What Is Peripheral Neuropathy?

Peripheral neuropathy occurs when nerves outside the brain and spinal cord (peripheral nerves) are damaged. This often results in weakness, numbness, and pain, primarily in the hands and feet, though it can also impact other areas and bodily functions, such as digestion and urination.

The peripheral nervous system communicates information from the brain and spinal cord (the central nervous system) to the rest of the body via motor nerves. Additionally, sensory nerves send information from the body back to the central nervous system.

Causes of peripheral neuropathy include traumatic injuries, infections, metabolic issues, inherited conditions, and exposure to toxins, with diabetes being a leading cause. Those with peripheral neuropathy often describe the pain as stabbing, burning, or tingling. Symptoms may improve if the underlying cause is treated. Medications can also help alleviate pain.

Symptoms

The symptoms of peripheral neuropathy depend on the type of nerves affected. These nerves are categorized into:

• Sensory nerves: Receive sensations like temperature, pain, vibration, or touch from the skin.
• Motor nerves: Control muscle movement.
• Autonomic nerves: Regulate functions such as blood pressure, sweating, heart rate, digestion, and bladder function.

Common symptoms of peripheral neuropathy include:

• Gradual onset of numbness, prickling, or tingling in the feet or hands, potentially spreading to the legs and arms.
• Sharp, jabbing, throbbing, or burning pain.
• Extreme sensitivity to touch.
• Pain during activities that shouldn’t be painful, like weight on the feet or under a blanket.
• Lack of coordination and frequent falls.
• Muscle weakness.
• A sensation of wearing gloves or socks when not.
• Inability to move if motor nerves are affected.

If autonomic nerves are affected, symptoms may include:

• Heat intolerance.
• Excessive sweating or inability to sweat.
• Bowel, bladder, or digestive problems.
• Blood pressure drops causing dizziness or lightheadedness.

Peripheral neuropathy can affect one nerve (mononeuropathy), multiple nerves in different areas (multiple mononeuropathy), or many nerves (polyneuropathy). Carpal tunnel syndrome is an example of mononeuropathy, while most individuals with peripheral neuropathy experience polyneuropathy.

When to See a Doctor

Seek medical attention promptly if you experience unusual tingling, weakness, or pain in your hands or feet. Early diagnosis and treatment can help control symptoms and prevent further nerve damage.

Causes

Peripheral neuropathy results from nerve damage due to various conditions, including:

• Autoimmune diseases: Such as Sjogren’s syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy, and vasculitis. Some cancers related to the immune system can cause polyneuropathy, known as paraneoplastic syndrome.
• Diabetes and metabolic syndrome: The most common cause, affecting over half of individuals with diabetes.
• Infections: Including Lyme disease, shingles, hepatitis B and C, leprosy, diphtheria, and HIV.
• Inherited disorders: Like Charcot-Marie-Tooth disease.
• Tumors: Both cancerous (malignant) and noncancerous (benign) growths can pressure nerves.
• Bone marrow disorders: Including monoclonal gammopathies, myeloma, lymphoma, and amyloidosis.
• Other diseases: Such as kidney or liver disease, and hypothyroidism.

Other contributing factors include:

• Alcohol use disorder: Poor dietary choices and vitamin absorption in people with alcoholism can lead to deficiencies.
• Exposure to toxins: Such as industrial chemicals and heavy metals (lead, mercury).
• Medications: Certain drugs, particularly chemotherapy for cancer, can cause neuropathy.
• Injury or nerve pressure: From accidents, falls, sports injuries, casts, crutches, or repetitive motions like typing.
• Low vitamin levels: Essential vitamins like B-1, B-6, B-12, copper, and vitamin E are crucial for nerve health.

In some instances, no identifiable cause is found, termed idiopathic peripheral neuropathy.

Risk Factors

Risk factors for peripheral neuropathy include:

• Diabetes, especially with poor blood sugar control.
• Alcohol misuse.
• Vitamin deficiencies, particularly vitamin B-12.
• Infections like Lyme disease, shingles, hepatitis B and C, and HIV.
• Autoimmune diseases such as rheumatoid arthritis and lupus.
• Kidney, liver, or thyroid disorders.
• Exposure to toxins.
• Repetitive motions.
• Family history of neuropathy.

Complications

Complications of peripheral neuropathy can include:

• Burns, skin injuries, and wounds: Especially on the feet, due to numbness and lack of sensation.
• Infection: Injuries may go unnoticed and untreated, leading to infection, particularly in people with diabetes.
• Falls: Weakness and loss of sensation can cause balance issues, increasing fall risk. Installing handrails, using mobility aids, and ensuring well-lit walking areas can help reduce this risk.

Prevention

To prevent peripheral neuropathy, it is crucial to manage underlying conditions and adopt healthy lifestyle choices:

• Manage medical conditions: Control diseases like diabetes that increase neuropathy risk.
• Healthy lifestyle habits: Eat a diet rich in fruits, vegetables, whole grains, and lean proteins. Ensure adequate intake of vitamin B-12 through meats, fish, eggs, dairy, or fortified cereals. Vegans and vegetarians should consider B-12 supplements after consulting a healthcare provider.
• Regular exercise: Aim for 30 minutes to one hour of exercise at least three times a week, with a healthcare professional’s approval.
• Avoid nerve damage factors: Steer clear of repetitive motions, toxic chemicals, smoking, and excessive alcohol consumption.

By understanding peripheral neuropathy’s causes, symptoms, and prevention strategies, individuals can better manage their health and seek appropriate medical care when necessary

A Quick Review

Peripheral neuropathy is a condition resulting from damage to peripheral nerves, often causing numbness, tingling, and pain in the hands and feet. Diabetes is a major cause, but other factors like infections, injuries, and toxins can contribute. Symptoms vary based on the type of nerve affected and can impact sensory, motor, or autonomic functions. Early intervention is key to managing symptoms and preventing complications.