What Is Peripheral Neuropathy?
Peripheral neuropathy refers to a problem with the peripheral nerves. These nerves send messages from the central nervous system, the brain and the spinal cord to the rest of the body. The peripheral nerves tell the body when, for example, the hands are cold. It can lead to tingling, prickling, numbness, and muscle weakness in various parts of the body. Peripheral neuropathy can affect a range of different nerves, so it can impact a variety of locations in different ways. It can affect a single nerve, or several nerves at the same time. It is also associated with a number of different underlying medical conditions. Sometimes there is no identifiable cause. It affects some 20 million people in the United States (U.S.). Here are some key points about peripheral neuropathy. More detail is in the main article. Neuropathy is a common complication of a number of different medical conditions. It can involve the autonomic nerves, the motor nerves, and the sensory nerves. Sometimes it affects a single nerve or nerve set, for example, in Bell's Palsy, which affects a facial nerve. Physical trauma, repetitive injury, infection, metabolic problems, and exposure to toxins and some drugs are all possible causes. Treatment Treatment either targets the underlying cause, or it aims to provide symptomatic pain relief and prevent further damage. In the case of diabetic neuropathy, addressing high blood sugars can prevent further nerve damage. For toxic causes, removing the exposure to a suspected toxin, or stopping a drug, can halt further nerve damage. Medications can relieve pain and reduce burning, numbness, and tingling. Drug treatment for neuropathic pain Medications that may help include: Opioid painkillers come with warnings about safety risks. Doctors can also prescribe skin patch Continue reading >>
Causes Of Peripheral Neuropathy: Diabetes And Beyond
Causes of peripheral neuropathy: Diabetes and beyond J Fam Pract. 2015 December;64(12):774-778,781-783 Department of Family and Community Medicine (Dr. L. Mayans), Department of Internal Medicine (Dr. D. Mayans), University of Kansas School of MedicineWichita; Neurology Consultants of Kansas, Wichita (Dr. D. Mayans) The authors reported no potential conflict of interest relevant to this article. Leg paresthesias can be challenging to evaluate because of the varied causes and clinical presentations. This diagnostic guide with at-a-glance tables can help. 1. Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff R, ed. Bradleys Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier; 2012:1915-1983. 2. Azhary H, Farooq MU, Bhanushali M, et al. Peripheral neuropathy: differential diagnosis and management. Am Fam Physician. 2010;81:887-892. 3. Alport AR, Sander HW. Clinical approach to peripheral neuropathy: anatomic localization and diagnostic testing. Continuum (Minneap Minn). 2012;18:13-38. 4. England JD, Gronseth GS, Franklin G, et al. Practice parameter: evaluation of distal symmetric polyneuropathy: role of laboratory and genetic testing (an evidence-based review). Neurology. 2009;72:185-192. 5. Smith AG, Singleton JR. Diabetic neuropathy. Continuum (Minneap Minn). 2012;18:60-84. 6. Shenoy AM. Guidelines in practice: treatment of painful diabetic neuropathy. Continuum (Minneap Minn). 2012;18:192-198. 7. Gibbons CH. Small fiber neuropathies. Continuum (Minneap Minn). 2014;20:1398-1412. 8. So YT. Immune-mediated neuropathies. Continuum (Minneap Minn). 2012;18:85-105. 9. Dimachkie MM, Saperstein DS. Acquired immune demyelinating neuropathies. Continuum (Minneap Minn). 2014;20:1241-1260. 10. Patwa HS, Chaudhry V, Katzberg H, et al. Evidence-based guid Continue reading >>
Nerve Damage (diabetic Neuropathies)
What are diabetic neuropathies? Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs. About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight. What causes diabetic neuropathies? The causes are probably different for different types of diabetic neuropathy. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. Nerve damage is likely due to a combination of factors: metabolic factors, such as high blood glucose, long duration of diabetes, abnormal blood fat levels, and possibly low levels of insulin neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to nerves autoimmune factors that cause inflammation in nerves mechanical injury to nerves, such as carpal tunnel syndrome inherited traits that increase susceptibility to nerve disease lifestyle factors, such as smoking or alcohol use What are the symptoms of diabetic neuropathies? Symptoms depend on the type of neuropathy and which Continue reading >>
Diabetes And Peripheral Neuropathy
