UNDERSTANDING PERIPHERAL NEUROPATHY?

 

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Peripheral neuropathy is a condition that causes weakness, pain, and numbness in your extremities (typically the hands and feet).
Your peripheral nerves send messages from your brain and spinal cord to the rest of your body. When those nerves are damaged, these messages are interrupted and affect how your body responds to pain, temperature, and other reflexes.
It’s often a result of damage to the peripheral nerves. A few things can cause this damage:

• diabetes mellitus
• traumatic injury
• alcoholism
• infection

The effects of peripheral neuropathy can develop suddenly or can spread slowly over time.

Your peripheral nervous system connects the nerves from your brain and spinal cord, or central nervous system, to the rest of your body. This includes your:

• arms
• hands
• feet
• legs
• internal organs
• mouth
• face

The job of these nerves is to deliver signals about physical sensations back to your brain.
Peripheral neuropathy is a disorder that occurs when these nerves malfunction because they’re damaged or destroyed. This disrupts the nerves’ normal functioning. They might send signals of pain when there’s nothing causing pain, or they might not send a pain signal even if something is harming you. This can be due to:

• an injury
• systemic illness
• an infection
• an inherited disorder

The disorder is uncomfortable, but treatments can be very helpful. The most important thing to determine is whether peripheral neuropathy is the result of a serious underlying condition.

 

What are the types of peripheral neuropathy?

More than 100 different types of peripheral neuropathy exist. Each type has unique symptoms and specific treatment options. Peripheral neuropathies are further classified by the type of nerve damage involved. Mononeuropathy occurs when only one nerve is damaged. Polyneuropathies, which are more common, occur when multiple nerves are damaged.

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SYMPTOMS
Symptoms from peripheral neuropathy depend on the type of nerves damaged. The three types are motor nerves, sensory nerves, and autonomic nerves.

Motor nerves

Your motor nerves send messages from the brain to the muscles so you can control your movements.
If your motor nerves are affected, you may experience symptoms including:

• muscle weakness or atrophy
• difficulty moving your arms or legs
• muscle spasms or uncontrolled twitching
• decreased reflexes

Sensory nerves

Sensory nerves send messages from other body parts to the brain and trigger your senses. When you experience a cold sensation or touch something sharp, you are using your sensory nerves.
If your peripheral neuropathy affects your sensory nerves, you may experience:

• tingling or numbness
• sensitivity to touch
• decreased sensation
• inability to feel temperature changes or pain with hot and cold
• loss of reflexes and coordination

 

Autonomic nerves

These nerves control involuntary and semi-voluntary functions including blood pressure, heart rate, bladder functions, and sweating.
If your autonomic nerves are affected from peripheral neuropathy, you may experience symptoms including:

• nausea
• vomiting
• dizziness while standing or changing position from sitting to standing
• excessive sweating
• inability to control bowel and bladder functions
• irregular heart rate
• difficulty swallowing

What are the causes of peripheral neuropathy?

People who have a family history of peripheral neuropathy are more likely to develop the disorder. However, a variety of factors and underlying conditions may also cause this condition.
Health conditions that can cause peripheral neuropathy include:

• Autoimmune diseases. These include Sjogren's syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and vasculitis.
• Diabetes. More than half the people with diabetes develop some type of neuropathy.
• Infections. These include certain viral or bacterial infections, including Lyme disease, shingles, Epstein-Barr virus, hepatitis B and C, leprosy, diphtheria, and HIV.
• Inherited disorders. Disorders such as Charcot-Marie-Tooth disease are hereditary types of neuropathy.
• Tumors. Growths, cancerous (malignant) and noncancerous (benign), can develop on the nerves or press nerves. Also, polyneuropathy can arise as a result of some cancers related to the body's immune response. These are a form of a degenerative disorder called paraneoplastic syndrome.
• Bone marrow disorders. These include an abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (myeloma), lymphoma and the rare disease amyloidosis.
• Other diseases. These include kidney disease, liver disease, connective tissue disorders and an underactive thyroid (hypothyroidism).

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Other causes of neuropathies include:

• Alcoholism. Poor dietary choices made by people with alcoholism can lead to vitamin deficiencies.
• Exposure to poisons. Toxic substances include industrial chemicals and heavy metals such as lead and mercury.
• Medications. Certain medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy. Also anticonvulsants, which people take to treat seizures, drugs to fight bacterial infections, some blood pressure medications.
• Trauma or pressure on the nerve. Traumas, such as from motor vehicle accidents, falls or sports injuries, can sever or damage peripheral nerves. Nerve pressure can result from having a cast or using crutches or repeating a motion such as typing many times.
• Vitamin deficiencies. B vitamins — including B-1, B-6 and B-12 — vitamin E and niacin are crucial to nerve health.

