The peripheral nervous system is made up of the nerves and ganglia outside the central nervous system (i.e., the brain and spinal cord). Neuropathic pain is a chronic condition that results from injury, dysfunction or damage to these peripheral nerves. The damaged nerves affect function and send pain messages to the brain. Estimates are that 20 million people suffer from peripheral neuropathy.*
Related Causes and Conditions
Various conditions can lead to loss of function within the peripheral nervous system, causing neuropathic pain. The most common is diabetes. In fact, it is standard practice that diabetics are automatically tested for neuropathy. In addition to diabetes, some of the causes and conditions related to neuropathic pain include:
- Carpal tunnel syndrome
- HIV infection/AIDS
- Hip, leg, back problems
- Infections (Lyme disease or shingles)
- Liver or kidney disease (chronic)
- Multiple sclerosis
- Pain due to chemotherapy
- Phantom limb pain (following amputation)
- Spine surgery
- Various other rare disorders of the nerves
- Vitamin deficiencies
Approximately 30 percent of cases are idiopathic,* meaning doctors cannot determine a cause for diagnosis.
Peripheral nerves consist of three types: sensory nerves (connected to the skin), motor nerves (connected to the muscles) and autonomic nerves (connected to the internal organs).
Peripheral neuropathy can impact any or all of these types of nerves, resulting in a variety of symptoms:
- Pain (burning, shooting, stabbing), worsening at night
- Numbness, prickling, tingling of feet or fingers
- Pins and needles
- Loss of sensation (of cold or heat)
- Limping, slow reflexes
- Ulcers on the feet or legs
- Infection (gangrene)
- Poor balance
- Muscle weakness or loss
- Coordination problems
- A drop in blood pressure
- Digestive problems
- Diarrhea or constipation
- Sexual dysfunction (in both men and women)
- Sweating excessively
When diagnosing peripheral neuropathy, the large number of potential causes must be taken into account. Diagnosis begins with a full medical history and physical exam. It might also include a neurological exam, and testing for reflexes, ability to feel certain sensations, muscle strength and coordination.
Lab work includes blood tests to explore diabetes or abnormal immune function, and imaging (CT or MRI scans) to check for herniated discs or other abnormalities, such as tumors.
Other possible diagnostic tools include nerve functioning tests. This could be nerve conduction (to check the speed of nerves sending signals) and electromyography (to check the activity of muscles). Finally, nerve and skin biopsies are also considered. Skin biopsies are a relatively new technique to examine peripheral nerves.
Although neuropathy cannot be cured it can be prevented, managed and treated with various techniques. It is important to get a neuropathy diagnosis and treatment early to mitigate the problems that often accompany this condition. These problems include everything from diminished function to depression and sleep problems.
Many conservative therapies are effective, and a pain management specialist can prove beneficial in customizing a pain management plan.
At Nova Spine & Pain Centers, our multidisciplinary approach utilizes a variety of modalities and procedures for pain associated with peripheral neuropathy. We also recommend important lifestyle adaptations and prescribe medications when applicable.
To learn more about your treatment options for peripheral neuropathy, contact us today.