Although references to “nerve-originated pain” were present in Persian medical writings dating back to the 9th-12th century, a lot about neuropathy remains uncovered to this day.
After all, there are 43 pairs of nerves responsible for transmitting signals between the body and the spinal cord or brain. So, it is easy to see how damage to the peripheral nervous system can lead to a cascade of symptoms and impact daily activities such as moving, touching, or even digesting.
So, if you are overwhelmed by pain, unfamiliar sensations, and impaired body functions deriving from nerve damage, you are certainly not alone. Fortunately, there is a lot that you can do to better understand peripheral neuropathy and find the best treatment for your needs – starting with evaluating your symptoms. Here is what you need to know.
Peripheral neuropathy is peripheral nerve damage as a result of underlying conditions. However, peripheral neuropathy is one of the most enigmatic conditions because there are dozens of causes and symptoms that also range from mild to severe.
It is crucial that patients experiencing peripheral neuropathy understand the signs and what they can do to alleviate their symptoms.
What Is Peripheral Neuropathy?
It is estimated that around 2.4% of the global population is affected by neuropathy – a prevalence that increases to 8% among older individuals.
But what is neuropathy? And why is treating it still considered clinically challenging?
Let’s start by clarifying that peripheral neuropathy, a phrase that derives from the Greek terms for “nerve” (neuron) and “condition” (pathos), describes a wide range of conditions that arise when the nerves outside of the brain and spinal cord become damaged.
The nervous system has two main components:
- The central nervous system (CNS)
- The peripheral nervous system (PNS)
The CNS is composed of the nerves in the brain and spinal cord, while the PNS accounts for all of those nerves outside of the CNS, which act as conduits between the different body parts and the brain.
The main function of the PNS is to transfer messages from the limbs, organs, and muscles to the brain. This function is fulfilled via three types of nerves that radiate from the spinal cord:
- Motor nerves – Motor nerves are in charge of transmitting motor signals to the brain, and they control muscle movements.
- Sensory nerves – Sensory nerves transmit sensations from the skin to the brain, including temperature, pain, and vibrations.
- Autonomic nerves – These nerves control the functioning of automatic processes, such as breathing, digesting, or sweating.
If one or more of the nerves in the peripheral nervous system become damaged or worn down, you’ll begin to experience symptoms such as pain, discomfort, tingling, numbness, and unfamiliar sensations (i.e.: excessive sweating).
Which Parts Of The Body Are Affected?
What parts of the body are affected by neuropathy and the type of symptoms you’ll experience will entirely depend on the type and location of the damaged nerves.
For example, if the nerves in charge of transmitting motor signals to the brain are damaged, you might experience spasms, muscle weakness, and a reduced ability to control movements. In severe cases, untreated neuropathy can also lead to muscle atrophy (the shrinking of muscles) and paralysis.
If the injury or damage affects sensory nerves, you’ll begin to notice unfamiliar sensations, such as tingling, and numbness, which indicates that the sensory signals traveling to the brain have been inhibited. This type of neuropathy can also cause you to feel pain in response to stimuli that should normally feel painless, or be incapable of feeling pain when you should.
Although rarer, damage to autonomic nerves can cause automatic processes to break down, which can translate to digestive issues, erratic heartbeat, excessive sweating, spikes in blood pressure, and the loss of control over bladder or bowel function. In people with diabetes, the prevalence of cardiovascular autonomic neuropathy (CAN) can range between 2.5% and 90%.
The area or areas of the body where you’ll experience these symptoms depend on where the damaged nerve is located.
Which Conditions Lead To Peripheral Neuropathy?
One of the main reasons why it remains challenging to treat neuropathy is that this condition can have several causes and risk factors. What’s more, up to 30% of patients live with idiopathic neuropathy, meaning that their nerve damage has no known cause.
Nonetheless, some diseases and health events can increase the risk of neuropathy, including the ones below.