Peripheral neuropathy is nerve damage caused by chronically high blood sugar and diabetes. It leads to numbness, loss of sensation, and sometimes pain in your feet, legs, and hands. Neuropathy linked with diabetes is also called diabetic polyneuropathy. It is a very common complication of diabetes. The NHS says the longer you have diabetes, the greater your chances are of developing diabetic polyneuropathy. It estimates that around half of all people who have had diabetes for 25 years or more have diabetic polyneuropathy. Studies have shown that people with diabetes can reduce or delay their risk of developing nerve damage by keeping their blood sugar levels as close to normal as possible. What causes peripheral neuropathy? Chronically high blood sugar levels damage nerves not only in your extremities but also in other parts of your body. These damaged nerves cannot effectively carry messages between the brain and other parts of the body. This means you may not feel heat, cold or pain in your feet, legs, or hands. If you get a cut or sore on your foot, you may not know it, which is why it's so important to inspect your feet daily. If a shoe doesn't fit properly, you could even develop a foot ulcer and not know it. An infection that will not heal because of poor blood flow increases the risk of developing ulcers and can lead to amputation, even death. This nerve damage shows itself differently in each person. Some people feel tingling, then later feel pain. Other people lose the feeling in fingers and toes - they have numbness. These changes happen slowly over a period of years, so you might not even notice it. Because it happens as people get older, experts say they tend to ignore the little tingles or subtle loss of sensation that is occurring - the signs of nerve dama Continue reading >>
Everything You Should Know About Diabetic Neuropathy
What is diabetic neuropathy? Diabetic neuropathy is a serious and common complication of type 1 and type 2 diabetes. It’s a type of nerve damage caused by uncontrolled high blood sugar levels. You may not initially have any symptoms. The condition usually develops slowly, sometimes over the course of several decades. If you have diabetes and are experiencing numbness, tingling, pain, or weakness of your hands or feet, call your doctor. These are the early symptoms of peripheral neuropathy. In cases of severe or prolonged peripheral neuropathy, you may experience injuries or infections in your extremities. In some cases, these can lead to amputation. Damage to other nerves of the body can cause other symptoms. That’s why it’s important to regularly monitor your blood sugar levels and contact your doctor if have any symptoms of neuropathy. It’s common for symptoms of neuropathy to appear gradually. In many cases, the first type of nerve damage to occur involves the nerves of the feet. This can lead to symptoms such as the sensation of pins and needles in your feet. Symptoms vary depending on the nerves affected. Common signs and symptoms of diabetic neuropathy include: sensitivity to touch loss of sense of touch difficulty with coordination when walking numbness or pain in your extremities muscle weakness or wasting nausea and indigestion diarrhea or constipation dizziness upon standing excessive sweating vaginal dryness in women and erectile dysfunction in men Symptoms may vary depending on the type of neuropathy you’re experiencing. The term neuropathy is used to describe several types of nerve damage. In people with diabetes, there are four main types of neuropathy you may develop. Peripheral neuropathy The most common form of neuropathy is peripheral neuropa Continue reading >>
Nerve Damage (diabetic Peripheral Neuropathy)
Diabetic peripheral neuropathy is a long-term complication of diabetes. Exposure to high blood glucose levels over an extended period of time causes damage to the peripheral nerves – the nerves that go to the arms, hands, legs, and feet. Symptoms of diabetic peripheral neuropathy Although diabetic peripheral neuropathy can occur in many places in the body, the most common symptoms are abnormal sensations in the toes and feet, including: Sharp, shooting pains Burning Tingling A feeling of being pricked with pins Throbbing Numbness (not able to properly feel pain, heat, or cold) Diabetic peripheral neuropathy increases the risk for foot ulcers and amputation. Due to nerve damage in their feet and toes, people with diabetes who have diabetic peripheral neuropathy often do not notice minor cuts, sores, or blisters in these areas. If left untreated, these small wounds can easily become infected, lead to gangrene, and may eventually require amputation of the affected area. Risk factors for diabetic peripheral neuropathy Risk factors for diabetic peripheral neuropathy include: High blood glucose (sugar) levels Elevated triglycerides Excess body weight Smoking High blood pressure Diagnosing diabetic peripheral neuropathy in the feet Your doctor or foot care specialist can test for diabetic peripheral neuropathy by lightly pressing a thin nylon rod (10-gram monofilament) to different areas of your foot (in particular, your big toe) or by using the 128-Hz tuning fork on the back of the big toe to determine if you can feel it. These are easy and pain-free tests. When to screen for diabetic peripheral neuropathy For type 1 diabetes Because diabetic peripheral neuropathy is uncommon within the first five years after onset of type 1 diabetes, annual screening for diabetic periphera Continue reading >>
Diabetic Neuropathy: Causes And Symptoms
