More than 20 million people in the US are suffering from a form of peripheral neuropathy. This is a condition that manifests when you suffer damage to the peripheral nervous system. The peripheral nervous system is the communications network that allows the body to share information between the brain and spinal cord and the rest of the body through the central nervous system.
You might experience different symptoms, ranging from a prickling sensation to tingling or numbness, or weak muscles. Some parts of your body might become too sensitive, followed by intense pain referred to as allodynia. You will feel pain in response to any stimuli in your surroundings, especially those that don’t usually provoke pain in your body.
Some of the severe symptoms that you might feel include a burning painful sensation at night, paralysis, muscle wasting, glandular or organ dysfunction. The problem with nerve damage, especially when it affects your internal organs is that it might affect your sexual function, digestion, urination or sweat glands. People who suffer from peripheral neuropathy usually have a difficult time breathing from time to time and might even experience organ failure.
The role of the peripheral nerves is to send sensory information between the brain spinal cord, the brain and the rest of the body. This is how the brain recognizes that your hands are cold, or any other sensation that you might be feeling. To stimulate movement, the peripheral nerves also relay signals from your brain and spinal cord to your muscles.
These are important connections in the body that should never be interfered with. Damage to the peripheral nerves, therefore, affects these important connections. Peripheral neuropathy therefore interrupts or distorts the messages from the brain or the spinal cord to the rest of the body.
Neuropathy can happen in different forms and patterns. In some cases, you can experience the symptoms for a few days, and for some people, the symptoms can last for months or even years. You can have chronic or acute neuropathy. In an acute neuropathy, your body’s immune system attacks some parts of your peripheral nervous system, interfering with the ability to receive and send nerve signals. In other cases, especially chronic neuropathy, you will notice subtle symptoms, then as time goes by, the symptoms will progress further. As the damaged nerves heal, the symptoms will also resolve slowly over time.
With peripheral neuropathy you can have relief for a while, then a relapse later on. Some people even get to a plateau stage. In this stage, the symptoms do not change over a very long time, even years. Most of the time chronic neuropathies will get worse with time. It might be painful and debilitating in some cases, but there are very few forms of peripheral neuropathy that have recorded fatalities.
Diabetic neuropathy is the most common type of neuropathy. In this case, you experience nerve damage over an extended period of time, and it happens in an ascending pattern. The fibers that connect the brain and the spinal cord are usually the first ones to malfunction. You will feel numb and pain symmetrically in both feet. The pain will progress slowly up your legs. After a while, your hands, fingers, and arms might be affected.
Peripheral Neuropathy Types
Scientists have identified more than a hundred types of peripheral neuropathy. Each of these has unique symptoms, and the prognosis is also different. Neuropathies are classified depending on the kind of damage that is done to the nerves. Types of neuropathy that only affect a single type of nerve are referred to as mononeuropathies. Neuropathies that affect more than one nerve, which is most often the case, are referred to as polyneuropathy.
There are neuropathies that occur as a result of damage to the axons, while others happen because the myelin sheath is affected. The myelin sheath is the fatty protein that insulates the axons. Some neuropathies might also be caused by both demyelination and damage to the axons. Doctors must conduct electrodiagnostic studies on the patient so that they can determine the kind of damage that has been done to the nerves and identify the peripheral neuropathy.
Peripheral Neuropathy Symptoms
The symptoms of peripheral neuropathy will often depend on the type of nerves that have been affected.
The damage can be on any of the following:
- Autonomic nerves
- Sensory nerves
- Motor nerves
The role of autonomic nerves is to control the activities of body organs that are automatically regulated. They are involved in things like glandular functions, heart functions, digestion, and breathing.
Sensory nerves are tasked with the transmission of information about sensations, like feeling pain from a cut or feeling the lightness of someone’s touch on the skin.
The role of motor nerves is to control the voluntary movement of the muscles that are used in grasping items, talking or walking.
