Polyneuropathy - symptoms, description and treatment

• Decreased sensitivity to numbness in various parts of the body
• Burning pain and tingling
• Weakness of the legs or arms
• Impaired coordination of movements
• Unsteady walking with risk of falls ^[2]
• Muscle cramps
• Fatigue and disturbed sleep ^[3]

It is distinguished according to what causes it and what its manifestations are. It can also be divided according to time, i.e. acute and chronic.

Common types of polyneuropathy are:

• chronic symmetrical peripheral neuropathy – a long-term disease affecting both limbs, usually the lower limbs,
• mononeuropathy, in which individual nerves are damaged,
• acute symmetrical peripheral neuropathy – usually caused by the severe autoimmune disease Guillain-Barré syndrome. ^[5]

• Diabetic polyneuropathy,
• alcoholic polyneuropathy,
• autoimmune polyneuropathy,
• related to bacterial or viral infection,
• related to endocrine diseases (for example, thyroid disorders.),
• related to liver and kidney diseases,
• caused by medication or treatment (for example, after chemotherapy),
• caused by a deficiency of certain B vitamins and vitamin E. ^[6]

You may also encounter the terms:

• Sensomotor polyneuropathy – this is damage to nerve cells, nerve fibres and the protective layer of neurons. ^[7]
• Polyneuropathy with paretic manifestations – a disease of various origins, which is accompanied by paresis (partial paralysis of a part of the body). ^[8]
• Sensitive polyneuropathy – affects the sensory fibers.
• Chronic inflammatory demyelinating polyneuropathy – CIDP (a condition where the immune system damages peripheral nerves and causes muscle weakness and impaired reflexes ). ^[9]

Patients may wonder if stress is one of the causes. This disease is not itself caused by stress, but prolonged stress can exacerbate neuropathic pain. ^[13]

• Diabetes mellitus – especially if your blood sugar is at the wrong level for a long time,
• high blood pressure,
• alcohol consumption and exposure to toxic substances including cigarette smoke,
• overweight and lack of physical activity,
• poor lifestyle and unbalanced diet,
• weakened immunity. ^[14]

• Up to 25% of patients with diabetes may be affected by diabetic polyneuropathy. ^[15]

If it is not treated or the treatment is not effective, complications can occur with a significant impact on your life.

• Muscle wasting. It can lead to muscle wasting.
• Difficulty walking. May cause unsteady gait, difficulty maintaining balance.
• Increased risk of falls and injuries. Exhaustion in polyneuropathy can lead to falls.
• Exceptionally, amputation. ^[16] In the final stage, it can mean a complete loss of sensation in the feet. In practice, this brings major limitations, such as the inability to walk and a high risk of amputation of the limb. ^[17]

All patients with this nerve disease wonder if polyneuropathy is curable. Treatment begins with determining the cause of the problem and your doctor will recommend a specific course of treatment accordingly.
There is no miracle cure for polyneuropathy that will quickly rid you of all the troubles, but various types of drugs and complementary treatment methods are used.

• Proper blood sugar control is essential for patients with diabetes.
• It is advisable to limit alcohol and take care of proper nutrition, including supplementation of missing vitamins. ^[18]
• Symptom relief can be provided by painkillers, for example.
• Antidepressants also have their place in treatment ^[19]

Nerve stimulation, physiotherapy, acupuncture or orthopaedic devices are sometimes used to improve the quality of life of patients with polyneuropathy. ^[20]
Patients often wonder if polyneuropathy can subside. If it is related to viral jaundice, for example, its symptoms may subside after the jaundice symptoms disappear. ^[21] Regression of polyneuropathy can also occur after the end of chemotherapy if the problems occurred in connection with this anti-cancer treatment. ^[22]

The composition of the diet can influence the development and severity of polyneuropathy. It is important to get enough B vitamins and vitamin E, which are essential for good nerve health. ^[25] For diabetics, adherence to a diabetic diet as recommended by a doctor is crucial.

For many people, regardless of age, morning coffee is a lifelong habit. But does coffee combine with polyneuropathy? Although the caffeine in coffee is stimulating, excessive amounts can have a negative effect on the nervous system. Caffeine itself does not cause polyneuropathy, but it can place a burden on the nervous system and accentuate neuropathic pain. ^[26]

Rehabilitation improves mobility, stability and the ability to engage in normal daily activities. The rehabilitation programme always respects the symptoms and condition of the individual patient.

What is usually part of rehabilitation for polyneuropathy?

• Exercises to strengthen muscles and increase overall fitness,
• exercises to promote musculoskeletal mobility,
• promoting balance to minimise the risk of falling,
• soft tissue massage,
• practical tips on how to use orthotics correctly. ^[27]

Spa treatment options should be discussed with the treating physician. The latter also issues a proposal for spa treatment under the conditions set by the health insurance company. ^[28]

The exact programme of spa treatment depends on the patient’s condition and may include, for example, hydrotherapy in addition to exercise, physiotherapy or massage. Hydrotherapy brings pain relief, relaxes muscles and improves blood circulation. ^[29]

A healthy lifestyle is an important part of both prevention and treatment. Varied blood values in polyneuropathy can be improved by a varied diet rich in vitamins and minerals and alcohol restriction. Make sure you also take regular exercise, which supports the body’s defences. You should, of course, follow the treatment of any additional diseases. ^[30]

What is the life expectancy in polyneuropathy?
It may not be any different from the life expectancy of healthy persons. Adherence to all recommendations from the doctor is a prerequisite. However, some types of polyneuropathy can worsen over time. ^{[31] [32]}

Dietary supplements can supply the body with missing vitamins or minerals. The emphasis is on vitamins B1, B12 and vitamin E. Supplements containing vitamin B12 are particularly important for vegans and vegetarians. ^[34] Consult your physician for the appropriate supplement.

Patients with polyneuropathy need to choose sports activities and exercises that do not compromise their safety and do not increase the risk of falls or injuries. Physical activity should respect current fitness and movement abilities. [35]

Properly selected exercises and physiotherapy will promote mobility, motor skills or stability. It can also relieve neuropathic pain.

One of the most important measures is to prevent diabetes. ^[36]
Preventive measures include:

• Adherence to a healthy lifestyle,
• early resolution of any health problems,
• limit alcohol consumption and smoking,
• following the doctor’s recommendations. ^[37]