Diabetic peripheral neuropathy—DPN for short—is diabetes-related damage to nerves that sit near the surface of your skin. DPN usually affects the feet and the hands, but can also harm nerves in arms and legs. Approximately 50 percent of people with type 2 diabetes and 20% of those with type 1 diabetes develop this kind of nerve damage.1 DPN can be extremely painful—or cause numbness so that you have little feeling, especially in your feet. DPN damages two different types of nerves close to the surface of your skin. DPN can affect small nerves that protect your body by sending signals about pain and temperature changes to your brain. This condition can also attack large nerves that detect touch, pressure and help you keep your balance. 2 Symptoms are different for each type. Most people with DPN have damage to both types of nerves. DPN usually affects extremities—feet, hands, legs and arms—where nerve fibers are the longest and most numerous. 3 Causes Experts are still investigating exactly how diabetes harms and kills these nerve cells. “The causes remain unknown,” the American Diabetes Association noted in a definitive 2017 review. One thing is certain: The conventional wisdom—that high blood sugar is the cause—is just part of the story. New research is revealing a bigger cast of culprits. These include high cholesterol, high triglycerides (another blood fat), high blood pressure, obesity and smoking, according to a British research report in a widely-cited 2005 study that tracked 1,172 people with diabetes for seven years. 4 The threats are major: Obesity and high triglycerides each doubled risk in people with diabetes in a 2013 University of Utah study of 218 people with type 2 diabetes. 5 Smoking increased risk by as much as 42% in a 2015 Harvard M Continue reading >>
Peripheral Neuropathy And Diabetes
Peripheral neuropathy is nerve damage caused by chronically high blood sugar and diabetes. It leads to numbness, loss of sensation, and sometimes pain in your feet, legs, or hands. It is the most common complication of diabetes. About 60% to 70% of all people with diabetes will eventually develop peripheral neuropathy, although not all suffer pain. Yet this nerve damage is not inevitable. Studies have shown that people with diabetes can reduce their risk of developing nerve damage by keeping their blood sugar levels as close to normal as possible. What causes peripheral neuropathy? Chronically high blood sugar levels damage nerves not only in your extremities but also in other parts of your body. These damaged nerves cannot effectively carry messages between the brain and other parts of the body. This means you may not feel heat, cold, or pain in your feet, legs, or hands. If you get a cut or sore on your foot, you may not know it, which is why it's so important to inspect your feet daily. If a shoe doesn't fit properly, you could even develop a foot ulcer and not know it. The consequences can be life-threatening. An infection that won't heal because of poor blood flow causes risk for developing ulcers and can lead to amputation, even death. This nerve damage shows itself differently in each person. Some people feel tingling, then later feel pain. Other people lose the feeling in fingers and toes; they have numbness. These changes happen slowly over a period of years, so you might not even notice it. Because the changes are subtle and happen as people get older, people tend to ignore the signs of nerve damage, thinking it's just part of getting older. But there are treatments that can help slow the progression of this condition and limit the damage. Talk to your doctors Continue reading >>
Diabetic Neuropathy
LYRICA is contraindicated in patients with known hypersensitivity to pregabalin or any of its other components. Angioedema and hypersensitivity reactions have occurred in patients receiving pregabalin therapy. There have been postmarketing reports of hypersensitivity in patients shortly after initiation of treatment with LYRICA. Adverse reactions included skin redness, blisters, hives, rash, dyspnea, and wheezing. Discontinue LYRICA immediately in patients with these symptoms. There have been postmarketing reports of angioedema in patients during initial and chronic treatment with LYRICA. Specific symptoms included swelling of the face, mouth (tongue, lips, and gums), and neck (throat and larynx). There were reports of life-threatening angioedema with respiratory compromise requiring emergency treatment. Discontinue LYRICA immediately in patients with these symptoms. Antiepileptic drugs (AEDs) including LYRICA increase the risk of suicidal thoughts or behavior in patients taking AEDs for any indication. Monitor patients treated with any AED for any indication for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Pooled analyses showed clinical trial patients taking an AED had approximately twice the risk of suicidal thoughts or behavior than placebo-treated patients. The estimated incidence rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one patient for every 530 patients treated with an AED. The most common adverse reactions across all LYRICA clinical trials are dizziness, somnolence, dry mouth, edema, blurred vision, weight gain, constipation, euphoric mood, balance Continue reading >>
Diabetic Neuropathydiabetic Neuropathy Symptoms, Causes, Diagnosis, And Treatment
