What is peripheral neuropathy?

Peripheral neuropathy is a condition in which the peripheral nerves become damaged resulting in numbness, pain and weakness, usually in the hands and feet.

Two components make up the nervous system in humans: The central nervous system and the peripheral nervous system.

The primary function of the peripheral nervous system is to connect the central nervous system to the rest of the body. It does this by acting as a communication relay, sending information back and forth from your central nervous system to muscles, organs, limbs and glands.

What causes peripheral neuropathy?

Peripheral neuropathy is not a disease in itself, but a form of nerve damage caused by other conditions and/or factors. These can include:

• Diabetes
• Infections
• Inherited conditions
• Trauma
• Autoimmune diseases
• Tumours
• Alcoholism
• Exposure to toxic substances
• Certain medications
• Vitamin deficiencies

What are the different types of peripheral neuropathy?

There are over 100 different types of peripheral neuropathy. They are often divided into four categories.

• Motor neuropathy — this is where there is damage to the nerves that control your muscles and movement. Your arms, hands, legs and facial muscles are usually affected.
• Sensory neuropathy — this is where there is damage to the sensory nerves which can affect the way you feel pain, temperature and your sense of touch.
• Autonomic nerve neuropathy — these nerves control body functions that you aren’t conscious of, such as your heartbeat and breathing.
• Combination neuropathies — when there is a mix of two or more of the above, it falls into this category.

What are the symptoms of peripheral neuropathy?

The symptoms of peripheral neuropathy depend on the nerves affected, but might include:

• Numbness or tingling in the feet and hands that spreads to your arms and legs
• Sharp, throbbing or burning pain
• Experiencing pain during activities that don’t normally cause pain
• Muscle weakness
• Paralysis
• Sensitivity to touch
• Heat intolerance
• Lack of coordination
• Bowel or digestive problems
• Dizziness
• Excessive sweating

Your symptoms also depend on how many nerves are affected. Peripheral neuropathy can affect:

• One nerve (mononeuropathy)
• Two or more nerves (multiple mononeuropathies)
• Many nerves (polyneuropathy)

How is peripheral neuropathy diagnosed?

Peripheral neuropathy can be hard to diagnose due to the variety of symptoms that can present, however, there are several ways to do it. This includes taking an extensive medical history and the use of neurological tests to find the location and extent of the nerve damage. Tests might include:

• Spinal fluid tests
• Blood tests
• Muscle strength tests
• CT scans
• MRI scans
• Electromyography
• Nerve and skin biopsy

How is peripheral neuropathy treated?

There is no cure for peripheral neuropathy, however, there are ways to prevent it from getting worse. Your doctor will first want to treat any underlying health problem causing it, which may well involve managing your diabetes more effectively or reducing your intake of alcohol, for example.

Other ways to manage peripheral neuropathy involve taking medication in combination with lifestyle changes, which can help support your nerve health and prevent it from getting worse. This includes eating better and getting more nutrition, exercising regularly and avoiding factors that can lead to nerve damage such as exposure to toxins, smoking and drinking too much alcohol.

You doctor will also want to help relieve and manage your symptoms with can involve the use of painkillers, anti-depressants, antiseizure drugs, topical creams, injections and therapies. Therapies may help improve symptoms and include transcutaneous electrical nerve stimulation (TENS), plasma exchange and intravenous immune globulin and physical therapy.

In rare cases, surgery can be used to either destroy or repair nerves that are causing pain and other symptoms.

Can peripheral neuropathy be prevented?

Your lifestyle choices play a key role in preventing peripheral neuropathy. You can reduce your risk of developing this condition by avoiding overindulging in alcohol, eloating a healthy and varied diet, losing weight, avoiding toxins and exercising regularly.

If you are living with a chronic condition such as diabetes or kidney disease, it is important to you manage it well by working with your doctor and taking the necessary steps to look after your health.