Neuropathy: Symptoms, What it is, and Treatment

The most common symptoms include:

• Gradual decrease in sensitivity and tingling in the limbs,
• sharp, burning, throbbing or stabbing pain, often during activities when the pain should not occur,
• extreme sensitivity to touch,
• impaired coordination of movements,
• muscle weakness,
• poor heat tolerance,
• excessive sweating,
• difficulty with digestion and defecation,
• changes in blood pressure and dizziness. ^[1]

Symptoms may vary depending on the type. Modern medicine knows more than 100 different types of this disease. ^[2]

Each nerve in the peripheral nervous system has a specific function, so the symptoms depend on the type of nerve damaged.

Neuropathy what is it?

It is a general term for a condition in which the peripheral nervous system is damaged.

Peripheral nerves are located outside the spinal cord and brain and are used to transmit signals from different parts of the body to the central nervous system and back. Peripheral neuropathy disrupts the normal transmission of these signals and can have many different causes. If the lower limbs are affected, the condition is referred to as neuropathy of the feet. Neuropathy of the hands, on the other hand, means damage to the nerves in the upper limbs.

Mononeuropathy means that only one nerve is damaged.

Polyneuropathy affects multiple nerves. ^[3]

Sensory nerves are responsible for the perception of pain, temperature or touch on the skin. Motor nerves transmit signals related to movement. If the ability to move and perceive is impaired, this is a condition known as sensorimotor polyneuropathy.

Autonomic nerves control bodily functions such as blood pressure, heart rate, sweating or digestion. Affection of the autonomic nerves is called autonomic neuropathy.

Sensory polyneuropathy means damage to multiple sensory nerves in the body.

We have already explained the basic division into mononeuropathy and polyneuropathy in the previous paragraphs. However, a description of all subtypes would be so extensive that we will present only 10 selected types.

• Peripheral – affecting peripheral nerves located outside the central nervous system.
• Autonomic – affecting the autonomic nerves that control the activity of internal organs.
• Proximal – affects nerves in the hips, buttocks, thighs, shoulders and arms.
• Focal – affects one particular nerve (most commonly in the hands, head and trunk), causing pain in that part of the body. ^[5]
• Multifocal motor neuropathy is a rare disease in which the muscles become flaccid due to an attack on the motor nerves by the body’s own immune system. ^[6]
• Chronic inflammatory demyelinating (CIDP) – patients with this rare disease have chronic inflammation that damages the protective covering of the nerves. Disruption of nerve signals leads to weakness and numbness. ^[7]
• Toxic – damage to peripheral nerves due to exposure to chemicals. ^[8]
• Alcoholic – a condition that occurs with excessive alcohol consumption. ^[9]
• Pudendal – nerve damage in the rectal and genital area that causes pain and incontinence, among other things. ^[10]
• Leber’s hereditary optic neuropathy is a hereditary disease in which rapid vision loss occurs. This is due to the malfunction of cells in the retina, which leads to damage to the optic nerve. ^[11]

Chronic polyneuropathy means long-term damage to more than one nerve.

A number of different investigative methods are used to make a diagnosis, given the large number of causes.

• The first step is a detailed analysis of the patient’s problems, during which the doctor asks about symptoms, chronic diseases, lifestyle, neurological diseases in the family, etc.
• The neurological examination checks reflexes, muscle strength and tension, sensitivity or coordination of movements.
• Blood tests are performed to check for signs of inflammation, to detect possible vitamin deficiencies, metabolic problems or incipient diabetes.
• Imaging methods (magnetic resonance imaging, computed tomography) can show a pinched nerve, a prolapsed intervertebral disc and other problems that can cause neuropathic pain.
• Using electromyography (EMG), the doctor will assess the electrical activity in the muscles and any nerve damage.
• Sensory tests record the ability to sense touch, vibration, cold or heat.
• Muscle and skin biopsies can reveal the cause of the disease. ^[12]

• The disease affects 1%-8% of the population and the number of cases increases with age.
• Approximately half of all cases are related to diabetes. ^[13]
• Peripheral neuropathy occurs in 5% of younger diabetics (20-29 years). On the other hand, in the age group 70-79 years, more than 40% of diabetics are affected.

How is treated?

During treatment, doctors focus on the cause of the problem and on relieving painful symptoms. The treatment of neuropathy of the lower limbs and other parts of the body can be a combination of various procedures – regimen measures, medication and physiotherapy. Specific recommendations for treatment always depend on the type of treatment.

For example, it is essential for patients with diabetic neuropathy to adhere to their diabetes treatment and proper blood sugar levels.

If the cause of the problem is inflammation or an autoimmune disease, for example, immunoglobulins (simply put, antibodies) can be used.

In rare cases, surgery may help, especially if the cause of the problem is nerve compression caused by a tumour.

Next steps in treatment include:

• Adherence to a healthy lifestyle (regular exercise, a healthy diet without alcohol, sufficient vitamins, maintaining the right weight),
• the use of various rehabilitation techniques,
• avoidance of toxic substances. ^[15]

However, there is no miracle cure and doctors always take into account the root cause of the problem. Medications that can relieve pain and other unpleasant symptoms but do not address the cause of the disease include:

• Antiepileptics (drugs used to treat epilepsy) – relieve pain of neurological origin,
• antidepressants – some types relieve pain,
• non-steroidal anti-inflammatory drugs,
• corticosteroids,
• over-the-counter analgesics (painkillers),
• topical gels and ointments to relieve pain. ^[16]

Some patients also seek alternative treatment options such as acupuncture, massage, meditation or various relaxation techniques. ^[17]

The best prevention is :

• A healthy lifestyle that can prevent these diseases.
• A healthy diet rich in vegetables, fruit, whole grains and protein contributes to a healthy nervous system.
• Regular physical activity (at least 30-60 minutes three times a week) is good for the whole body and reduces the risk of developing many chronic diseases.
• Avoid activities and situations that can cause nerve damage. These include, for example, prolonged overloading of certain parts of the body, excessive drinking of alcohol, smoking and contact with chemical substances. ^[18]

If you suffer from peripheral neuropathy, you can try various tips to relieve pain, discomfort and other symptoms of the disease.

• The disease may be related to a deficiency of certain vitamins and minerals. Therefore, do not forget to take B vitamins, vitamin E, calcium and magnesium in your diet or in the form of supplements.
• A warm bath has a soothing effect and can relieve pain. It also promotes blood circulation.
• Various meditation techniques help to manage everyday life and the stress that this disease brings.

Some herbs have anti-inflammatory effects and help with painful conditions. These include turmeric, cayenne pepper, sage, eucalyptus and bergamot. They can be used as an ointment or in the form of essential oils. ^[19]

One of the newer approaches to treatment is laser therapy. Its principle is to stimulate nerve cells and promote nerve regeneration. The result can be relief from pain and other symptoms. However, the findings on laser therapy are not consistent. While some studies show that laser can help with diabetic neuropathy, for example, other research suggests that laser may not be suitable for all types of the disease. Laser therapy options should always be consulted about with your doctor. ^[20]

Experts are focusing on stem cells or microsurgical techniques to research new treatment options.

Closer investigation of the molecular mechanisms of nerve damage and various bioengineering methods may provide further insights into treatment. ^[21]