Neuropathy

Neuropathic pain is an abnormal sensation that occurs when nerves are damaged or become dysfunctional causing a misfiring of pain signals to the brain. Neuropathic pain can be experienced as burning, aching, shooting, stabbing or electric shock-like pain. It is often intense, worse at night and may lead to disability. Due to alteration in nerve sensitivity, pain may even be brought on by mild stimuli such as a gentle touch or a cold breeze.

Peripheral neuropathy is a condition of nerve damage, usually in the lower extremities. It is a complication of uncontrolled diabetes, which results in diminished sensation, and decreased ability to feel pain and temperature in your feet. Because of this loss of sensation, you may not be aware of infections or trauma, and do not seek appropriate treatment and continue to walk. This can lead to Charcot neuropathy, a condition characterized by fragile bones that can break or dislocate even with minor forces.

Diagnosis

Diagnosis of neuropathy involves the exact detection of nerve damage and its cause, which may be difficult to diagnose. Your doctor will review your medical history and family history for neurological diseases, and will conduct physical and neurological examinations for muscle strength, sensation, posture and coordination.

Your doctor may order other tests including:

• Blood tests for vitamin, sugar and thyroid levels and liver and kidney function.
• Computed tomography (CT) scan or MRI to detect herniated disks or spinal tumors.
• Nerve function tests using electromyography to measure the electrical activity of the nerves.
• Nerve biopsy, in which a part of the damaged nerve is removed to test for abnormalities.
• Lumbar puncture to test cerebrospinal fluid in the lower back for signs of disease.

Treatment

The main aim of treatment is to control the underlying cause of neuropathy and manage pain. Symptoms of neuropathy can be relieved with:

Medications: Your doctor may prescribe neuropathic drugs, anti-seizure and antidepressant drugs, and topical medications.

Neuromodulation such as Spinal cord stimulation or Peripheral field stimulation has been successful as a treatment options to lessen the painful sensations in many patients. It involves using one or two electrodes placed near the nerve or spinal area correlating with your pain and sending signals to your nerve or spinal cord to decrease the pain signals to your brain.

Acupuncture: A therapist inserts thin needles into the body close to the nerves. This will stimulate the nerves and release endorphins.

Prevention

Peripheral neuropathy can be prevented by:

• Managing the underlying disease condition such as diabetes.
• Maintaining a healthy diet and lifestyle to keep your nerves healthy.
• Eating a vitamin B-12 rich diet or including supplements.
• Preventing nerve damage by avoiding repetitive motions, restricted positions, toxic chemicals, and excessive alcohol.

Summary

Peripheral neuropathy affects the peripheral nerves causing severe pain. Symptoms can be relieved with medications and various therapies that block the pain causing nerve signals to the brain. A healthy lifestyle and management of diabetes will help prevent peripheral neuropathy.