Neuropathy refers to conditions involving damage to the nerves. Neuropathy may affect only one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy or mononeuropathy multiplex), or it can affect many or most of the nerves (polyneuropathy).
Signs and symptoms of neuropathy can range from mild to disabling and depend on the type of nerve fibers affected and the type and severity of damage. Symptoms can develop over days, weeks, or years.
17 Warning Signs of Neuropathy
Warning signs of neuropathy include:
- “Pins and needles” feeling
- Burning pain radiating in hands or feet
- Numbness and tingling
- Muscle weakness
- Pain when walking
- Problems walking
- Balance problems
- Knotted feeling in the soles of the feet and palms of the hands
- Pain from even a light touch
- Inability to grasp with the hands
- Painful cramps
- Fingers twisting and locking
- Pain when twisting the wrists
- Hands and feet feel tired or heavy
- Restless legs and feet
- Pain is worse at night
- Problems sleeping
Other symptoms of neuropathy may include:
- Uncontrolled muscle twitching (fasciculations)
- Muscle shrinking
- Diminished ability to feel vibrations and touch, especially in the hands and feet
- Loss of reflexes
- Loss of position sense
- Diminished ability to feel pain or changes in temperature
- Excess sweating
- Heat intolerance
- Inability to expand and contract the small blood vessels that regulate blood pressure
- Gastrointestinal symptoms
- Problems eating or swallowing (rare)
What Causes Neuropathy?
Neuropathy is caused by genetics or may be acquired, such as from the result of another disorder or condition. Sometimes, neuropathy has no known cause (idiopathic).
Causes or triggers of symptomatic acquired neuropathy include:
- Physical injury (trauma)
- Vascular and blood problems such as diabetes, smoking, and narrowing of the arteries from high blood pressure (hypertension or atherosclerosis
- Diabetes
- Alcoholism
- Systemic autoimmune diseases such as lupus, rheumatoid arthritis, and Sjögren’s syndrome
- Autoimmune diseases that attack nerves only such as Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy
- Hormonal imbalances
- Nutritional or vitamin imbalances (vitamin B12 deficiency and excess vitamin B6)
- Kidney and liver disease
- Exposure to toxins
- Certain cancers and benign tumors
- Chemotherapy drugs and radiation therapy used to treat cancer
- Infections including varicella-zoster virus (which causes chickenpox and shingles), human immunodeficiency virus (HIV), herpes simplex West Nile virus, cytomegalovirus, and Lyme disease
What Is the Treatment for Neuropathy?
Treatment for neuropathy depends on the type of nerve damage, symptoms, and location.
Treating the underlying cause of the neuropathy can resolve the problem, for example:
- Managing blood sugar in patients who have diabetes
- Controlling inflammatory and autoimmune conditions
Lifestyle changes that can help nerves recover and regenerate include:
- Not smoking
- Eating a balanced diet
- Maintaining a healthy weight
- Getting regular exercise
- Correcting vitamin deficiencies
- Avoiding toxic exposures
For motor symptoms of neuropathy, treatments may include:
- Splints for carpal tunnel syndrome
- Mechanical aids such as hand or foot braces to reduce physical disability and pain
- Orthopedic shoes or inserts to improve gait disturbances and prevent foot injuries
- In severe cases, tendon transfers or bone fusions to hold the limbs in better position or to release a compressed nerve
For autonomic symptoms of neuropathy, treatments may include:
- Complementary techniques such as:
- Massage
- Acupuncture
- Herbal preparations
- Cognitive behavioral therapy or other psychotherapeutic approaches
For sensory symptoms of neuropathy, treatments may include:
- Behavioral strategies to cope with chronic pain, anxiety, and depression, that may occur following nerve injury
Medications used to treat neuropathic pain are also used for other medical conditions and may include:
- Antidepressants including nortriptyline and serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine hydrochloride
- Epilepsy medications such as gabapentin, pregabalin, topiramate, lamotrigine, carbamazepine, and oxcarbazepine
- Local anesthetics and related drugs that block nerve conduction
- Narcotics (opioids) for pain that doesn’t respond to other pain-control medications
Surgery to treat some types of neuropathies such as:
- Protruding disks (“pinched nerves”) in the back or neck
- Trigeminal neuralgia on the face
- Injuries to a single nerve (mononeuropathy) caused by compression, entrapment, or rarely, tumors or infections
Transcutaneous electrical nerve stimulation (TENS) is a treatment that involves attaching electrodes to the skin at the site of pain or near associated nerves and then administering a gentle electrical current. TENS may improve neuropathic symptoms associated with diabetes.
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https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet
https://www.neuropathyreliefmiami.com/en/neuropathy/the-top-17-peripheral-neuropathy-warning-signs-and-symptoms/