The risk of neuropathy increases for people who:

• are overweight
• have high blood pressure
• are over the age of 40

When to see a doctor
Seek medical care right away if you notice unusual tingling, weakness or pain in your hands or feet. Early diagnosis and treatment offer the best chance for controlling your symptoms and preventing further damage to your peripheral nerves.

Diagnosis

Peripheral neuropathy has many potential causes. Besides a physical exam, which may include blood tests, diagnosis usually requires:

• A full medical history. Your doctor will review your medical history, including your symptoms, your lifestyle, exposure to toxins, drinking habits and a family history of nervous system (neurological) diseases.
• Neurological examination. Your doctor might check your tendon reflexes, your muscle strength and tone, your ability to feel certain sensations, and your posture and coordination.

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Tests

Your doctor may order tests, including:

• Blood tests. These can detect vitamin deficiencies, diabetes, abnormal immune function and other indications of conditions that can cause peripheral neuropathy.
• Imaging tests. CT or MRI scans can look for herniated disks, tumors or other abnormalities.
• Nerve function tests. Electromyography (EMG) records electrical activity in your muscles to detect nerve damage. A thin needle (electrode) is inserted into the muscle to measure electrical activity as you contract the muscle.
  At the same time as an electromyogram, your doctor or an EMG technician typically performs a nerve conduction study. Flat electrodes are placed on the skin and a low electric current stimulates the nerves. Your doctor will record your nerves' responses to the electric current.
• Other nerve function tests. These might include an autonomic reflex screen that records how the autonomic nerve fibers work, a sweat test that measures your body's ability to sweat, and sensory tests that record how you feel touch, vibration, cooling and heat.
• Nerve biopsy. This involves removing a small portion of a nerve, usually a sensory nerve, to look for abnormalities.
• Skin biopsy. Your doctor removes a small portion of skin to look for a reduction in nerve endings.

What are the medical treatment options for peripheral neuropathy?

The treatment is based on treating the underlying disorder. If diabetes is the cause, making certain that the blood glucose is controlled is important. If a vitamin deficiency is causing the problem, then correcting the deficiency is the treatment. Many treatments can bring relief and help you return to your regular activities. Sometimes a combination of treatments works best.

Pain medications

Over-the-counter (OTC) pain medications like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen, can be very helpful in controlling moderate pain. If you take them in excess, these drugs can affect your liver or stomach function. It’s important to avoid using them for an extended period, especially if you drink alcohol regularly.

Prescription medications

Many prescription pain medications can also help to control the pain of this condition. These include narcotics, some antiepileptic medicines, and some antidepressants. Other helpful prescription medicines include:

• cyclooxygenase-2 inhibitors
• tramadol
• corticosteroid injections
• seizure medications, such as gabapentin or pregabalin
• antidepressants, such as amitriptyline
• Cymbalta, which is a serotonin norepinephrine reuptake inhibitor

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Medical treatments

Your doctor can use several medical treatments to control the symptoms of this condition. Plasmapheresis is a blood transfusion that removes potentially irritating antibodies from your bloodstream. If you get a nerve block, your doctor will inject an anesthetic directly into your nerves.

Transcutaneous electronic nerve stimulation (TENS)

Transcutaneous electronic nerve stimulation (TENS) doesn’t work for everyone, but many people like it because it’s a drug-free therapy. During TENS, electrodes placed on the skin send small amounts of electricity into the skin. The goal of this treatment is to disrupt nerves from transmitting pain signals to the brain.

Ergonomic casts or splints

Ergonomic casts or splints can help you if your neuropathy affects your:

• feet
• legs
• arms
• hands

These casts provide support for the part of your body that’s uncomfortable. This can relieve pain. For example, a cast or splint that holds your wrists in a
proper position while you sleep can relieve the discomfort of carpal tunnel syndrome.

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What are natural treatments for peripheral neuropathy?

Treatment for peripheral neuropathy depends on the cause. Some common treatments involve physical therapy, surgery, and injections for increased nerve pressure. Other treatments focus on reducing pain and discomfort with over-the-counter painkillers such as ibuprofen or aspirin.
There are also a number of natural treatments to help reduce symptoms and peripheral neuropathy.