Diabetes/Metabolic Problems
It is estimated that over 50% of diabetic patients will develop neuropathy, making type 1 and type 2 diabetes the leading risk factor for nerve damage. Diabetic peripheral neuropathy is mainly caused by inadequately controlled blood sugar levels. Spikes and drops in blood glucose can damage the blood vessels responsible for delivering essential nutrients and oxygen to the surrounding nerves, thus leading to the loss of nerve fibers.
The likelihood of developing neuropathy, if you have diabetes, increases nearly five-fold if your blood sugar levels aren’t properly managed over long periods.
Other metabolic disorders might also lead to a type of neuropathy called dysautonomia, or metabolic neuropathy. This condition affects the autonomic nerves in the PNS and can lead to complications such as irregular heartbeat and blood pressure, excessive sweating, and abnormal functioning of the eyes’ pupils.
Injuries
Direct trauma can damage nerves and sever their connection to the spinal cord or the brain. This leads to numbness, paralysis, and the inability to feel sensations in the affected limb or another part of the body.
Nerve damage can also be caused by injuries to areas of the body surrounding the nerve. For example, you might begin to experience tingling and numbness in your arms and hands if you suffer from cubital tunnel syndrome or have reported an injury to the elbow. This is because torn ligaments, ruptured tendons, fractures, and inflammation can put excessive pressure on nearby nerves.
Infections
Neuropathy is a common complication in people battling infections caused by viruses and bacteria. For example, in patients with HIV/AIDS, the prevalence of nerve damage is as high as 60%.
In this case, neuropathies arise because the high levels of inflammation in the body during the early stages of the disease have a detrimental effect on the myelin, or the protective coat around nerves (demyelinating neuropathy).
Genetic Causes
Some autoimmune diseases such as lupus, rheumatoid arthritis, Guillain-Barre syndrome, and Sjogren’s syndrome can cause nerve damage. In the case of Charcot-Marie-Tooth disease, neuropathy can also be a hereditary disorder. This disease affects an estimated 126,000 people in the U.S. and 2.6 million worldwide, and it can lead to impaired motor and sensory nerves.
Toxins
The toxins contained in certain foods, alongside some chemicals and heavy metals, can cause nerve damage in patients who are exposed to them for long periods. These chemicals include lead and mercury.
However, common toxins that can increase the risk of demyelinating neuropathy are the ones contained in alcohol and nicotine.
These substances degrade the sheath that protects nerves from damage, contribute to nutritional deficiencies, and make it more difficult for patients with diabetes to control their blood sugar levels.
However the opposite is also true, you might develop nerve damage if you consume too much of some vitamins, such as B6 and B12.
What Are The Common Symptoms Of Peripheral Neuropathy?
Approximately 20 million Americans are diagnosed with peripheral neuropathy. But, despite how widespread this condition is, no two people will experience the same symptoms.
That is because there are 43 pairs of nerves that make up the peripheral nervous system – 12 pairs radiating from the cranial opening and 31 pairs radiating from the spinal cord – which connect to over 7 trillion nerve endings. And, any of them can be affected by peripheral neuropathy.
Additionally, the underlying cause of neuropathy can determine whether the nerve damage is permanent or temporary (such as in the case of neuropathy caused by chemotherapy), and how severe the degeneration will be.
Understanding the symptoms you are experiencing is the first step to finding the best type of treatment for your needs, preventing further complications, and addressing the underlying cause of nerve damage. Let’s start by looking at the most common symptoms of neuropathy, in order of prevalence.
1. Pain In Hands And Feet
One of the most common symptoms of neuropathy, and the earliest telltale sign of nerve damage, is a pain in the hand and feet. The discomfort can increase in intensity over time, and it is often accompanied by sensations such as tingling and pins and needles. If left untreated, the pain can begin to radiate through the forearms, ankles, and legs.
The reason why hands and feet are the first parts of the body to be affected can be found by looking at a phenomenon called “dying-back” neuropathy – or the principle that shows how neuropathy is dependent on the length of nerves.
