Neuropathy: Causes, Symptoms, and Treatment

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Welcome to the ultimate guide on neuropathy. Here, you'll find answers to the most common questions to help you or your loved ones understand and manage this condition better.

Description for neuropathy

Damage to the peripheral nerves, causing pain, weakness, or numbness, often in the hands and feet.

Symptoms of neuropathy

loss of coordination, numbness, pain, tingling sensation, weakness in muscles

Precautions for neuropathy

Control blood sugar levels if diabet, Engage in physical therapy, Wear comfortable shoes, Take pain management medications

Questions Covered:

what is neuropathy?
What are the usual symptoms of neuropathy?
causes of neuropathy?
How do doctors usually figure out if someone has neuropathy, diagnosis?
How do doctors usually treat neuropathy?
What are the ways to prevent neuropathy?

Answers:

Question: what is neuropathy?

Peripheral neuropathy occurs when these nerves don't work properly because they're damaged or destroyed. They might send pain signals for no reason, or not send a signal when you're experiencing harm.
Read on to learn about the types of peripheral neuropathy, its symptoms, causes, treatment, and more.

Question: What are the usual symptoms of neuropathy?

There are three types of nerves in the body. Since there are so many types of peripheral neuropathy, doctors will diagnose your type by the group of nerves it affects. The three groups are:
Motor. These nerves are responsible for muscle movement, like walking, talking, or using your hands or arms.
Sensory. These are responsible for sensory information, like hot or cold, pain, or touch.
Autonomic. These are responsible for body processes you don't see, like breathing, heartbeat, and digestion.
Peripheral neuropathy can affect one nerve group, two groups, or all three. Sometimes it will affect one nerve only, and that's called mononeuropathy.
The symptoms of peripheral neuropathy depend on the kind of neuropathy.
Motor neuropathy symptoms include:
muscle cramps
twitching
muscle weakness
foot drop
muscle wasting
paralysis
Sensory neuropathy symptoms include:
prickling and tingling sensation, or 'pins and needles'
numbness
reduced sensations of pain or hot and cold
increased pain from things that shouldn't cause pain, like light touch
burning or sharp pain
loss of balance or coordination
Autonomic neuropathy symptoms include:
constipation or diarrhea
bloating, belching, or feeling of sickness
faint or dizziness upon standing from low blood pressure
rapid heart rate
sweating too much or too little
problems with sexual function
loss of bowel control
difficulty emptying bladder completely
Symptoms can cause challenges in daily life, like trouble walking or sleeping because of pain in the feet and legs.
These symptoms can also indicate other conditions. Make sure you tell your doctor about all of your symptoms so they can find the right diagnosis and the best treatment.

Question: causes of neuropathy?

A variety of factors and underlying conditions can cause
this condition. In rare cases, peripheral neuropathy is genetic, but most cases are acquired.
An acquired case of peripheral neuropathy is often idiopathic, which means doctors don't know why it's happening. In most cases, doctors can connect the condition to one or more causes.
Generalized diseases
Nerve damage caused by diabetes is one of the most common forms of neuropathy. This leads to numbness, pain, and a loss of sensation in the extremities.
The American Diabetes Association recommends taking these steps to delay or prevent nerve damage:
Monitor your blood sugar level to keep it in target range and to assess whether your diabetes care plan is on track.
Inspect your feet for signs of injury, infection, or hot spots.
Report signs of neuropathy to your doctor and get early treatment.
Protect your feet with special shoes and take care when washing and exercising.
According to the National Institutes of Health, 60 to 70 percent
of people with diabetes have some sort of nerve damage.
Other chronic diseases that may cause nerve damage include:
autoimmune diseases like lupus or rheumatoid arthritis
kidney or liver disorders
vascular and blood disorders
Injury
Physical trauma is a common cause of injury to the nerves. This can include car accidents, falls, or fractures. Inactivity, or holding still too long in one position, can also cause neuropathy.
Increased pressure on the median nerve, a nerve in the wrist that supplies feeling and movement to the hand, causes carpal tunnel syndrome. This is a common type
of peripheral neuropathy.
Alcohol and toxins
Alcohol can have a toxic effect on nerve tissue, putting people with severe alcohol use disorder at a higher risk of peripheral neuropathy.
Exposure to toxic chemicals like glue, solvents, or insecticides, either through chemical abuse or in the workplace, can also cause nerve damage. Additionally, exposure to heavy metals such as lead and mercury can also cause this condition.
Infections and autoimmune disorders
Certain viruses and bacteria directly attack nerve tissue.
Viruses such as herpes simplex, varicella-zoster virus (which causes chickenpox and shingles), and Epstein-Barr virus damage sensory nerves and cause intense episodes of shooting pain.
Bacterial infections such as Lyme disease can also cause nerve damage and pain if they aren't treated. People with HIV or AIDS can also develop peripheral neuropathy.
Autoimmune diseases like rheumatoid arthritis and lupus affect the peripheral nervous system in various ways. Chronic inflammation and damage to tissues throughout the body, as well as pressure caused by inflammation, can all lead to severe nerve pain in the extremities.
Medications
Certain medications may also cause nerve damage. These include:
anticonvulsants, which people take to treat seizures
drugs to fight bacterial infections
some blood pressure medications
medications used to treat cancer
A 2020 study found that although there's no direct evidence that statins, a class of drugs used to lower cholesterol and prevent cardiovascular disease, cause neuropathy, statins may increase the risk of neuropathy from other causes.

Question: How do doctors usually figure out if someone has neuropathy, diagnosis?

