Peripheral Neuropathy and its Management
Peripheral Neuropathy and its Management.
Do you find your hands or feet often feel numb, tingly, painful, and either too hot or too cold? Perhaps they have a sensation of tightness, or you have started to experience difficulties with your balance? The problem could be down to peripheral neuropathy, a problem that occurs most frequently in patients already suffering from diseases such as diabetes and vascular disorders, certain hereditary conditions and autoimmune disorders, and cancer patients who have had chemotherapy. Vitamin deficiencies, exposure to toxins such as heavy metals, and alcohol abuse can also be contributory factors. There are many possible causes however sometimes there is no obvious reason as to why you have peripheral neuropathy.
What is peripheral neuropathy?
It is a condition of the nervous system that arises when the nerve endings in your extremities fail to function correctly. There are several types of nerve fibers that can be involved in cases of peripheral neuropathy:
- Larger nerve fibers that are responsible for motor control.
- Smaller sensory nerve fibers that transmit feedback on physical sensations to the brain.
- Very small sympathetic nerve fibers that regulate skin temperature and transmit burning pain.
The small sensory fibers are those most commonly affected in peripheral neuropathy, but both motor and sympathetic nerve fibers can be involved too. Your symptoms will vary according to which of your nerve fibers are affected. If only one nerve is affected, it is known as a mononeuropathy, or if there are multiple nerves involved it’s known as a polyneuropathy. Most peripheral neuropathy cases are polyneuropathic.
How do you know if you have it?
It can sometimes be picked up when you undergo testing for other problems such as low back pain. In the early stages, you may not experience any obvious symptoms, but as time goes on you will start to experience some of the symptoms described above. You may also find that you encounter problems such as weakened grip, a tendency to fumble over tasks you’ve previously found easy, or an inability to accurately gauge water temperature. In severely affected feet, wounds and sores can appear and are then slow to heal. If you experience any of symptoms of peripheral neuropathy consult your doctor for an assessment. At Piedmont Physical Medicine and Rehabilitation clinics we use advanced nerve testing methods including electrodiagnostic studies and sympathetic skin response thermology tests which measure skin temperature regulation using non-invasive infrared imaging technology. Further tests may be needed, such as a nerve density biopsy. Depending on the results we may also recommend vasculature testing to examine blood vessel to nerve endings, to help isolate the cause of the neuropathy.
What treatments are available for peripheral neuropathy?
Your treatment options will vary according to which of your nerve fibers are affected. If sensory and sympathetic nerves are involved the treatment will focus on reversing the signs and symptoms of your peripheral neuropathy. If the motor nerves are involved then there will be emphasis on restoring function as well. It is important to be diligent with your skin care routine if your sensory nerves are affected, as you are more likely to develop ulcers and wounds that can be both painful and difficult to manage. Certain analgesic drugs can help reduce pain in patients with peripheral neuropathy, but as with all medications, they may have unwanted side effects. At PPMR we are able to provide an alternative range of treatment options:
- Nerve blocks are often successful in reducing pain by disrupting activity in specific nerves.
- Realief Laser therapy can be applied to the affected areas of skin and has been shown in medical studies to reverse the signs and symptoms of peripheral neuropathy.
- Regenerative medicine approaches are a safe alternative that also has a place on the treatment of peripheral neuropathy. For example, by strengthening disrupted ligaments in the foot many have experienced functional improvement and pain relief from lower extremity related peripheral neuropathy symptoms.
It is best to get as accurate a diagnosis as you can in order to receive the most appropriate treatments for peripheral neuropathy. That is something we specialize in at Piedmont Physical Medicine and Rehabilitation.