Neuropathy

Peripheral Neuropathy

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Peripheral neuropathy refers to damage to nerves of the peripheral nervous system.  The most common cause of neuropathy is diabetes, although there area other several other causes including drug and alcohol use, some genetic disorders and exposure to toxic or hazardous materials in the work environment.  Interestingly, about half of the people with neuropathy symptoms have no identifiable cause - in many cases we simply don't know why some people have this problem.

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Signs and symptoms

There are many signs and symptoms of peripheral neuropathy the most common of which are burning pain, tingling and numbness.  Other sensations include a pins and needles sensation, electrical or sharp shooting pain or even an itching sensation.  Many of these sensations start in the tips of the toes and fingers and eventually work its way up the feet and legs or hands and arms.

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Some people even notice a tiredness, heaviness or a change in how they walk with these symptoms.  Their gait is less stable and may be associated with tremors, muscle cramps or twitching.  Others may notice other changes such as dry skin or a hot and cold sensation in the feet that bother them as well.

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Commonly, neuropathy pain may be more noticeable at night or the end of the day and may be associated with increased swelling of the feet and ankles.  The skin can becomes so hypersensitive that people may not want anything to touch the feet - especially at night.

 

Nerve Testing

Establishing a firm diagnosis of peripheral neuropathy is an essential part in treating this problem.  Many times either a peripheral neuropathy will go undiagnosed or  it may be that there is only one or two particular nerves or areas that may be having some localized problems.  It is important to know this difference.

If you are diabetic or have any suspected nerve problem, it is important to get a baseline study to see where or to what extent the problem may be occurring.  Nerve testing over several years can show progression or even improvement of neuropathy if done appropriately.  In this way treatment plans can be determined if they are working or not based on these studies.   Dr. Davis can recommend which form of nerve testing is right for you.

Click here for more details on Nerve Testing.

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Treatment

Contrary to what many people and even physicians may think, there are many forms of treatment that can be used for neuropathy.  The most common include:

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​Medications 

There are several prescription medications including Neurontin, Lyrica, Cymbalta and others that help control painful burning pain.

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Topicals 

These include both prescription and over the counter applications that can greatly decrease pain to localized areas.

Supplements:  Prescription (Metanx) and non-prescription (Neuremedy) and other natural supplements that can be bought in the health foot store can also be of great benefit.

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Electrical stimulation

TENS units or other electrical nerve stimulation devices can also be of great benefit.

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Physical Therapy

This may help those with gait, balance or walking problems.

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Other modalities:  Control of weight and swelling issues (compression stockings, meds), orthotics and excercising can also help significantly.

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Surgical nerve decompression

  This can be a good alternative to long term pain or symptom control of neuropathy -more information about Surgical Nerve Decompression can be found here.