Peripheral Neuropathy

What is peripheral neuropathy?

Peripheral neuropathy is a condition that affects how your nerves work. Nerves carry information from your brain to your body and back. The information does not transfer along your nerves correctly when you have neuropathy. When you have peripheral neuropathy, the nerves in your legs, arms, feet, or hands are affected. It also may affect your organs, such as your lungs, stomach, bladder, or genitals. This condition may go away on its own or you may always have it.

What causes peripheral neuropathy?

The following are common risks:

• Trauma or pressure on the nerve: A car or sports accident may cause nerve damage that leads to neuropathy. If you wear a cast or a splint, it may cause pressure that pinches nerves. Repeated movements, such as typing, may cause nerve pressure and pain. An example is carpal tunnel syndrome.
  
  
• Alcohol abuse: You may develop neuropathy if you drink a lot of alcohol. This may cause a decrease of vitamins in your body which may cause peripheral neuropathy.
  
  
• Family history: You may inherit a medical disorder that causes peripheral neuropathy.
  
  
• Infections: You may get neuropathy after you are exposed to certain infections, such as herpes and Lyme disease.
  
  
• Health conditions or treatments: Certain health conditions may cause you to develop neuropathy. Some examples are rheumatoid arthritis, cancer, and lupus. You are also at risk if you have some medical treatments, such as chemotherapy or surgery. Certain medicines for heart conditions or HIV also put you at risk. Ask for more information about these or other health conditions or treatments.

What are the signs and symptoms of peripheral neuropathy?

Peripheral neuropathy can affect the nerves that allow you to move or to feel things. It also may affect nerves that control your body functions, such as digestion (breaking down food) or urination. The following are common signs and symptoms:

• You have pain or tingling in your legs, feet, arms, or hands. The pain may feel sharp, stabbing, or burning. The area may itch or be numb.
  
  
• It is hard for you to walk or to keep your balance.
  
  
• You feel weak or have a hard time holding things.
  
  
• You lose your sense of touch.
  
  
• You bruise easily.
  
  
• It is hard for you to control your bladder or bowels, or to have sex.

How is peripheral neuropathy diagnosed?

Your caregiver will examine you and ask questions about your symptoms. He may ask you about your overall health and about your family history. Your caregiver may gently touch your skin in different areas with a cotton ball or a pin. This test is done to check your sense of touch. He may also check how well you can feel hot and cold. Your caregiver will ask you to do simple movements. For example, he may ask you to walk or to move your fingers. You may also have any of the following tests:

• Blood tests: You may need blood taken to check for conditions that may be causing your peripheral neuropathy. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. You may need to have blood drawn more than once.
  
  
• Electromyography: This is also called an EMG. An EMG is done to test the function of your muscles and the nerves that control them. Electrodes (wires) are placed on the area of muscle being tested. Needles that enter your skin may be attached to the electrodes. The electrical activity of your muscles and nerves is measured by a machine attached to the electrodes. Your muscles are tested at rest and with activity.
  
  
• Nerve conduction studies: Nerve conduction studies (NCS) test how your nerves respond to stimulation. Electrodes (wires) are placed on affected areas of your body. Then they send electrical currents into the nerve to see how quickly it responds.
  
  
• Nerve biopsies: A sample of skin and nerve tissue is collected by biopsy. Many methods and sites may be used for a biopsy. After a site is selected and cleaned, the area is numbed. A small piece of skin is removed so that nerves in the sample can be examined. Ask for more information about nerve biopsies.

How is peripheral neuropathy treated?

Treatment may help relieve your pain and help you function in your daily activities. Treatment of the condition causing the peripheral neuropathy may improve your symptoms. You may need the following treatments:

• Medicines:
  
  
  • Pain medicine: You may be given medicine to take away or decrease pain. You may take pain medicine as a pill or apply it to your skin. Do not wait until the pain is severe before you take your medicine.
    
    
  • Antidepressants: This medicine is given to decrease or stop the symptoms of depression. It also may be given to help with your pain. Take this medicine as directed.
    