Diabetic neuropathy definition and facts Diabetes is thought to damage nerves as a result of prolonged elevated levels of blood glucose. Peripheral neuropathy most commonly causes: Autonomic neuropathy causes symptoms related to dysfunction of an organ system, such as: Diagnosis of diabetic neuropathy is usually done by a clinical exam. There is no cure for diabetic neuropathy, but treatments are available to manage the symptoms. Diabetic nerve pain may be controlled by medications such as tricyclic antidepressants, duloxetine (Cymbalta), or certain antiseizure medications. Keeping tight control of blood sugar levels is the best way to prevent diabetic neuropathy and other complications of diabetes. Diabetic Peripheral Neuropathy: Improve Diabetes Nerve Pain What are the symptoms and signs of diabetic neuropathy? The symptoms and signs of diabetic neuropathy depend upon the type of neuropathy that is present. Signs and symptoms can also vary in severity among affected people. Signs and symptoms of diabetic peripheral neuropathy include: Numbness or tingling of the feet and lower legs Pain or burning sensations Loss of sensation in the feet or lower legs Sometimes, but less commonly, these symptoms can occur in the hands or arms Signs and symptoms of diabetic proximal neuropathy include: Pain, usually on one side, in the hips, buttocks, or thighs Signs and symptoms of diabetic autonomic neuropathy depend upon the organ system that is involved and can include: Feeling full after eating a small amount Inability to empty the bladder completely Decrease in vaginal lubrication in women Rapid resting heartbeat Signs and symptoms of diabetic focal neuropathy also depend upon the location of the affected nerve. The symptoms can appear suddenly. It usually does not cause a long t Continue reading >>
Diabetic Neuropathy
Print Overview Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet. Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal. Diabetic neuropathy is a common serious complication of diabetes. Yet you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle. Symptoms There are four main types of diabetic neuropathy. You may have just one type or symptoms of several types. Most develop gradually, and you may not notice problems until considerable damage has occurred. The signs and symptoms of diabetic neuropathy vary, depending on the type of neuropathy and which nerves are affected. Peripheral neuropathy Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Signs and symptoms of peripheral neuropathy are often worse at night, and may include: Numbness or reduced ability to feel pain or temperature changes A tingling or burning sensation Sharp pains or cramps Increased sensitivity to touch — for some people, even the weight of a bed sheet can be agonizing Muscle weakness Loss of reflexes, especially in the ankle Loss of balance and coordination Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain Autonomic neuropathy The autonomic nervous system controls your hea Continue reading >>
Diabetic Peripheral Neuropathy
Pain is a part of the body’s magic. It is the way the body transmits a sign to the brain that something is wrong. —Norman Cousins Neuropathy is an abnormality anywhere in a nerve pathway that disrupts nerve signals, causing the brain to misinterpret feelings or sensations. Different types of neuropathy go by different names, depending on the number of nerves affected, their function, and where in the body they are located. Peripheral neuropathy is the name for nerve damage that causes malfunction of the peripheral nerves – the nerves that go to the arms, hands, legs, and feet. Damage to a single peripheral nerve is called mononeuropathy. If the damage is in two or more nerves, it is called multiple mononeuropathy. If damage occurs to many nerves simultaneously in the peripheral nervous system, it is called polyneuropathy. Diabetes is associated with several types of neuropathy, including chronic polyneuropathy. Chronic polyneuropathy occurs slowly, often over months or years, and usually begins in the feet and hands. Peripheral neuropathy There are over a hundred types of peripheral neuropathy, each of which has a characteristic set of symptoms and pattern of development. The type of nerve damaged determines what symptoms are experienced and what effect the damage has on physical functioning. Peripheral neuropathy can be inherited, or it can be acquired. Acquired peripheral neuropathy is usually caused by physical injury to the nerve, tumors, deficiencies in nutrition, alcoholism, or vascular (blood vessel) disease. Neuropathy can also be acquired from toxins produced, for example, by certain bacteria or by some types of cancer. In addition, metabolic disorders such as diabetes can contribute to the development of peripheral neuropathy. If you have damage to your Continue reading >>
Symptoms Of Diabetic Peripheral Neuropathy