Unfortunately, there are neuropathies that might affect all the three types of nerves. Most of the time, only one or two types of nerves are affected. Upon diagnosis, the doctor can identify the type of neuropathy as predominantly motor neuropathy, sensory-motor neuropathy, predominantly sensory neuropathy or autonomic neuropathy.
Peripheral Neuropathy Causes
You can get peripheral neuropathy from a disease, trauma or passed down genetically. More often, the real cause of a peripheral neuropathy cannot be identified easily. A neuropathy whose cause the doctors cannot identify is an idiopathic neuropathy.
For acquired neuropathy, there are different causes, including the following:
Trauma. This is the most common cause of injury to the nerves. This happens as a result of physical injury. Sudden trauma from a fall, sporting activity, accidents or surgical procedure can severe the nerves or damage them. The nerves can be compressed, crushed, or stretched forcefully, detaching them from the spinal cord completely or partially.
The trauma does not always have to be severe. There are cases where minor trauma can also cause major nerve damage. A dislocated or broken bone might exert pressure on the nerves in the neighboring parts of the body, causing nerve damage.
Frequent, repetitive stress can cause entrapment neuropathy. This is a compression injury. In some cases, engaging in forceful, awkward or repetitive activity that requires you to move a group of joints for a long time might also cause trauma to the nerves. The irritation from this traumatic event might cause the muscles, tendons, and ligaments to be inflamed, swelling and interfering with the passageways where nerves pass.
Some of the common examples of this type of neuropathy are carpal tunnel syndrome and ulnar neuropathy, which happen as a result of nervous compression at the wrist or elbow. Most diseases can actually be linked to peripheral neuropathy.
Autoimmune Diseases. This is a situation where the body’s immune system attacks the body’s tissues. When this happens, the nerves can be damaged in the process. Some of the common conditions that might cause this include lupus and rheumatoid arthritis. Inflammation of the tissue surrounding the nerves can spread to the nerve fibers, and if this progresses over time, the disease can cause damage to the connective tissues, organs, and joints. As a result, the nerve fibers become more vulnerable to entrapment and compression injuries.
One of the biggest challenges of such chronic conditions is that they tend to alternate between relapse and remission from time to time, so you will need proper management especially for the pain. Most people will recover from the syndrome. However, in severe cases, this can be life-threatening.
Kidney Disorders. It is also possible to develop peripheral neuropathy from a kidney disorder. Dysfunctional kidneys can result in a high level of toxicity in the blood, which damages the nerve tissues over time. Most of the people who go for dialysis as a result of kidney failure tend to develop polyneuropathy.
Infections. Peripheral neuropathy can be caused by infections. Bacteria and viruses that affect the nerve tissues like herpes damage the sensory nerves, causing a lot of pain in the process. An inflammation that is caused by infection can cause different types of inflammatory neuropathies, which might either progress very slowly or very fast.
There are different forms of neuropathy that are linked to HIV, especially depending on the nerves that are affected, and the part of the body that the active immunodeficiency disease attacks. One of the first signs of HIV infection is polyneuropathy that is very painful and affects the hands and feet. At least 30% of people who have HIV develop peripheral neuropathy, while another 20% develop distal neuropathic pain.
Cancer. Cancers often infiltrate and damage nerve fibers. Cancers can also compress the fibers, causing a lot of pain. The tumors might arise from nerve tissue cells. Chemotherapy agents are often toxic, and this toxicity or that of the radiation used in treating cancer can cause peripheral neuropathy.
Close to 40% of people who have undergone chemotherapy develop peripheral neuropathy. This is one of the reasons why a lot of people tend to stop chemotherapy very early. The severity varies from one person to the other. There are people who have been able to reduce the painful symptoms by reducing their dose of chemotherapy, while others have to stop chemotherapy altogether. Chemotherapy-induced peripheral neuropathy (CIPN) can persist for a very long time into the future, even after the patient has stopped chemotherapy.