    
  • Antiseizure medicine: This medicine is usually given to control seizures (uncontrolled movements), but it also helps with nerve pain.
  
  
• Therapy: Physical and occupational therapists may exercise your arms, legs, and hands. They may teach you new ways to do things at home.
  
  
• Transcutaneous electrical nerve stimulation: This treatment, called TENS, stimulates your nerves and may decrease your pain. Wires are attached to pads. The pads are attached to your skin. The wires send a mild current through your nerves. Do not have TENS if you have a pacemaker or are pregnant.
  
  
• Brace or splint: You may need a device that supports you or holds a body part still. For example, if you have carpal tunnel syndrome, you may need to wear a wrist brace.

What are the risks of peripheral neuropathy?

• The needles used during EMG may cause pain when they are inserted and may leave bruises. If you have a nerve biopsy, you may lose your sense of touch in that area. Medicines used to treat your condition may cause you to feel sick to your stomach, dizzy, or sleepy. You may become dependent on some medicines (you feel like you have to take them). You may still have pain even while you are taking medicines. Peripheral neuropathy may cause permanent damage to your nerves. It may not go away.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling. It can also stop blood from flowing where it needs to go in your body. The blood clot may break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.
  
  
• You may injure yourself because you cannot control your movements. You may have a poor sense of touch and not be able to grasp things, such as zippers or keys. You may develop muscle or bone weakness and sores from lack of movement. Pain may make you feel upset or cause you not to sleep. You may get an infection or kidney disease if it is hard for you to control your bladder or bowels. You may have trouble breathing if the nerves that work with your lungs are affected. This can be life-threatening.

How can I manage my peripheral neuropathy?

• Avoid falls: Move with care and stand up slowly. Wear shoes that support your feet, and do not go barefoot. Ask about walking aids, such as a cane or walker. You may want to install railings or nonslip pads in your home, especially in the bathroom. Ask for more information on how to avoid falls.
  
  
• Check your skin daily: Sores can form where your skin makes contact with chairs, beds, or other body parts. They also can form under splints. Keep your skin clean, and check your skin daily for sores.
  
  
• Exercise: Physical activity makes the heart stronger, lowers blood pressure, and helps keep you healthy. It may increase your balance and strength and may decrease your pain. It is best to start exercising slowly and do more as you get stronger. Talk to your primary healthcare provider before you start exercising. Together you can plan the best exercise program for you.
  
  
• Limit alcohol: Limit the amount of alcohol you drink. Drinking too much can damage your brain, heart, and liver. The risk of getting high blood pressure and certain types of cancer are greater for people who drink too much alcohol. Drinking too much alcohol also increases the risk of having a stroke. Women should limit alcohol to one drink a day. Men should limit alcohol to two drinks a day. A drink of alcohol is 12 ounces of beer, or five ounces of wine. One and one-half ounces of liquor, such as whiskey, is one drink of alcohol. If you drink alcohol, talk to your caregiver.
  
  
• Manage stress: Stress may slow healing and cause illness later. Because it is hard to avoid stress, learn to control it. Learn new ways to relax, such as deep breathing, meditating, or listening to music. Talk to someone about things that upset you.

Where can I find more information?

Contact the following:

• National Institute of Neurological Disorders and Stroke
  P.O. Box 5801
  Bethesda , MD 20824
  Phone: 1- 301 - 496-5751
  Phone: 1- 800 - 352-9424
  Web Address: http://www.ninds.nih.gov
  

• Neuropathy Association
  60 East 42nd Street Suite 942
  New York , NY 10165
  Phone: 1- 212 - 692-0662
  Web Address: www.neuropathy.org
  

When should I contact my caregiver?

Contact your caregiver if:

• Your pain is severe.
  
  
• You cannot control your bladder.
  
  
• You have trouble with sex.
  
  
• Your medicine makes you feel sick to your stomach, sleepy, or dizzy.
  
  
• You have questions about your condition or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You fall down.
  
  
• You cannot walk at all.
  
  
• Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  
  
• You have chest pain or trouble breathing that is getting worse over time.
  
  
• You suddenly feel lightheaded and have trouble breathing.
  
  
• You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.