Peripheral Neuropathy

Peripheral Neuropathy

Peripheral neuropathy is a disorder of the peripheral nervous system (PNS), caused by damage, inflammation, or degeneration of the nerves. The PNS includes nerves that transport information to and from the brain and spinal cord to the skin and muscles. These nerves carry signals related to sensation, muscle control and control of the autonomic (involuntary) nervous system (such as circulation).

Neuropathies can affect just a single peripheral nerve, in which case they are called mononeuropathy, or several nerves, which are known as polyneuropathies.

Most neuropathies affect the lower extremities (such as the feet and legs). Symptoms and pain intensity depend upon the nerves involved. When a sensory nerve is damaged, symptoms include tingling, burning, numbness, or sensory loss in the part of the body from which the nerve carries messages. When a motor nerve is involved, weakness or paralysis of the muscles controlled by that nerve are observed. Autonomic nervous system involvement may be associated with a fall in blood pressure on standing, leading to lightheadedness or fainting, as well as an impaired ability to perspire, impotence, and bowel or bladder dysfunction.

A neuropathy can be caused by diabetes, toxicity (alcohol or lead poisoning), or the result of vitamin deficiencies, especially the B vitamins. The disorder can affect multiple family members (familial neuropathy), and is sometimes associated with inflammation of the nerves (neuritis), and other systemic illnesses.

The treatment plan for peripheral neuropathy depends upon many factors, such as the severity of the disease, dysfunction and pain, the type and location of the pain, as well as patient’s age, ongoing medical conditions, and ability to tolerate other medical therapies. The doctor will take all of these factors into consideration when prescribing a treatment plan.

In general, the standard course of therapy for the pain associated with peripheral neuropathy will follow the chronic pain treatment continuum, and may involve medications, exercise programs, dietary changes, physical or occupational therapy, or nerve blocks. Neuromodulation therapy, such as neurostimulation, may also be an option if the neuropathy is accompanied by unresolved neuropathic pain.