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Peripheral Neuropathy


What is peripheral neuropathy?

Peripheral neuropathy is a condition that affects your nerves. Nerves carry information from your brain to your body. When you have neuropathy, the information does not transfer along your nerves correctly. 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?

  • Trauma or pressure on the nerve: Any accident that causes nerve damage can lead 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.
  • Alcohol abuse: Alcohol abuse can cause a decrease of vitamins in your body, which can cause 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, such as rheumatoid arthritis, cancer, lupus, and inherited disorders, may cause neuropathy. Certain medical treatments, such as chemotherapy or surgery, increase your risk of peripheral neuropathy. Some 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 or urination. The following are common signs and symptoms:

  • Pain or tingling in your legs, feet, arms, or hands that may feel sharp, stabbing, or burning
  • Trouble walking or keeping your balance
  • Weakness or difficulty holding things
  • Loss of your sense of touch or numbness
  • Bruising easily
  • Trouble controlling your bladder or bowels or having sex

How is peripheral neuropathy diagnosed?

Your healthcare provider will examine you and ask about your symptoms. He may ask you about your other health conditions and about your family health history. Your healthcare provider may gently touch your skin in different areas with a cotton ball or a pin. This is done to check your sense of touch. He may also check how well you can feel hot and cold. Your healthcare provider 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.
  • An electromyography (EMG) test measures the electrical activity of your muscles at rest and with movement.
  • Nerve conduction studies: Nerve conduction studies (NCS) test how your nerves respond to stimulation. Electrodes (wires) are placed on affected areas of your body. 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:
    • Antidepressants: This medicine helps to decrease or stop the symptoms of depression. It also used to help decrease pain. Take this medicine as directed.
    • Antiseizure medicine: This medicine is usually given to control seizures, but it also helps with nerve pain.
    • Pain medicine: You may be given medicine to 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.
  • Physical therapy: Physical and occupational therapists may help you 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 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. 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.
  • You may injure yourself if 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 to have trouble sleeping. 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: Ask your healthcare provider about the best exercise plan for you. Physical activity 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.

When should I contact my healthcare provider?

  • Your pain is severe.
  • You cannot control your bladder.
  • You have trouble having sex.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You fall.
  • You cannot walk at all.

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 healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. 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.

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Further information

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