Peripheral Neuropathy
Peripheral Neuropathy is the term used to describe damage to the body's peripheral nerves. These nerves carry feelings to the brain from the rest of the body. The nerves to the feet are the longest in the body and therefore most likley to be damaged by diseases of the nerves or from the side effects of systemic illnesses such as diabetes. Neuropathy can cause insensitivity or a loss of ability to feel sensations such as touch, pressure, vibration, pain, position in space and temperature. A person whose nerves are damaged by diabetes may not realise they have cuts, corns, blisters, pressure sores or ulcers.
As well as a loss in sensation, nerve damage can cause:
- Painful feet
- Numbness in the feet
- Pins and needles or shooting pain in the feet
- weakness
- Burning sensation, particularly on the soles of the feet.
- Electric shock, tingling, itching
- Shooting pains
and other abnormal sensations (paresthesia)
Symptoms of neuropathy can vary in severity and location, according to the number of nerves affected and their locations. These symptoms are often worse at night
Skin can also become quite hypersensitive (over sensitive) causing some people to have difficulties tolerating sensations such as gentle touch on their feet. In other cases people may experience other abnormal feelings such as pain on light touch when it should otherwise be pain free. Keeping feet warm and covered can sometimes help with these sensations.
Common Causes
- Diabetes (approximately 50 per cent of diabetics suffer from diabetic neuropathy).
- Metabolic disease such as diabetes, chronic renal failure, liver failure and hypothyroidism
- Autoimmune diseases such as rheumatoid arthritis and Sjögren's syndrome
- Infections such as leprosy, shingles (post herpetic neuralgia) or AIDS
- Nerve impingment (pinched nerve) or irritation of the nerve (such as in mortons neuroma)
- Toxic substances, including alcohol or heavy metals
- Vitamin deficiency, which may or may not be related to other medical conditions such as coeliac disease
- Radiation & Chemotherapy.
- Trauma (eg bone fractures)
- Injury or tumour of the spinal cord.
- Inherited neuropathies such as Charcot Marie Tooth
However, in many cases, no underlying disorder can be diagnosed.
Treatment
Treatment of peripheral neuropathy depends on the underlying cause .
Mortons neuroma may be relieved by the use of shoe paddings, an orthotic, or in extreme cases may require surgery on the foot.
Diabetic neuropathy is a slow progressive condition which is why prevention is so important (such as keeping blood sugar levels strictly controlled), however as the level of sensation in the feet decreases, so too do many of the other symptoms such as burning and tingling. These symptoms normally occur at night time. Some people find that gentle massage or heating/cooling gels on their feet can help reduce the symptoms, medication can alleviate the symptoms.
Toxic substance related neuropathies may improve if those substances are avoided.
Deficiency neuropathies may improve following vitamin therapy.
Inflammatory neuropathies may respond to immune therapy.
In cases where no underlying cause can be identified, pain clinics, physical therapy, medications and pain management techniques, including psychological therapy, may also be required.
Prevention is key
Prevention of neuropathy where possible is key, as once the nerves are destroyed, sensation rarely improves. It is important for those who do experience a loss of sensation to protect their feet as much as possible from harm. Daily foot checks are extremely important, as is timely treatment for cuts, bruises, burns, redness, cracks or blisters etc. The good news is that when a person with neuropathy takes the necessary preventative foot care measures, he or she reduces the risk of serious foot conditions significantly.
The prognosis for patients suffering from peripheral neuropathy depends on whether an underlying cause can be identified and treated. While some patients may be able to treat the cause and halt the progress, others may develop a chronic condition requiring ongoing therapy and may require the support of one of a neurologist or one of Adelaide's Pain Clinics.
As well as a loss in sensation, nerve damage can cause:
- Painful feet
- Numbness in the feet
- Pins and needles or shooting pain in the feet
- weakness
- Burning sensation, particularly on the soles of the feet.
- Electric shock, tingling, itching
- Shooting pains
and other abnormal sensations (paresthesia)
Symptoms of neuropathy can vary in severity and location, according to the number of nerves affected and their locations. These symptoms are often worse at night
Skin can also become quite hypersensitive (over sensitive) causing some people to have difficulties tolerating sensations such as gentle touch on their feet. In other cases people may experience other abnormal feelings such as pain on light touch when it should otherwise be pain free. Keeping feet warm and covered can sometimes help with these sensations.
Common Causes
- Diabetes (approximately 50 per cent of diabetics suffer from diabetic neuropathy).
- Metabolic disease such as diabetes, chronic renal failure, liver failure and hypothyroidism
- Autoimmune diseases such as rheumatoid arthritis and Sjögren's syndrome
- Infections such as leprosy, shingles (post herpetic neuralgia) or AIDS
- Nerve impingment (pinched nerve) or irritation of the nerve (such as in mortons neuroma)
- Toxic substances, including alcohol or heavy metals
- Vitamin deficiency, which may or may not be related to other medical conditions such as coeliac disease
- Radiation & Chemotherapy.
- Trauma (eg bone fractures)
- Injury or tumour of the spinal cord.
- Inherited neuropathies such as Charcot Marie Tooth
However, in many cases, no underlying disorder can be diagnosed.
Treatment
Treatment of peripheral neuropathy depends on the underlying cause .
Mortons neuroma may be relieved by the use of shoe paddings, an orthotic, or in extreme cases may require surgery on the foot.
Diabetic neuropathy is a slow progressive condition which is why prevention is so important (such as keeping blood sugar levels strictly controlled), however as the level of sensation in the feet decreases, so too do many of the other symptoms such as burning and tingling. These symptoms normally occur at night time. Some people find that gentle massage or heating/cooling gels on their feet can help reduce the symptoms, medication can alleviate the symptoms.
Toxic substance related neuropathies may improve if those substances are avoided.
Deficiency neuropathies may improve following vitamin therapy.
Inflammatory neuropathies may respond to immune therapy.
In cases where no underlying cause can be identified, pain clinics, physical therapy, medications and pain management techniques, including psychological therapy, may also be required.
Prevention is key
Prevention of neuropathy where possible is key, as once the nerves are destroyed, sensation rarely improves. It is important for those who do experience a loss of sensation to protect their feet as much as possible from harm. Daily foot checks are extremely important, as is timely treatment for cuts, bruises, burns, redness, cracks or blisters etc. The good news is that when a person with neuropathy takes the necessary preventative foot care measures, he or she reduces the risk of serious foot conditions significantly.
The prognosis for patients suffering from peripheral neuropathy depends on whether an underlying cause can be identified and treated. While some patients may be able to treat the cause and halt the progress, others may develop a chronic condition requiring ongoing therapy and may require the support of one of a neurologist or one of Adelaide's Pain Clinics.
