FAQs on Peripheral Neuropathy and Treatment Options
Peripheral neuropathy is a condition that occurs due to damage to the peripheral nervous system, which transmits information between the brain and spinal cord and other areas of the body. The medical term neuropathy means nerve damage or disease. According to research statistics, 20 million people in the U.S. have some form of peripheral neuropathy.
What are the symptoms of peripheral neuropathy?
The symptoms of neuropathy can range from tingling to numbness, or from muscle weakness to pricking sensations (called paresthesia). Certain parts of the body become abnormally sensitive, which causes an exaggerated intense reaction to touch.
Pain occurs in response to a stimulus that usually does not provoke discomfort. In severe cases, the patient experiences burning pain (worse at night), organ dysfunction, gland disorders, muscle wasting, and/or paralysis. In addition, damage to nerves that supply internal organs may impair digestion, sweating, urination, and/or sexual function.
How does peripheral neuropathy affect the body?
Peripheral neuropathy is the result of damage to the peripheral nervous system. The peripheral nerves transmit sensory information back to the spinal cord and brain, such as a message that the hand itches.
These nerves also carry signals from the central nervous system to the muscles responsible for movement. With peripheral neuropathy, there is a distortion, and possible, and interruption of messages between the brain and spinal cord and the regions of the body.
What are the causes of peripheral neuropathy?
There are numerous causes of peripheral neuropathy, and the type of neuropathy depends on the cause. Common contributors include:
- Injury or sudden trauma
- Repetitive stress which leads to nerve entrapment
- Metabolic and endocrine disorders
- Autoimmune diseases
- Small vessel disease
- Kidney disorders
- Exposure to toxins
- Heavy alcohol consumption
How are the types of peripheral neuropathy classified?
There are more than 100 types of peripheral neuropathy, and each has its own symptoms and prognosis. Usually, peripheral neuropathies are classified based on the kind of nerve damage associated with the disease. The two types are:
- Mononeuropathy – Damage only occurs to one nerve.
- Polyneuropathy – Multiple nerves are affected.
What are the types of nerve damage?
Motor, sensory, and/or autonomic nerves can be damaged from peripheral neuropathy. Certain neuropathies damage all three types of nerves. Symptoms depend on which nerves are damaged. The motor nerves control voluntary muscle movements, such as grasping, walking, and talking. Motor nerve damage is often associated with muscle weakness, muscle twitching, painful cramps, and decreased reflexes.
Sensory nerves transmit information related to feeling light touch or pain. Sensory nerve damage impairs touch sensations, loss of reflexes, trouble fastening buttons, and balance problems. Autonomic nerves control organ activities, such as breathing, heartbeat, food digestion, and glandular function. Autonomic nerve damage causes inability to sweat normally, heat intolerance, problems regulating blood pressure, and loss of bladder control.
What are the treatment options for peripheral neuropathy?
There are several treatment options for the pain associated with neuropathy. Based on the type of peripheral neuropathy and the severity of symptoms, treatment options include:
- Selective nerve root block (SNRB) – This technique is useful for diagnosing the specific site of nerve pain, and it is used to provide relieve of leg and/or low back pain. The doctor inserts a fine needle near the spinal cord and injects an anesthetic agent, which is used to safely produce a diagnostic block. In a recent clinical study, more than 70% of patients reported that they did not require surgery after a SNRB, and in a follow-up study, patients avoided surgery for 5 years or more following the procedure.
- Epidural steroid injection (ESI) – With this procedure, the patient lies on his/her belly, and the doctor inserts a small needle into the epidural space using fluoroscopy (x-ray guidance). A local anesthetic and steroid is injected into the space, which lies between the epidural layer and the spinal cord. In a study involving almost 300 patients, researchers found that 90% of patients reported relief after ESI.
- Ganglion impar block – With this procedure, the terminal end of the sympathetic chain is treated with a local anesthetic and steroid. The doctor inserts a small needle near the sacral/coccyx region of the spine using x-ray guidance to inject the medication. In a 2007 study, all patients who had this block reported significant pain relief at 2-month follow-up, with pain scores reduced by 50% of more.
- Spinal cord stimulation (SCS) – This implantable device delivers small doses of electricity to certain regions of the spinal cord. This blocks the transmission of painful sensations. In one study of patients with peripheral neuropathy, the majority experienced relief of pain and improved quality of life from SCS, reporting improved functional status, decreased disability, and reduction in use of medication.