Diagnosing Peripheral Neuropathy
Diagnosing peripheral neuropathy might not be easy, considering that the symptoms are not always the same in all patients. You need a thorough examination to determine the cause of the symptoms before the doctor can diagnose peripheral neuropathy. Some of the things that the doctor will look into include your medical history, exposure to toxins, use of alcohol, social habits, your work environment and anything else that might be responsible for the symptoms you are experiencing.
The tests are carried out not just to determine whether you have peripheral neuropathy or not, but also to identify the level and type of nerve damage that you are experiencing. Physical examination will help the doctor find out the systemic disease that is responsible for your nerve damage. To determine whether your nerve fibers are affected, the doctor will assess your ability to sense a light touch, vibration, pain, temperature and body position.
Blood tests are important in that they can help the doctor tell whether you have a kidney dysfunction, liver problem, vitamin deficiency, diabetes, or any other metabolic disorder. This can also help the doctor identify an abnormal immune system activity.
To detect abnormal antibodies, the doctor has to examine the cerebrospinal fluid. This will help identify peripheral neuropathy as a result of immunity challenges. For inherited neuropathy, genetic tests are also available.
From the results of the neurological exam, a study of your medical history, previous screening or testing and your physical exam, the doctor will recommend any of the following tests to understand the extent of your peripheral neuropathy:
Electromyography (EMG). The doctor inserts a needle into your muscle to determine the electrical activity when your muscles contract and when they are relaxed. These tests help identify abnormal electrical activity in the event of motor neuropathy and have been helpful in differentiating nerve disorders from muscle disorders.
Magnetic Resonance Imaging (MRI). This test will show the size and quality of your muscles. It can also help the doctor rule out herniated discs, tumors and any other abnormality that might be the cause of your peripheral neuropathy.
Nerve Conduction Velocity (NCV). This test determines the extent of the damage in large nerve fibers. It shows the doctor whether your symptoms are as a result of a degeneration of the axon or myelin sheath. The doctor uses a probe to stimulate your nerve fiber, generating an electrical impulse. Placing an electrode along the pathways of the nerve will measure how fast impulses are transmitted along the axon. A slow transmission or blocked impulses mean that the myelin sheath is damaged. In case of axonal degeneration, the test will record weaker impulses at normal speed.
Skin Biopsy. This is a test where the doctor takes a sample of your skin to study the nerve endings. It’s often preferred for nerve biopsy or NCV. It is possible to identify damage even to the smallest fibers, which cannot be done through nerve biopsy. It also has very few side effects, is easy to perform, and less invasive.
Nerve Biopsy. Here the doctor takes a sample of your nerve tissue, especially from the lower leg. This sample should provide lots of information about the nature and extent of nerve damage. However, it is an invasive procedure, is complex, and might also cause peripheral neuropathy as an after-effect.
Treating Peripheral Neuropathy
Given that peripheral neuropathy can be caused by a lot of things, it is important that you identify the underlying cause, then deal with it. Naturally, peripheral nerves can regenerate their axons. As long as the nerve cell is not dead, you should be able to get a functional recovery with proper management. addressing the underlying condition is one of the best ways of getting peripheral neuropathy to resolve on its own because the nerves will recover and regenerate.
You also need to adopt a healthy lifestyle. This gives you a shot at speedy recovery. In this regard, you should maintain an ideal weight, limit your exposure to toxic substances in your environment that might have been responsible for your neuropathy, eat a balanced diet, talk to your nutritionist to correct your nutritional deficiencies, reduce or stop drinking alcohol, exercise often.
Exercising will help you improve your muscle strength, reduce cramps and stop muscle wasting. There are diet schedules that you can start which will improve your gastrointestinal symptoms. To prevent further damage to the nerves, you should consider getting treatment for injuries as soon as possible.
Smoking affects the blood vessels, constricting them and making it difficult to transport nutrients and oxygen-rich blood to the peripheral nerves. Therefore, smoking makes the symptoms worse. You should stop smoking if you have peripheral neuropathy.
