It can start as “pins and needles,” as if your hand or foot has fallen asleep, followed by burning, feelings of electric shock, muscle weakness, or extreme sensitivity to the lightest touch. Peripheral neuropathy (PN) is a chronic and painful condition which involves damage to the nerves outside the brain and spinal cord. This condition is more common among older adults.
There are over 100 known types of neuropathy, a third of them are idiopathic, meaning the cause is unknown. Neuropathy is often difficult to diagnose, is frequently mistaken for other disorders, or even dismissed as something that is imagined. Increased awareness of neuropathy is important, because early diagnosis can result in effective treatment which will allow peripheral nerves to slowly regenerate. Also, pain can be managed, restoring quality of life. If ignored, symptoms may intensify to include loss of sensation, lack of coordination, weakness, dizziness, digestive disorders, unremitting pain and disability.
Who is at the greatest risk of developing peripheral neuropathy? Consider the risk factors which could cause the onset of this disease. They include traumatic injuries, infections, autoimmune disease, repeated nerve pressure, metabolic disorder and exposure to toxins. But by far the greatest risk factor exists for those with diabetes. Approximately 60 to 70 percent of all diabetics develop diabetic peripheral neuropathy (DPN), and that risk rises with age and longer duration of diabetes, reports the National Diabetes Information Clearinghouse.
As a result of the increasing number of diabetics in the United States, as well as chemotherapy survivors, another high risk group, the incidence of peripheral neuropathy continues to climb. Awareness of this disease, however, remains at a very low seven percent. Many more people are affected than the 1-in-15 currently reported, according to Tina Tockarshewsky, president and CEO, The Neuropathy Association. Previously, 20 million Americans were diagnosed with the condition, but another 79 million people with pre-diabetes are also at risk for developing DPN. “We are all gravely underestimating the millions of people struggling and suffering with neuropathies,” contends Tocharshewsky.
The severity of the condition varies depending on the location and type of the affected nerves, according to Medical News Today. Motor nerve damage can leave patients with muscle weakness, cramps, spasms, a loss of balance and coordination, and heaviness of the lower extremities, making it difficult to walk or run. Damage to arm nerves may make it difficult to do routine tasks such as opening jars or turning door knobs. Sensory nerve damage can cause tingling, numbness, pinching and pain, and frequently patients report a sensation of wearing an invisible glove or stocking. Autonomic nerve damage affects internal organs and involuntary functions which can lead to abnormal blood pressure and heart rate, reduced ability to perspire, constipation, bladder dysfunction, diarrhea, incontinence, sexual dysfunction and thinning of the skin. If you experience any of these symptoms, it is of utmost importance to discuss them promptly with your physician. A referral to a neurologist for a complete workup may be indicated.
Even if the underlying cause cannot be identified or corrected, there are fortunately a number of highly effective ways to control pain and restore function. Not surprisingly, one of the top recommendations from Mayo Clinic is a healthy lifestyle: a diet rich in fruits, vegetables, whole grains and lean protein, especially foods with vitamin B-12 (meats, fish, eggs, low-fat dairy foods and fortified cereals), regular exercise, drinking only in moderation, and no smoking at all. For diabetic patients, management of blood glucose levels is essential, along with the same healthy lifestyle choices listed above.
A wide variety of prescription medications have been proven to control pain in neuropathy patients. Additionally, according to a new study from the University of Texas, anti-oxidants appear to offer great potential in the ongoing quest to minimize neuropathy pain and improve quality of life. Antioxidant supplements should not be taken without physician approval.
Current research projects funded by the National Institute of Neurological Disorders and Stroke (NINDS) are exploring the implication of genetics, biological factors in diabetesassociated neuropathies, and how the immune system contributes to peripheral nerve damage. Developing more effective therapies for neuropathic pain is also under the microscope at NINDS.
This new research is encouraging for the millions afflicted with any form of this disease. If you are experiencing symptoms or have questions, please consult your personal physician.
For more information on the benefits of Concierge Medicine, please visit Wellesley Primary Care Medicine. To enroll as a new patient, please call us directly at (781) 705-7272. Current patients with any health concerns, should call Dr. Glaser’s office directly at (781) 431-2345. Thank you!