Peripheral neuropathy is a condition affecting the nerves that send sensory information back to the brain and spinal cord. Frequently this condition causes pain, tingling or burning sensation and numbness and feeling loss in the hands and feet.
In addition to its many causes, including traumatic injuries, infections, diseases, metabolic problems and exposure to toxins, there are many types of peripheral neuropathy.
Idiopathic Neuropathy
In cases where no specific cause can be diagnosed, doctors will identify the peripheral neuropathy as "idiopathic." These types of neuropathies typically affect those 60 years and older. The progression of the neuropathy is slow (if any occurs), but due to the age demographic, it can be disruptive to everyday life.
For treatment, doctors may recommend over-the-counter medication or prescription medication. Additionally, it is common to recommend that patients take safety measures to make up for sensation loss.
Diabetic Neuropathy
When diabetes causes nerve damage, diabetic neuropathy ensues. According to the Jack Miller Center for Peripheral Neuropathy "nearly 60 percent of diabetics having some form of nerve damage." As a result, this type of neuropathy is the most common. It occurs most often in people who are overweight, have high blood pressure, and are over the age of 40. Additionally, those who have difficulty managing their blood sugar levels are also at a high risk. The progression of the neuropathy may be slow (over the course of several years), the result may be a loss of sensation in the feet, disruption with digestive system functions, and interference with normal functions of sex organs. Or it may progress suddenly, affecting a specific group of nerves, causing muscle atrophy or muscle weakness.
For treatment, doctors may recommend over-the-counter medication or prescription medication for the pain. Additional treatment options may include weight loss, regularly monitoring blood sugar levels, daily foot care and safety measures to make up for sensation loss.
Hereditary Neuropathy
When a genetically transmitted nerve disorder leads to the deterioration of muscles (generally below the knees, and in the hands), doctors refer to these neuropathies as hereditary motor or sensory neuropathies. Common hereditary disorders that cause peripheral neuropathy are Charcot-Marie-Tooth disease and hereditary neuropathy with liability to pressure palsies.
Often times, the genetic defect is known in advance, and prenatal counseling and tests are available to predict the onset of the neuropathy and to address symptoms quickly.
For treatment, doctors may recommend over-the-counter medication or prescription medication for the pain. Additional treatment options may include special therapeutic shoes and leg braces, physical therapy, moderate activity, and safety measures to make up for sensation loss.
Toxin-Related Neuropathy
Certain peripheral neuropathies result from exposure to toxins and chemicals.
Intentional exposure, like that of drug or chemical abuse, often leads to peripheral neuropathy. Chronic alcohol consumption is a primary example of this type of exposure. Alcoholics who have nerve damage may be able to alleviate the neuropathy or at least prevent further damage if they stop drinking. However, due to alcohol's damaging impact on nerve tissue, the damage is usually permanent.
Unintentional exposure to chemicals like lead, mercury, arsenic, thallium, some organic insecticides and solvents can result in neuropathy as well. These exposures are typically related to occupational contact or environmental factors.
Treatment for alcoholic neuropathy includes the cessation of drinking alcohol, alcohol treatment and therapy and nutritional adjustment (to account for the malnourishment usually associated with alcoholism).
For treatment to non-intentional exposure, contact to environmental toxins must stop. In addition, doctors may recommend over-the-counter medication or prescription medication for the pain and safety measures to make up for sensation loss.
Drug-Related Neuropathy
Medications---particularly those used for HIV/AIDS and chemotherapy---often feature peripheral neuropathy as a side effect. In most cases with drug-related neuropathies, the cessation or alteration of the drug will cause the neuropathy to stop. According to the Jack Miller Center for Peripheral Neuropathy, drugs that commonly cause peripheral neuropathy include "the anti-alcohol drug disulfiram; the anticonvulsant drug phenytoin (Dilantin); the cancer medications cisplatin and cincristine; the heart or blood pressure medications amiodarone, hydralazine, and perhexiline; the infection-fighting drugs metronidazole (Flagyl), nitrofurantoin, thalidomide, INH (isoniazid) and the skin condition treatment drug Dapsone."
Treatment for drug-related neuropathies include cessation or alteration of the medication or dosage. In addition, doctors may recommend over-the-counter medication or prescription medication for the pain and safety measures to make up for sensation loss.
Compression Neuropathies
Compression neuropathies occur when nerves become compacted or constrained. This pressure can be a result of trauma or inflammation. A primary example of compression neuropathy results from carpal tunnel syndrome.
Treatments for compression neuropathies focus on identifying and removing or correcting the underlying cause of the nerve dysfunction. Methods for correction include vocational or occupational counseling, physical therapy, surgery, and wrist splints. Doctors may recommend over-the-counter medication or prescription medication for the pain, and many will recommend precautionary safety measures to make up for for sensation loss.
Nutritional/Vitamin Deficiency Neuropathy
Nutritional and dietary problems can also cause peripheral neuropathy. According to the Neuropathy Association "these (neuropathy-inducing vitamin) deficiencies could be due to malnutrition (e.g., alcoholism) or a reduced absorptive surface as a result of physical alteration (e.g., surgical resection/bypass) or intestinal wall infiltration (e.g., Crohn's disease). Additionally, according to the Foundation for Peripheral Neuropathy, scientists and nutritionists have confirmed that a lack of vitamin B12 (a vitamin essential to stomach acids and digestion) is a common and direct cause of peripheral neuropathy.
Treatment for a neuropathy due to nutrition or vitamin deficiency includes the increase of B12 intake with foods like meat products, dairy products or B12 supplements. Injections of B12 are usually necessary. Additionally, it is common to recommend that patients take safety measures to make up for sensation loss.
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