Peripheral Neuropathy

Overview

Definition

Peripheral neuropathy is damage to the nerves that connect the spinal cord to the rest of the body.

Peripheral Nerves of the Foot
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Causes

Nerve damage may be from:

  • Trauma from nerve compression or inflammation
  • Some medicines, such as chemotherapy treatments for cancer
  • Lacking some vitamins
  • Exposure to toxins and heavy metals, such as lead , mercury , or pesticides
  • Exposure to cold or radiation
  • Alcohol use disorder

Health problems that can damage these nerves are:

  • Diabetes
  • Infections, such as Lyme disease and tuberculosis
  • Kidney failure
  • Autoimmune disorders, such as rheumatoid arthritis
  • Acute or chronic demyelinating polyneuropathy
  • Porphyria
  • Paraneoplastic syndromes
  • Hereditary syndromes, such as Charcot Marie Tooth disease

Risk Factors

Having certain health problems may raise the chance of getting peripheral neuropathy.

SymptomsandDiagnosis

Symptoms

Damage may cause sensory and motor problems in the arms, hands, legs, and feet. Other parts of the body may also have problems. It depends on which nerves are affected.

Problems may be mild and then get worse over time. They may be worse at night. A person may have:

  • Numbness or lack of feeling
  • Tingling
  • Pain, often a burning or sharp, or cutting feeling
  • Sensitivity when touched
  • Muscle spasms
  • Muscle weakness
  • Problems walking
  • Loss of coordination or balance

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

Blood and urine tests will be done.

Your nerves will be tested. This can be done with:

  • Electromyography (EMG)
  • Nerve conduction studies (NCS)

Images may be taken. This can be done with:

  • CT scan
  • MRI scan

Other tests may be:

  • Lumbar puncture to test the fluid around your spine
  • Nerve or muscle biopsy

Treatments

Treatment

Treatment depends on what is causing the neuropathy. This can ease symptoms or make them go away. Other treatment options may be:

Physical Therapy

Exercises may be given to help with flexibility. It may help make walking easier.

Medicine

Pain medicine is often used. Botulinum toxin A injections may also ease pain.

Medicines used to treat depression and prevent seizures can ease some symptoms.

People with severe problems may need:

  • IV immunoglobulins to suppress the immune system
  • Plasma exchange of the blood to ease swelling and suppress the immune system

Prevention

Manage chronic health problems, such as diabetes. This may prevent some forms of peripheral neuropathy.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

RESOURCES

American Chronic Pain Association http://www.theacpa.org 

The Neuropathy Association http://www.neuropathy.org 

CANADIAN RESOURCES

Canadian Diabetes Association http://www.diabetes.ca 

Health Canada https://www.canada.ca 

References

Barrell K, Smith AG. Peripheral Neuropathy. Med Clin North Am. 2019 Mar;103(2):383-397.

Peripheral neuropathy fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/peripheral-neuropathy-fact-sheet. Updated August 13, 2019. Accessed October 16, 2019.

Peripheral neuropathy. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/peripheral-neuropathy . Updated February 19, 2019. Accessed October 16, 2019.

12/1/2016 DynaMed Plus Systematic Literature Surveillance  http://www.dynamed.com/topics/dmp~AN~T474253/Peripheral-neuropathy  : Attal N, de Andrade DC, et al. Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomized, double-blind, placebo-controlled trial. Lancet Neurol. 2016 May;15(6):555-565.