This means that the longest nerves in the body are the first ones to be affected, and they tend to “dye back” towards the spinal cord or cranial opening. Since the nerves in your hand and feet are the furthest ones from the spinal cord, they are also the longest ones in the body and the first ones to be affected.
Additionally, because of the complex infrastructure of nerves and receptors throughout the body, you might experience pain in the hand and feet even if your extremities are not directly affected. This can happen, for instance, if connected tissue in your shoulders, knees, or elbows is affected by injury, trauma, inflammation, or degenerative diseases.
The hand and feet are packed with both motor and sensory nerves, which means that damage to these nerves can lead to experiencing unfamiliar sensations, changes in how you experience cold or heat, or even mobility issues.
Although pain in your extremities is the first and most common indicator that you might have nerve damage, this symptom often appears in combination with other signs. Let’s look at them below.
2. Cramps
Cramps are a common complaint among people with neuropathy, especially because uncontrolled muscle movements can disrupt sleep and lead to sudden discomfort. As a form of neuropathic pain, cramps are caused by improper signaling, which interferes with the messages that should travel from motor nerves around the body to the brain.
In turn, the damaged nerves can excite the intramuscular nerves, which cause the surrounding muscles to fire up spontaneously or discharge suddenly, leading to cramps.
A 2013 study has shown that 60% of patients with this symptom and no other neuropathic symptoms had small fiber sensory neuropathy (SFSN), which only affects the small cutaneous nerves.
3. Spasms
Muscle spasms and uncontrollable twitching are telltale signs that motor nerves have been affected. When the connection between the brain and intramuscular nerves is interrupted, these nerves will become hyperactive on their own and without a known cause.
This can lead to uncontrolled muscle movements which, over time, can affect a patient’s ability to carry out normal daily activities and professional tasks. In the long term, neuropathy can also lead to disability.
Rarer complications of neuropathy that share similar mechanisms to the ones of muscle spasms include:
- Painful legs and moving toes (PLMT) – PLMT is a type of neuropathic pain syndrome that affects a person’s ability to control the movements of their lower limbs, especially their feet, and toes.
- Fasciculations – Fasciculations are contractions of the muscle fibers that happen spontaneously and intermittently. These spontaneous twitches are caused by sporadic dischargers of motor nerves and are visible under the skin.
4. Burning Sensation
Neuropathy is most commonly associated with a burning sensation, which is a sign that sensory nerves have been affected and no longer transmit signals to the brain as they should.
In particular, a burning sensation can indicate that the neuropathy has extended to the free nerve endings and receptors in the epidermis. When this happens, the nerve fibers become overactive and begin to send signals of pain and burning to the brain, even though there is no wound or fire.
Similarly, if these sensory nerves are damaged, you might feel pain in response to stimuli that should normally be painless or heightened sensations of hot or cold. These sensations often begin in the hands and feet, and it isn’t common for neuropathic patients to also suffer from hyperesthesia, or hypersensitivity to touch.
Sensory neuropathy is also one of the main causes of burning feet.
5. Loss of Feeling
Although numbness is a symptom shared among many conditions, it is most commonly associated with nerve damage. The loss of feeling can be either partial or complete, and it often begins in the hands and feet when the connection between sensory nerves and the brain is severed. Numbness is also a leading complication in diabetic peripheral neuropathy.
Although a mild loss of feeling in the toes or fingers might not be immediately serious, it is important not to underestimate this condition. Indeed, if left untreated, it can begin to spread to the hands, feet, and limbs, and cause a myriad of consequences.
Some examples include:
- If you are unable to feel pain, you might not notice a wound or infection in the foot, which can turn into ulcers and, in severe cases, lead to gangrene and limb amputation.
- If you can’t feel your feet, you might struggle to position them while walking or running, which can make injuries such as sprains more likely.
- You might accidentally expose your numb extremities to extreme heat or cold, which can cause severe damage.