To improve your quality of life, you should also look at proper self-care tips. Take good care of your feet, manage your wounds well, especially if you have diabetes. These are some of the simple things you can do which eventually help you in nerve regeneration.
Monitor and manage your blood glucose levels. This will improve your symptoms and help you prevent further damage to the nerves.
Your doctor can recommend a variety of drugs to help manage peripheral neuropathy. Immunosuppressive drugs might be helpful in this regard, especially cyclosporine, prednisone or azathioprine.
This is another option in treating peripheral neuropathy. In this procedure, your blood is removed, cleaned of antibodies, immune system cells and then returned back to the body. This helps suppress immune system activity and reduce inflammation.
To stop or reduce abnormal immune system activity, you can be given immunoglobulins. Immunoglobulins are antibodies that alter the way your immune system works. A good example is a rituximab, an immunoglobulin that targets inflammatory cells.
Symptom management is another way of easing your troubles with peripheral neuropathy. It might be difficult to control pain as a result of injured nerves. Using over the counter analgesics can make the pain worse. You should look for ways of easing the pain. Talk to your doctor about the type of pain you are feeling, how often it happens, and anything else that might be unique about the pain. With the help of a physician, you should be able to manage your symptoms better.
There are different types of medicine that can be administered to help you manage the pain you are feeling, such as narcotic agents, anticonvulsant medicine, and antidepressants. Your doctor will advise you on the best option, considering your medical history, and the risk of allergic reactions.
Peripheral Neuropathy and Dieting
In case you are suffering from neuropathy, you may have already considered a number of options, from medicine to your food choices. More often, people will want to look into the changes that they can make to their diet in order to make their condition better. Over the years, there has been significant research on the types of food that we eat, and how they affect or support our fight against some diseases and conditions. Bearing this in mind, there is a strong connection between the food that we eat and the state of the nervous system. Given that there can be positive and negative effects, it is important that you learn the type of food that you should keep in your diet, and the ones you should do away with.
Nutrition is always the first line of defense when it comes to preventative medicine for any condition, not just peripheral neuropathy. You need to develop a good diet that will go a long way in helping you manage and reduce the symptoms that you are currently experiencing. In some cases, the type of food you eat might even help you heal the nerves.
There are different conditions that might be responsible for your case of peripheral neuropathy. Diabetes is one of the most notorious reasons. Because of this, you need to keep an eye on your blood sugar levels, so that you can have a better chance at fighting or preventing peripheral neuropathy. At the same time, consuming too much alcohol increases your risk of developing Vitamin B deficiencies, hence leaving you at risk of developing peripheral neuropathy.
Whether you have peripheral neuropathy, diabetes, cancer, or even a disorder associated with an addiction, you must make sure your diet contains vegetables, whole grains, lean protein, and fruits. You also need to make sure you have a good food diary. A food diary will help you understand the foods that make you feel worse and the ones that make you feel better. You can also note down how long it takes before your body responds to the type of food that you have taken. This is a significant step towards helping you manage your peripheral neuropathy better.
Depending on the type of food you eat, your case of peripheral neuropathy can improve or get worse. There are foods that will only end up aggravating your nerves, making them weaker. This is one of the reasons why you should be keen on what you eat. You should also know what not to eat so that you can reduce the numbness, tingling or nerve pain you are already experiencing.
You should focus on eating foods that strengthen your nerves, in the process making your condition better. There are specific foods that will even help your body repair nerves that have been damaged. The prospect of getting full relief from the peripheral neuropathy symptoms is something that you should strongly look into.
Foods You Should Eat
Water. For any healthy diet, water has to be a constant. Water might not be one of the miracle workers when dealing with peripheral neuropathy, but it can go a long way in providing you relief from inflammation. By drinking sufficient amounts of water, you will not feel as much pain as you currently feel.
