Peripheral Neuropathy

Topic Overview

What is peripheral neuropathy?

Peripheral neuropathy is a problem that affects the peripheral nerves. These are the nerves that control your sense of touch, how you feel pain and temperature, and your muscle strength. Most of the time the problem starts in the fingers and toes. As it gets worse, it moves into the limbs, causing pain and loss of feeling in the feet, legs, and hands.

When you have peripheral neuropathy, you may have less feeling in your fingers and toes. You may have trouble with your balance. It may be hard to do things that require coordination, such as walking or fastening buttons.

What causes peripheral neuropathy?

Doctors don't always know what causes peripheral neuropathy. It is often caused by other health problems. It can also run in families.

The most common cause is diabetes. Having your blood sugar too high for too long a time can damage the nerves.

Other problems can also cause peripheral neuropathy, such as:

• Kidney problems. These can lead to toxic substances in the blood that damage nerves.
• Vitamin deficiencies and alcoholism. Not getting enough nutrients, such as vitamin B-12, can damage nerves. Overuse of alcohol and not eating a healthy diet can lead to these vitamin deficiencies.
• Infectious or inflammatory diseases, such as HIV or Guillain-Barré syndrome. These diseases can damage the central and peripheral nerves.
• Exposure to toxic substances, such as arsenic, or by certain medicines such as those used for chemotherapy.

What are the symptoms?

Symptoms can occur slowly over time. The most common ones are:

• Numbness, tightness, and tingling, especially in the legs, hands, and feet.
• Loss of feeling.
• Burning, shooting, or stabbing pain in the legs, hands, and feet. Often the pain is worse at night.
• Weakness and loss of balance.

How is peripheral neuropathy diagnosed?

It can be hard to diagnose peripheral neuropathy, because symptoms can vary. People who have diabetes need to get a complete foot exam every year. During the foot exam, the doctor will check for signs of this peripheral neuropathy.

Your doctor will start by asking questions about:

• Your symptoms.
• Your medical history, including use of alcohol, risk of HIV infection, or exposure to toxic substances.
• Your family's medical history, including nerve disease.

Your doctor may also test your muscle strength and ability to feel touch, temperature, and pain. These tests include electromyography and nerve conduction tests.

You may also have blood tests to find out if you have diabetes, vitamin deficiencies, thyroid disease, or kidney problems that might cause neuropathy.

How is it treated?

The focus of treatment for peripheral neuropathy is to relieve symptoms by treating the health problem that's causing it. For example, vitamin deficiency caused by overuse of alcohol can be treated by eating a healthy diet, taking vitamin supplements, and stopping alcohol use. If you have diabetes, controlling your blood sugar can slow neuropathy and may improve it.

You may have physical therapy to increase muscle strength and help build muscle control. Over-the-counter medicine can relieve mild nerve pain. Your doctor may also prescribe medicine to help with severe pain, numbness, tingling, and weakness.

How can you care for yourself at home?

Adopting healthy habits can reduce the effects of peripheral neuropathy. Be sure to eat a balanced diet, get regular exercise, avoid alcohol, and quit smoking.

It's also a good idea to take care to avoid injury.

• When your feet or legs feel numb, it's easier to lose your balance and fall. At home:
  • Remove throw rugs and clutter.
  • Install sturdy handrails on stairways.
  • Put grab bars near your shower, bathtub, and toilet.
• To protect your hands:
  • Use pot holders, and avoid hot water when you are cooking.
  • Always check your bath or shower using a part of your body that can feel temperature normally, such as your elbow.
• Check your feet every day (or have someone else check for you) using this checklist:
  • Look at all areas of your feet, including your toes.
  • Use a handheld mirror or a magnifying mirror attached to the bathroom wall near the baseboard to inspect your feet.