Patient education: Peripheral neuropathy (The Basics)

What is peripheral neuropathy? — Peripheral neuropathy is a type of nerve damage.

The nervous system has 2 main parts. The "central nervous system" is made up of the brain and spinal cord. The "peripheral nervous system" is made up of the nerves in the body. The peripheral nerves pass signals between the central nervous system and the rest of the body.

The peripheral nervous system includes different types of nerves:

●Motor – This means related to movement. Your motor nerves help your body move and keep its balance.

●Sensory – This means related to the senses. Your sensory nerves help you touch, taste, smell, see, and hear.

●Autonomic – Your autonomic nerves control body functions that you do not have to think about. For example, they control your heartbeat, breathing, digestion, and blood pressure.

Peripheral neuropathy is when 1 or more of these nerves is damaged. This causes symptoms.

What causes peripheral neuropathy? — Peripheral neuropathy can have many different causes. These include some health problems and certain medicines. Sometimes, the cause is not known.

Some possible causes include:

●Diabetes – This is a very common cause of peripheral neuropathy.

●Injury to or pressure on the nerves

●Inherited conditions – These are medical conditions that run in families.

●Certain medicines – Some medicines, such as chemotherapy to treat cancer, can cause peripheral neuropathy as a side effect.

●Autoimmune diseases – These are diseases in which the body's infection-fighting system attacks healthy tissue instead of infections.

●Infections

●Vitamin deficiency – This is when you are missing certain important vitamins from your diet.

●Certain poisons and toxins

What are the symptoms of peripheral neuropathy? — People can have different symptoms. The symptoms depend on which nerves are damaged.

Motor symptoms can include:

●Weakness – Sometimes, weakness can make you clumsy. For example, you might have trouble running or climbing up stairs. Or you might have trouble with tasks like writing, buttoning clothes, opening jars, or tying your shoes.

●Trouble balancing

Sensory symptoms can include:

●Numbness

●Tingling or feeling "pins and needles"

●Pain or burning

Autonomic symptoms can include:

●Bowel and bladder problems – For example, a person might have loose or hard bowel movements, leak urine, or be unable to urinate.

●Trouble swallowing

●Dizziness

●Sweating a lot

●Problems with sex

Will I need tests? — Probably. If you have symptoms of nerve damage, your doctor or nurse will talk to you about your symptoms and do an exam. You will probably also need tests to check how well your nerves are working and try to find the cause of your nerve damage.

Tests might include:

●Tests to check how your nerves respond to vibrations, pain, or changes in temperature

●Electromyogram ("EMG") – This test checks how well the nerves in your muscles are working when the muscles are at rest and when you squeeze or tense them.

●Nerve conduction studies ("NCS") – This test checks how fast your nerves can send signals.

●Lab tests

●Lumbar puncture (also called "spinal tap") – This involves testing a small sample of fluid from around the spinal cord.

●Imaging tests, such as a CT scan or MRI – Imaging tests create pictures of the inside of the body.

●Skin or nerve biopsy – This is when doctors take a small sample of tissue from the body and then look at it under a microscope. They might take a sample of skin tissue, nerve tissue, or both.

How is peripheral neuropathy treated? — Peripheral neuropathy is usually permanent. But there might be ways to keep it from getting worse.

Treatment depends on what is causing your nerve damage and which symptoms you have. It might include:

●Treatment for the problem that is causing nerve damage – If your doctor knows the cause, they will try to treat that health problem or condition. For example, if your nerve damage is caused by diabetes, it can help to keep your blood sugar under control. If it is caused by a problem with your immune system, you might need medicine to treat that condition.

●Treatment to relieve symptoms – This will depend on your symptoms and what is causing them. Treatments might include:

•Taking pain-relieving medicines – For mild symptoms, you might be able to take over-the-counter medicines. For more severe symptoms, your doctor might prescribe a stronger medicine.

•Pain-relief medicines that go on the skin – These include creams or patches.

•Taking anti-seizure or antidepressant medicines – Both of these medicines can help reduce pain.

•Physical therapy – If you have weakness or numbness, physical therapy can help you move more easily.

•Using "assistive devices" – These are devices such as hand and foot braces, a cane, a walker, or a wheelchair.

•TENS therapy – With TENS therapy, small patches called "electrodes" are placed on your skin. A machine delivers a very low electric current to the skin through the patches. TENS therapy can help reduce pain.

•Treatments for problems with eating, sex, or bladder and bowel function

Sometimes, pain from peripheral neuropathy will go away on its own without treatment.

Is there anything I can do on my own? — Yes. There are things you can do that might help to prevent peripheral neuropathy or keep it from getting worse. You should:

●Limit alcohol – Drinking too much alcohol can make peripheral neuropathy worse. Talk to your doctor or nurse about how much alcohol you can safely drink.

●Stop smoking, if you smoke – Smoking can reduce how much blood flows to the peripheral nerves. This can make your symptoms worse. If you are having trouble quitting, your doctor or nurse can help.

●Keep your diabetes under control – If you have diabetes, managing your blood sugar is one of the best things that you can do to prevent or improve peripheral neuropathy.

●Avoid burns or cuts – Peripheral neuropathy can make it harder to feel temperature changes or pain. Be very careful when handling hot objects, using hot water, or using anything sharp that could cause injury.

●Avoid falls – Weakness and trouble balancing can increase your risk of falling. Get rid of things in your home that might cause you to trip. This might include furniture, electrical cords, clutter, and loose rugs. Keep your home well-lit so that you can easily see where you're going. Avoid storing things in high places so you don't have to climb or reach.

●Check your feet regularly – If you have peripheral neuropathy in your feet, it is important that you check them often. Look for sores, cracks, or signs of infection. These can lead to serious problems, especially if you have diabetes. If you have trouble seeing your feet, ask someone else to check them, or go to your doctor or nurse.

Living with peripheral neuropathy can be hard. Sometimes, this can lead to depression and anxiety. Talk to your doctor or nurse if you feel depressed or anxious. Getting treatment for these problems can make it easier to cope.

When should I call the doctor? — Call for advice if you have:

●A fever of 100.4°F (38°C) or higher, chills, or a wound that will not heal

●Swelling, redness, warmth around a wound, a foul smell coming from a wound, or yellowish, greenish, or bloody discharge

●New numbness or weakness in a foot or leg

●Worsening symptoms

●Dizziness or lightheadedness

●Double vision or confusion

●Problems with your blood sugar, if you have diabetes

●Trouble breathing

●Chest pain or discomfort

More on this topic

Patient education: Nerve damage caused by diabetes (The Basics)
Patient education: Neuropathic pain (The Basics)
Patient education: Foot care for people with diabetes (The Basics)
Patient education: Chronic pain (The Basics)
Patient education: Intravenous immune globulin (IVIG) (The Basics)
Patient education: Quitting smoking (The Basics)

Patient education: Diabetic neuropathy (Beyond the Basics)
Patient education: Foot care for people with diabetes (Beyond the Basics)
Patient education: Quitting smoking (Beyond the Basics)