When you are dehydrated, the blood gets thicker, which can lead to muscle spasm. Because of this reason, your body gets inflamed, and this affects the pain receptors and nerves. The body generally works better when you are hydrated, thereby improving your well-being too.
Ginger. Ginger is one of the traditional pain relievers that has been used in many alternative medicines and traditional medicines for a long time. Including ginger in your diet will help you feel much better. Other than that, ginger has gingerols. These are the anti-inflammatory ingredients that help your body fend off inflammation. For people who have struggled with mobility in the past, including ginger in your diet will help you feel better, reduce the pain you feel and help you move better.
Vegetables and Fruits. Vegetables and fruits give your body important vitamins, antioxidants, minerals and dietary fibers. Together, these are important in supporting your immune system, and at the same time help you fight off illnesses and diseases.
If you have peripheral neuropathy, you need to increase the number of fruits and vegetables in your diet as soon as possible. When you come to think about it, most of the people who have peripheral neuropathy also tend to suffer from diabetes. Therefore, by increasing your intake of fruits and vegetables, you will also be able to improve your diabetes.
Where possible, try and eat no less than 5 portions of vegetables and fruits a day. This will help you get results faster. Choose the fruits and vegetables that have a high level of antioxidants, especially onions, oranges, grapefruits, cherries, bell pepper, and berries. The good thing with fruits and vegetables is that they are usually ready to eat. Therefore, you have very little work to do in the kitchen in terms of preparation.
Lean Protein. The role of lean protein in the body is to help repair and build new tissue. You must keep it lean, however, so that you do not end up eating a lot of animal fats. Some of the best sources you can consider include poultry and low-fat dairy. If you have diabetic neuropathy or peripheral neuropathy, you should strongly consider eating more lean protein.
By all means possible try to stay away from any processed food or anything that has saturated fats and high trans fats. This includes butter, deep fried food, fatty meat and whole milk. Other than making your peripheral neuropathy worse, they can also increase your risk of diabetes, high cholesterol, and heart disease.
Some of the food you should add to your diet include legumes, yogurt, fish, tofu, and skinless poultry. Lean protein does so much more than helping you fight peripheral neuropathy, it helps you improve your blood sugar level.
In some cases, your doctor can also recommend a product that can help you ease nerve pain.
Foods You Should Avoid
Diabetic and peripheral neuropathy can become worse as a result of alcoholism, diabetes, traumatic injury, vitamin deficiency and so much more. In order to treat it well, you should learn to find ways of managing the cause, which in most cases will include therapy and medication. A keen look at your diet will also help you identify the foods that make your situation worse so that you can get rid of them. The following are some of the foods that you should try and keep out of your diet:
Refined Grains. The problem with refined grains is that they have a very high glycemic level. A high glycemic level will have a negative effect on your blood sugar. If you are to keep peripheral neuropathy in check, your body should be able to control the glucose and insulin levels. Instead of refined grains, try and consume more refined grains. This will improve the glycemic impact in your diet.
Gluten. You should stay away from gluten. This particularly applies to anyone who has celiac disease. In case you are allergic to gluten, consumption would trigger neuropathy or even make the symptoms worse. Foods that contain gluten include things made from wheat, cake, baking, or white flower. When you go shopping, ask for gluten-free varieties of the food items you need.
Sugar. While sugar is a good ingredient in the sense that it adds flavor to your food, it offers little or no nutritional value at all. If you suffer from a nutritional deficiency, you will most probably suffer neuropathy. Instead of eating sugar, consider getting vegetables, whole grains or fresh fruits if you need something sweet.
Saturated Fats. Saturated fats are common in fatty meat and fatty dairy products. The problem with these fats is that they increase your risk of inflammation and leave you vulnerable to type 2 diabetes.
Like most conditions, infections, and diseases, treating peripheral neuropathy is all about proper management. Early detection will go a long way in helping you start proper management and handle the neuropathy better.