6. Trouble Sleeping
Neuropathic pain can have a profound impact on all aspects of a person’s life, starting with affecting their sleep quality and duration.
In particular, neuropathy can cause involuntary muscle spasms that can wake you up during the night. Additionally, neuropathic pain tends to become more intense and noticeable when distractions are not present, such as when you are getting ready for sleep.
What’s more, the unfamiliar sensations and extreme sensitivity to touch can make it more difficult to fall asleep, which can lead to sleep deprivation. In turn, a lack of sleep can kickstart a vicious circle that involves fatigue, loss of productivity, and the worsening of neuropathic pain.
7. Loss of Balance
Loss of balance and impaired coordination are typical symptoms of nerve damage simultaneously affecting sensitive, motor, and autonomic nerves. This happens because of the multiple complications of neuropathy, which include:
- Nerve damage severs the connection between sensory nerves and the brain, thus inhibiting important signals regarding the body’s positioning in the surrounding space. Because of this, you might notice yourself bumping into objects when walking.
- Sensations used by the brain to keep track of the position of hands and feet no longer reach the brain, thus causing clumsiness and loss of balance. For example, dropping things can be a sign that the nerves in the hands or fingers have been damaged.
- Neuropathic pain can affect the gait and movements of the ankle, foot, and arms. In turn, you might notice an uneven walking pattern or difficulty climbing stairs.
- Unprovoked twitching, spasms, and cramps can make it harder to maintain balance. These involuntary movements can happen without warning and might affect your stability while walking or running.
This symptom is more common among aging patients and can be a severe cause for concern for patients who already have weakened muscles or mobility issues because it can lead to an increased risk of falls and injuries.
8. Difficulty Standing From A Low-Seated Position
As we have seen above, neuropathy can manifest itself with a wide range of symptoms, which can vary in intensity and type from one patient to another. One of the less common symptoms is an intensifying difficulty in standing up from a low seated position.
Multiple factors come into play when you are experiencing this neuropathic symptom. Firstly, neuropathy can affect balance, thus making it challenging to stand up without using handrails or other mobility tools.
Additionally, motor neuropathy can cause the weakening and shrinking of muscles. Especially among older adults, this can contribute to muscle atrophy, reduced range of motion, and inability to bear weight on your legs and feet.
If you are experiencing this symptom, strengthening your muscles becomes paramount to prevent injuries and maintain an active and independent life.
How To Treat The Symptoms Of Peripheral Neuropathy
Regardless of the cause of a patient’s peripheral neuropathy, there are several treatments to address its frustrating symptoms and complications.
In the case of diabetic peripheral neuropathy, the cause is due to insulin imbalances and resulting blood sugar levels, in a complex interaction that is beyond the scope of this writing.
While patients work to control their diabetes and related symptoms, patients may also wonder what steps they can take in managing the complications associated with peripheral neuropathy.
Some patients may also choose to undergo expensive surgery to address the pain. Other, more simple solutions include the use of pain-relievers such as acetaminophen or ibuprofen or soaking the affected areas in cold water for a short period of time.
However, solutions for peripheral neuropathy may be both simple and lasting.
Treatment sessions with electroanalgesia offered through Neuragenex often result in immediate and long-lasting solutions to the conditions of peripheral neuropathy.
Patients express relief from the pain but also the peace of mind that they do not need to rely on potentially addictive medications that have less than desirable side-effects, or the stress and fear of surgeries and invasive implanted medical devices.
We Can Help You Manage The Pain From Peripheral Neuropathy
With over 100 different neuropathies, each with their own symptoms and causes, there is no doubt that finding the right treatment for your nerve pain and damage can be challenging.
However, if you suffer from diabetes or you have noticed the early symptoms of neuropathy, it is important to have a clear understanding of the telltale signs and prognosis of this condition.
Having a clear idea of what neuropathy is and how it can affect your life can help you make the best decision when it comes down to choosing a treatment and taking the first step towards recovery.
