Neuropathy occurs in the feet or hands due to nerve damage. When a patient suffers from neuropathy, they can experience so-called neuropathic pain ranging from mild to severe and described as burning, pinpricks, or sudden shocks of electricity, as well as numbness, tingling, and weakness. The peripheral nervous system utilizes nerves to send messages to and from the central nervous system, which includes both the brain and spinal cord. When these peripheral nerves become damaged and their ability to transmit signals, neuropathy results. Although neuropathy is an encompassing diagnosis, there are many causes.
Diabetes can cause chronic neuropathy. High blood sugar levels can damage nerves, predominantly in the feet. This is why neuropathy more often occurs in people whose blood sugar is not under control than those who maintain low blood sugar levels. Diabetic neuropathy as a result of uncontrolled blood glucose levels can create irreversible damage to the nerves. When diabetes is under control, the amount of sugar in the blood remains at a safe level, thus reducing the risk of potential nerve damage.
A vitamin B12 deficiency can wreak havoc on the entire body, leading to symptoms such as lightheadedness, general weakness or lack of energy, shortness of breath, muscle aches, and heart palpitations. A lack of vitamin B12 can also cause neuropathy. The protective layer around the nerves, the myelin sheath, quickly becomes damaged when there is insufficient B12. Without this layer of protection, the nerves may stop functioning properly, resulting in neuropathy.
Experts break down neuropathy into two categories: mononeuropathy and polyneuropathy. The former affects only one nerve, while the latter affects many nerves at the same time. The effects of chemotherapy can damage many nerves throughout the body; radiation treatment can have a similar effect. The good news is that many patients recover from some of the damage associated with chemotherapy-induced peripheral neuropathy after the treatments are complete.
Sometimes toxins or poisons, including insecticides and pesticides, can lead to neuropathy, especially when a person is exposed to larger qualities of these chemicals, through farm work, for example. Exposure to chemicals in the workplace, especially over a long period, can cause nerve damage. Common culprits include mercury, lead, thallium, and arsenic. Recreational drugs containing certain chemicals can also cause neuropathy.
Some types of cancer can cause neuropathy, particularly cancers that affect the nervous system. Tumors that grow in or near the brain or spine, especially, can lead to nerve damage. However, any cancer that causes the growth of tumors can lead to neuropathy if, as the tumor grows, it presses on the nerves.
After diabetes, an injury is the next most common cause of neuropathy. When trauma damages a muscle or tissue, the surrounding tissues begin to swell, which can damage the nerves. Similarly, when a bone breaks, the broken edges or bone fragments can easily damage the nerves. This is why it is imperative to see a physician as soon as possible when following an injury. Walking around on an untreated broken ankle will raise the risk of neuropathy.
Some infections can directly cause neuropathy. Those that produce a significant inflammatory response are the primary cause of inflammatory neuropathy. In this case, as the immune system strives to heal the body, it may mistakenly attack the nerves and the nervous system, as well. Problematic infections include Lyme disease, human immunodeficiency virus (HIV), and shingles. Symptoms of neuropathy typically improve once the infection is under control or has been eradicated. However, in more severe cases, some symptoms of neuropathy may persist long term.
Another possible cause of neuropathy is kidney disease, which develops when the kidneys are unable to perform their essential job of removing waste from the body. As a result, waste and excess fluids build up and, when the kidneys fail, nerves damaged by an imbalance of chemicals and the salts in the body can cause neuropathy.
Inflammatory diseases such as sarcoidosis and celiac disease can cause neuropathy. Many medical professionals consider neuropathy an early warning sign of Celiac disease. This autoimmune inflammatory disease causes damage to the small projections that line the intestines, called villi. When a person with this disease continues to eat foods containing gluten, the villi begin to shorten and flatten, causing many health problems, including neuropathy.
Idiopathic peripheral neuropathy is a type of neuropathy for which the cause is unknown. In today's age of scientific testing and advancements, this is rare. Patients with this type of neuropathy can undergo the same treatments as those for whom a cause has been identified, but more trial and error may be necessary to find the most beneficial treatment.
Another potential cause of neuropathy is alcohol. Around 46 percent of people who chronically consume alcohol eventually develop a condition called alcoholic neuropathy. The exact mechanics behind this are unknown.
Some experts believe that heavy and long-term alcohol consumption directly harms the nerves, impacting their ability to function. Researchers also point out that heavy alcohol use has links to poor nutrition, and vitamin deficiencies could also play a role.
Many autoimmune conditions can involve some form of neuropathy, each with a broad range of symptoms. How these neuropathies develop is as diverse as the diseases themselves. Type 1 diabetes, for example, causes high blood glucose and triglyceride levels that damage the nerves.
Many other conditions can promote inflammation of the nerves themselves or the surrounding tissues, damaging the nerves.
HIV slowly destroys the body's immune system, leaving people vulnerable to life-threatening cancers, infections, and complications. Nerves often suffer damage as a result of HIV battling the body, leading to neurological problems like neuropathy.
If HIV progresses to AIDS, the damage can be far more severe. Neuropathy is most common in people with advanced AIDS, but it can technically occur at any stage.
Some of the least understood neuropathies are those that people inherit, such as Charcot-Marie-Tooth disease. Hereditary neuropathies typically fall into four categories: motor and sensory neuropathy, sensory neuropathy, motor neuropathy, and sensory and autonomic neuropathy. Each type causes different symptoms, ranging from numbness and tingling to hypothesis and pain insensitivity.
Because so much remains unknown about these conditions, there are no standard treatments.
Diagnosing neuropathies typically takes a combination of methods. The process usually begins with observing symptoms and taking a detailed medical history. Doctors may also ask about nutrition, activity levels, and other habits. Both physical and neurological exams are also common.
A healthcare provider will look for physical signs of neuropathy, like weakness or changes in reflexes or balance. If necessary, technicians will also perform a variety of lab, diagnostic, and imaging tests to find any other potential signs of neuropathy.
The choices for treating neuropathy are largely dependent on the origin of the condition. Painkillers are extremely common and may include opioids, gabapentinoids, or even topical treatments. In some cases, doctors may even use botulinum toxin to numb the pain in certain areas.
However, current treatment methods often carry serious side effects, limiting their use.
Sometimes, living with neuropathy is immensely difficult. Learning how to cope with and manage the condition is key. Healthy lifestyle steps like quitting smoking, treating injuries, and taking meticulous care of feet and hands are the best ways to limit pain and avoid complications.
Gentle massages may help improve circulation and temporarily relieve pain. Mechanical aids, braces, and orthopedic shoes also help reduce pressure and alleviate symptoms.
Researchers are constantly performing studies and tests to learn more about neuropathies. Experts have discovered unique genetic mutations that contribute to over 80 distinct hereditary neuropathies. Other scientists are working on improving tests to better identify conditions responsible for these neuropathies, leading to earlier diagnoses and better treatments.
Clinical trials of various drugs and medications targeting specific neuropathies are constantly progressing, aiming to help those with the diseases.
Each form of neuropathy carries many possible complications. When experiencing a lack of sensation, injuries and burns become far more common and often go without treatment. In turn, this leads to frequent and severe infections. Loss of sensation and weakness can also contribute to more falls.
Furthermore, people with neuropathies are prone to developing conditions like depression and anxiety, leading to suicidal thoughts. Speaking with a mental health professional is often the best course of action in these cases.
In many ways, prevention is the best "treatment" for neuropathy. However, many neuropathies stem from conditions that are difficult to avoid.
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