Diabetic peripheral neuropathy is a condition caused by long-term high blood sugar levels, which causes nerve damage. Some people will not have any symptoms. But for others symptoms may be debilitating. Between 60 and 70 percent of people with diabetes have some form of neuropathy, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Peripheral neuropathy, the most common form of diabetic neuropathy, affects the legs, feet, toes, hands, and arms. Many people do not know that they have diabetes. People unaware of their diabetes may not know what’s causing some of the unusual sensations they’re experiencing. Nerve damage is the result of high levels of blood glucose over long periods of time. It isn’t entirely clear why high glucose levels damage nerves. A number of factors may play a role in nerve fiber damage. One possible component is the intricate interplay between the blood vessels and nerves, according to the Mayo Clinic. Other factors include high blood pressure and cholesterol levels and nerve inflammation. Diabetic peripheral neuropathy usually first appears in the feet and legs, and may occur in the hands and arms later. A common symptom of diabetic peripheral neuropathy is numbness. Sometimes you may be unable to feel your feet while walking. Other times, your hands or feet will tingle or burn. Or it may feel like you’re wearing a sock or glove when you’re not. Sometimes you may experience sudden, sharp pains that feel like an electrical current. Other times, you may feel cramping, like when you’re grasping something like a piece of silverware. You also may sometimes unintentionally drop items you’re holding as a result of diabetic peripheral neuropathy. Walking with a wobbly motion or even losing your balance can res Continue reading >>
Diabetic Neuropathy (nerve Damage) - An Update
Nerve damage or diabetic neuropathy resulting from chronically high blood glucose can be one of the most frustrating and debilitating complications of diabetes because of the pain, discomfort and disability it can cause, and because available treatments are not uniformly successful. Some patients find some relief from this nerve damage or neuropathy by keeping blood sugars as closely controlled as possible, getting regular exercise and keeping their weight under control. Using non-narcotic pain relievers consistently throughout the day—rather than waiting until nighttime when symptoms can become more severe—also seems to help if pain is the major symptom. Surprisingly, clinicians have also found that certain antidepressants may be helpful and can take the edge off the pain of neuropathy. Although pain or numbness in the legs or feet may be the most common complaint from people diagnosed with neuropathy, it is not the only symptom of this complication. Neuropathy can cause a host of different types of symptoms, depending on whether nerves in the legs, gastrointestinal tract, or elsewhere in the body are affected. If you have any of these symptoms, neuropathy may be the culprit: inability to adequately empty the bladder of its contents, resulting in frequent infections; nausea, vomiting, abdominal fullness or bloating, diarrhea, or constipation; low blood pressure upon standing that causes fainting or dizziness; inability to lift the foot or new deformities of the foot, or foot ulcers; trouble achieving or maintaining an erection. Although physicians have found some medications and other treatments that help ease these symptoms in some people, prevention continues to be the key. "Hemoglobin A1C readings should ideally be at 7.0% or lower. Those that are consistently n Continue reading >>
Peripheral Neuropathy
What is peripheral neuropathy? Peripheral neuropathy is disorder of nerve(s) apart from the brain and spinal cord. Patients with peripheral neuropathy may have tingling, numbness, unusual sensations, weakness, or burning pain in the affected area. Oftentimes, the symptoms are symmetrical and involve both hands and feet. Because the symptoms are often present in the areas covered by gloves or stockings, peripheral neuropathy is often described as having a “glove and stocking” distribution of symptoms. Peripheral neuropathy can involve different nerve types, including motor, sensory, and autonomic nerves. Peripheral neuropathy can also be categorized by the size of the nerve fibers involved, large or small. Neuropathy can present with many differing symptoms, including numbness, pain of different types, weakness, or loss of balance, depending on the type of nerve involved. Because the autonomic nerves control bodily functions that we do not consciously think of, such as heart rate, digestion, and emptying of the bowel and bladder, autonomic neuropathy manifests with symptoms affecting the loss of control of these functions. Symptoms may include problems with blood pressure, voiding, passage of stools (diarrhea, or constipation), heart rate, or sweating. Cranial neuropathy is similar to peripheral neuropathy, except that the cranial nerves are involved. Any of the cranial nerves can be involved. One of the more common causes of cranial neuropathy is loss of blood flow from the optic artery to the optic nerve, causing ischemic optic neuropathy. Amyloidosis is one of the more common causes of this rare disorder. Specific nerves can be involved in neuropathy. When a specific nerve is involved, the symptoms are limited to the distribution of that nerve. The most commonly i Continue reading >>
