel syndrome may require surgical nerve release or decompression if conservative options fail. Direct traumatic nerve injuries may also require surgical exploration if recovery is adjudged to be too slow or to not be occurring at all.