 

1. Vitamins

Some cases of peripheral neuropathy are related to vitamin deficiencies. Vitamin B is essential for your nerve health. A deficiency can lead to significant nerve damage.
While you can get vitamin B from your meals, your doctor may also recommend taking a supplement. Stick to the recommended dose to prevent toxicity and worsening symptoms.
Vitamin D can also help prevent nerve pain. Your skin typically produces vitamin D in response to sunlight. A deficiency can cause neuropathy pain. Taking a supplement can help reduce the symptoms of neuropathy.

 

2. Cayenne pepper

Cayenne pepper contains capsaicin, an ingredient in hot peppers that makes them spicy. Capsaicin has been used in topical creams for its pain relief properties. It decreases the intensity of pain signals sent through the body.
Incorporating cayenne pepper in your diet or taking a capsaicin supplement can help to reduce neuropathy pain.
Topical capsaicin ointments can also be used on the body. Although it may initially burn, continued use will gradually reduce neuropathy sensations.
Be sure to discuss this treatment method with your doctor before using it to prevent adverse symptoms.

 

3. Quit smoking

Smoking affects your blood circulation. The blood vessels narrow and less oxygenated blood can get through. Without proper blood circulation, you may experience increased numbness and pain from your peripheral neuropathy. Eliminating smoking habits can help to improve your symptoms. Let this motivate you to make positive changes.

 

4. Warm bath

Taking a warm bath can be soothing and can also alleviate pain symptoms from neuropathy. Warm water increases blood circulation throughout the body, decreasing pain symptoms from numbness.
If your sensory nerves are affected from peripheral neuropathy and you’re not as sensitive to temperature, be careful not to make your bath water too hot.

 

5. Exercise

Regular exercise can help to combat pain and improve your overall health. Being active can reduce your blood sugar, which, in turn, can reduce or slow down nerve damage. Exercise also increases blood flow to your arms and legs and reduces stress. These are all factors that help to reduce discomfort and pain.

 

6. Essential oils

Some essential oils, including chamomile and Roman lavender, help to increase circulation in the body. They also have pain-relieving and anti-inflammatory properties that could boost healing.
Dilute essential oils (a few drops) in 1 ounce of a carrier oil such as olive oil. Applying these diluted oils to the affected area can reduce stinging and tingling pains from peripheral neuropathy.

 

7. Meditation

Meditation techniques can help people struggling with neuropathy symptoms live through their pain. It can help to lower stress, improve your coping skills, and decrease your pain intensity. Taking a mind-body approach is a noninvasive technique that provides you with more control over your condition.

8. Acupuncture

Acupuncture promotes natural healing by stimulating the body’s pressure points. This technique triggers the nervous system to release chemicals that can change the pain experience or threshold. Acupuncture helps to provide an energy balance to the body that can affect your emotional well-being.

 

9. Homeopathic Treatment of Peripheral Neuropathy

The homeopathic mode of treatment remains quite effective in managing peripheral neuropathy. The approach to homeopathic treatment for peripheral neuropathy is entirely symptomatic. The symptoms of the patient in a given case of peripheral neuropathy serve as the basis of homeopathic prescription. Every case of peripheral neuropathy needs to be thoroughly investigated to rule out the cause behind it. Every individual case requires a detailed case analysis to find the presenting symptoms unique to them. The homeopathic medicines for treating peripheral neuropathy are very safe to use among people of all age groups. A person should take homeopathic medicines for peripheral neuropathy under the supervision of a homeopathic physician and avoid self – medication.
 

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Prevention

Manage underlying conditions

The best way to prevent peripheral neuropathy is to manage medical conditions that put you at risk, such as diabetes, alcoholism or rheumatoid arthritis.

 

Make healthy lifestyle choices

These habits support your nerve health:

• Eat a diet rich in fruits, vegetables, whole grains and lean protein to keep nerves healthy. Protect against vitamin B-12 deficiency by eating meats, fish, eggs, low-fat dairy foods and fortified cereals. If you're vegetarian or vegan, fortified cereals are a good source of vitamin B-12, but talk to your doctor about B-12 supplements.
• Exercise regularly. With your doctor's OK, try to get at least 30 minutes to one hour of exercise at least three times a week.
• Avoid factors that may cause nerve damage, including repetitive motions, cramped positions that put pressure on nerves, exposure to toxic chemicals, smoking and overindulging in alcohol.

 
CONCLUSION 
The good thing about living with peripheral neuropathy is that you can still have a good quality of life. Especially when some kinds  of peripheral neuropathy can actually be cured. All depends on the cause and on how you get the best working treatment for you.