Peripheral Neuropathy

Peripheral neuropathy

Peripheral neuropathy refers to disorders of the nerves which are outside of the central nervous system (nerves which are away from the brain and spinal cord).  Unfortunately, this problem is all too common.  Peripheral neuropathy can have various causes and produce many different symptoms.

Symptoms that involve the feet may include burning, tingling, numbness, or shooting pains.  Numbness often affects the bottom of the toes and balls of the feet.  Peripheral Neuropathy affects the longest nerves in the body first, which are the nerves that start from the bottom of the spinal cord and extend to the toes.  It is not uncommon for the big toe to be involved first.  If symptoms progress, the hands can become involved as well.  Some experience a sensation as if a band was around the foot or that a stocking was on when it is not.   At times the feet may be overly sensitive.  Even common sensations can be irritating such as the wearing of shoes, walking on carpet, etc.

Causes of Neuropathy

There are many causes of peripheral neuropathy.   It is quite common, however, that an exact cause cannot be discovered.  Poor circulation is usually not the cause of numbness.  So, numbness does not necessarily mean you are at risk as a result of poor blood flow!  Your health care provider will check your circulation to be sure it is adequate.

Known causes of peripheral neuropathy include:

¨ Diabetes (the most common cause)

¨ Alcohol toxicity

¨ Thyroid abnormalities.

¨  Nutritional deficiencies such as inadequate Vitamin B-12 or the  inability of the body to utilize vitamins and nutrients.

¨ Illnesses such as Guillian-Barre.

¨ Inherited conditions that affect nerves.

¨ Entrapment of nerves can occur with back problems, sciatica, or  tarsal tunnel (a pinched nerve near the inside of the ankle similar to carpal tunnel).

¨ Growths that press on nerves.

¨ Injury to nerves.

Drugs used in the treatment of cancer, HIV/AIDS, and other conditions

Treatment of Neuropathy

Treatment for peripheral neuropathy depends on the cause.  Blood tests or nerve conduction studies may be used to check for various causes.  If an underlying cause can be identified, such as diabetes, then treating that cause is important.  Injections or even surgery in some cases can relieve a pinched nerve.

Though symptoms may sometimes improve, the sensations such as numbness do not always go away.  If pain is associated with neuropathy, then your health care provider may recommend trying a cream such as capsaicin which is available without a prescription.   Your health care provider may also recommend the use of oral medications to treat neuropathic pain.  The types of medication often used to treat neuropathy are for other conditions such as seizures or depression.  Common medications that may be prescribed are Neurontin, Lyrica, or Cymbalta to name a few.  Many individuals find that neuropathy is most irritating or painful when trying to go to sleep as there are no distractions from the irritation.  Occasionally, neuropathy medications are combined with pain medications, such as Ultram, to help patients through the initial period as the Neuropathy medications may take some time to reach their maximum benefit.  The important point to remember is there is treatment available, which is tailored to fit each individual patient.  Check out our website www.alaskapodiatry.com.  Also see us on twitter (alaskapodiatry), and become a fan on facebook (Alliance Foot and Ankle).