First, your doctor will perform a physical exam and ask about your medical history. They might perform
other tests, which include:
Electromyography
Electromyography can show problems with how your body's nerve signals move to your muscles.
For this test, your doctor will place a small needle into your muscle. Your doctor will then ask you to move your muscle gently. Probes in the needle will measure the amount of electricity moving through your muscle.
This test may feel like you're receiving a shot. Sometimes the area becomes sore for a few days afterward.
Nerve conduction study
In a nerve conduction study, your doctor places electrodes on your skin. They then pulse tiny amounts of electricity through your nerves to see if the nerves are transmitting signals properly.
This procedure is slightly uncomfortable while it's happening, but it shouldn't hurt afterward.
If you need help finding a primary care doctor, then check out our FindCare tool here.

Question: How do doctors usually treat neuropathy?

Treatment for the symptoms of peripheral neuropathy focuses on treating
the underlying disorder. If diabetes is the cause, the focus is on blood sugar control. If a vitamin deficiency is causing the problem, then correcting the deficiency is the treatment.
Many treatments can bring relief and help you return to your regular activities. Sometimes a combination of treatments works best.
Pain medications
Over-the-counter (OTC) oral pain medications like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen, can be very helpful in controlling moderate pain.
If you take them in excess, these drugs can affect your liver or stomach function. It's important to avoid using them for an extended period, especially if you drink alcohol regularly.
The Foundation for Peripheral Neuropathy includes a list of additional topical OTC medications you may consider trying. They include:
Absorbine Jr. This is a blend of menthol and other herbal ingredients that can soothe muscle pain. Other menthol-based creams may also help. They include Flex-All, Flexgen, Tiger Balm, or Vicks VapoRub.
Capsaicin cream. This cream contains chili pepper oils, which create a heating effect that helps relieve pain for some people. There are brands and formulations.
Neuragen PN. Made from botanical oils, this cream is meant specifically for nerve pain on hands and feet.
Sore No More. This is another botanical anesthetic that may provide some relieve for neuropathic discomfort.
Prescription medication
Many prescription pain medications can also help to control the pain of this condition. These include narcotics, some antiepileptic medications, and some antidepressants. Other helpful prescription medications include:
lidocaine in a patch on the affected area
pregabalin (an anti-epileptic medication)
duloxetine (an antidepressant)
steroids
anesthetics
Prescription drugs for sexual dysfunction in men due to nerve damage include phosphodiesterase 5 inhibitors (PDE5Is) like:
sildenafil
vardenafil
tadalafil
avanafil
Medical treatments
Your doctor can use several medical treatments to control the symptoms of this condition. Plasmapheresis is a blood transfusion that removes potentially irritating antibodies from your bloodstream.
If you get a nerve block, your doctor will inject an anesthetic directly into your nerves.
Transcutaneous electronic nerve stimulation (TENS)
Transcutaneous electronic nerve stimulation (TENS) doesn't work for everyone, but many people like it because it's a drug-free therapy.
During TENS, electrodes placed on the skin send small amounts of electricity into the skin. The goal of this treatment is to disrupt nerves from transmitting pain signals to the brain.
Ergonomic casts or splints
Ergonomic casts or splints can help you if your neuropathy affects your muscles. Splints can help with:
muscle weakness
stability
These casts provide support for the part of your body that's uncomfortable. This can relieve pain. For example, a cast or splint that holds your wrists in a proper position while you sleep can relieve the discomfort of carpal tunnel syndrome.
Self-care
In addition to OTC pain relievers, many people have found relief for peripheral neuropathy through:
having a foot bath with chamomile or nettle leaves for at least 30 minutes
using a heating pad or electric socks
applying an ice pack to affected areas for 10 minutes twice daily in the morning and the evening
trying acupuncture
undergoing biofeedback
trying different types of holistic therapy such as reflexology, tai chi, or reiki
massaging affected areas to promote circulation
avoiding pressure on the affected area, like not crossing legs or leaning on elbows
seeking social support and activities with others
setting priorities daily and not doing more than you feel you are capable of
avoiding caffeine and developing a regular bedtime routine to promote sleep
Moderate, regular exercise can also help lessen discomfort.
If you drink alcohol or smoke, consider cutting back or stopping. Both alcohol and tobacco aggravate nerve pain and can cause nerve damage when used for long periods.
Take precautions at home
If you have peripheral neuropathy, you're potentially at greater risk for accidents in the home. You can do the following to improve your safety:
Use safety guards and other tools for sharp objects like scissors and knives.
Use thermometers to measure the temperature of bath or tap water.
Use potholders and gloves when handling hot items.
Use a walker or cane for added stability.
Install nightlights to avoid tripping in the dark.
Carefully wrap your hands and feet when it's cold out.

Question: What are the ways to prevent neuropathy?

You can take steps to prevent
peripheral neuropathy and lower your risk by:
talking with your doctor about genetic risk and steps to prevent onset of hereditary neuropathy
asking about medications that have lower neuropathy risk
getting vaccinated for conditions like shingles that can cause neuropathy
treating the underlying cause of neuropathy, like managing blood sugar if you have diabetes
quitting smoking to promote healthy circulation
avoiding caffeine to improve sleep
Eating healthy to prevent vitamin deficiency and support vascular health is of particular importance. Keeping a balanced diet that includes all the food groups is your best course of action.
However, the Foundation for Peripheral Neuropathy has a list of some specific nutrients and vitamins to look out for in your food that may play a role in improving some symptoms
If you have diabetes, take special care of your feet. Wash and inspect your feet daily, and keep the skin moist with lotion.

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Conclusion & Takeaways

Learning about neuropathy is the first step toward taking control of your health. By understanding its causes, symptoms, and treatments, you empower yourself to make informed decisions. Remember to consult healthcare professionals for personalized advice and support.