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Integrated Pain Management


Neuropathies and Where to Find Them

You’ve been feeling weird tingling sensations in your arms, legs, and feet for quite some time now. You go to the doctors and you’ve been diagnosed with peripheral neuropathy, but what even is that? Well, look no further –  this guide will help you learn all about the different types of neuropathies. This condition is more common than you think and, if treated properly, can be resolved easily, getting you back to your active lifestyle. 

Neuropathies and Where to Find Them

Once Upon a Neuropathy

Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, the vast communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body. 

Nerve signaling in neuropathy is disrupted in three ways:

> Loss of signals normally sent (like a broken wire)

> Inappropriate signaling when there shouldn’t be any (like static on a telephone line)

> Errors that distort the messages being sent (like a wavy television picture)

Some forms of neuropathy involve damage to only one nerve, known as mononeuropathy. Neuropathy affecting two or more nerves in different areas is called multiple mononeuropathies or mononeuropathy multiplex. More often, many or most of the nerves are affected (called polyneuropathy).

Symptoms can range from mild to disabling and are rarely life-threatening. The symptoms depend on the type of nerve fibers affected and the type and severity of the damage. Symptoms may develop over days, weeks, or years. In some cases, the symptoms improve on their own and may not require advanced care. Unlike nerve cells in the central nervous system, peripheral nerve cells continue to grow throughout life.

More than 20 million people in the United States have been estimated to have some form of peripheral neuropathy, but this figure may be significantly higher—not all people with symptoms of neuropathy are tested for the disease and tests currently don’t look for all forms of neuropathy. Neuropathy is often misdiagnosed due to its complex array of symptoms.

How are Peripheral Neuropathies Classified?

More than 100 types of peripheral neuropathy have been identified, each with its own symptoms and prognosis. Symptoms vary depending on the type of nerves—motor, sensory, or autonomic—that are damaged.

> Motor nerves control the movement of all muscles under conscious control, such as those used for walking, grasping things, or talking.

> Sensory nerves transmit information such as the feeling of a light touch, temperature, or the pain from a cut.

> Autonomic nerves control organs to regulate activities that people do not control consciously, such as breathing, digesting food, and heart and gland functions.

Most neuropathies affect all three types of nerve fibers to varying degrees; others primarily affect one or two types. Doctors use terms such as predominantly motor neuropathy, predominantly sensory neuropathy, sensory-motor neuropathy, or autonomic neuropathy to describe different conditions.

What are the Causes of Peripheral Neuropathy?

Most instances of neuropathy are either acquired, meaning the neuropathy or the inevitability of getting it isn’t present from the beginning of life, or genetic. Acquired neuropathies are either symptomatic (the result of another disorder or condition) or idiopathic (meaning it has no known cause).

How is Peripheral Neuropathy Diagnosed?

The bewildering array and variability of symptoms that neuropathies can cause often make diagnosis difficult.  A diagnosis of neuropathy typically includes:

> Medical history

> Physical and neurological exams

> Body fluid tests

> Genetic tests

Additional tests may be ordered to help determine the nature and extent of the neuropathy.

What Treatments are Available?

Treatments depend entirely on the type of nerve damage, symptoms, and location. Your doctor will explain how nerve damage is causing specific symptoms and how to minimize and manage them. Definitive treatment can permit functional recovery over time, as long as the nerve cell itself has not died.

For motor symptoms, mechanical aids such as hand or foot braces can help reduce physical disability and pain. Some people with severe weakness benefit from tendon transfers or bone fusions to hold their limbs in a better position, or to release a nerve compression.

Autonomic symptoms require detailed management depending on what they are. Many people use complementary methods and techniques such as acupuncture, massage, herbal medications, and cognitive-behavioral or other psychotherapy approaches to cope with neuropathic pain.

Sensory symptoms, such as neuropathic pain or itching caused by injury to a nerve or nerves, are more difficult to control without medication.  Some people use behavioral strategies to cope with chronic pain as well as depression and anxiety that many may feel following nerve injury.

Medications recommended for chronic neuropathic pain are also used for other medical conditions. 

Local anesthetics and related drugs that block nerve conduction may help when other medications are ineffective or poorly tolerated.  Medications put on the skin (topically administered) are generally appealing because they stay near the skin and have fewer unwanted side effects.

Surgery is the recommended treatment for some types of neuropathies. Injuries to a single nerve (mononeuropathy) caused by compression, entrapment, or rarely tumors or infections may require surgery to release the nerve compression. Polyneuropathies that involve more diffuse nerve damage, such as diabetic neuropathy, are not helped by surgical intervention.

Integrated Pain Management Team Can Help!

Neuropathies are one of the many conditions treated at Integrated Pain Management. We are focused on getting you a treatment plan that is best for your specific symptoms and conditions. We want to help you get back to the active life you lead. If you have any questions about neuropathies, treatment options, or other conditions, reach out to our team today!