The peripheral nervous system is a network of 43 pairs of motor and sensory nerves that connect the brain and spinal cord (the central nervous system) to the entire human body. These nerves control the functions of sensation, movement and motor coordination.
Peripheral neuropathy is a disorder that occurs when these nerves malfunction because they’re damaged or destroyed. This disrupts the nerves’ normal functioning. They might send signals of pain when there’s nothing causing pain, or they might not send a pain signal even if something is harming you. Among the most common causes can be:
- An injury
- Systemic illness
- An infection
- An inherited disorder
- Metabolic causes
The disorder is uncomfortable, but treatments can be very helpful. The most important thing to determine is whether peripheral neuropathy is the result of a serious underlying condition.
People who have a family history of peripheral neuropathy are more likely to develop the disorder. However, a variety of factors and underlying conditions may also cause this condition.
More than 100 different types of peripheral neuropathy exist. Each type has unique symptoms and specific treatment options. Peripheral neuropathies are further classified by the type of nerve damage involved. Mononeuropathy occurs when only one nerve is damaged. Polyneuropathies, which are more common, occur when multiple nerves are damaged.
The three types of peripheral nerves are:
- sensory nerves, which connect to your skin
- motor nerves, which connect to your muscles
- autonomic nerves, which connect to your internal organs
Peripheral neuropathy can affect one nerve group or all three.
The symptoms of peripheral neuropathy include:
- tingling in the hands or feet
- a feeling like you’re wearing a tight glove or sock
- sharp, stabbing pains
- numbness in the hands or feet
- a weak, heavy feeling in the arms and legs, which sometimes may feel like your legs or arms lock in place
- regularly dropping things from your hands
- a buzzing or shocking sensation
- thinning of the skin
- a drop in blood pressure
- sexual dysfunction, especially in men
- digestive difficulty
- excessive sweating
These symptoms can also indicate other conditions. Make sure you tell your doctor about all of your symptoms.
First, your doctor will perform a physical exam and ask about your medical history. If they still can’t tell whether your symptoms are due to peripheral neuropathy, other tests to perform include:
- Blood Tests – can measure vitamin and blood sugar levels and determine whether your thyroid is functioning correctly.
- Blood CT Scan – Your doctor may also order a CT scan or MRI to see if anything is pressing on a nerve, such as a herniated disk or a tumor.
- Blood Nerve Biopsy – Sometimes your doctor will order a nerve biopsy. This is a minor surgery that involves removing a small amount of nerve tissue that they can then examine under a microscope.
Electromyography (EMG) is a diagnostic procedure that evaluates the health condition of muscles and the nerve cells that control them. These nerve cells are known as motor neurons. They transmit electrical signals that cause muscles to contract and relax.
An EMG is a test that checks the health of nerves and muscles. An EMG involves inserting tiny needles into your muscles to record electrical activity.
Nerve Conduction Study
A nerve conduction velocity (NCV) test — also called a nerve conduction study (NCS) — measures how fast an electrical impulse moves through your nerve. NCV can identify nerve damage. During the test, your nerve is stimulated, usually with electrode patches attached to your skin. Healthy nerves send electrical signals more quickly and with greater strength than damaged nerves.
The nerve conduction study stimulates specific nerves and records their ability to send the impulse to the muscle. The study can show where there is a blockage of the nerve pathway. Nerve conduction studies are done to help diagnose nerve disorders, such as carpal tunnel syndrome or Guillain-Barré syndrome among others.
The treatment is based on treating the underlying disorder. If diabetes is the cause, making certain that the blood glucose is controlled is important. If a vitamin deficiency is causing the problem, then correcting the deficiency is the treatment. Many treatments can bring relief and help you return to your regular activities. Sometimes a combination of treatments works best.
Many prescription pain medications can also help to control the pain of this condition. These include narcotics, some antiepileptic medicines, and some antidepressants.
Your doctor can use several medical treatments to control the symptoms of this condition. Plasmapheresis is a blood transfusion that removes potentially irritating antibodies from your bloodstream. If you get a nerve block, your doctor will inject an anesthetic directly into your nerves.
Transcutaneous electronic nerve stimulation (TENS)
Transcutaneous electronic nerve stimulation (TENS) doesn’t work for everyone, but many people like it because it’s a drug-free therapy. During TENS, electrodes placed on the skin send small amounts of electricity into the skin. The goal of this treatment is to disrupt nerves from transmitting pain signals to the brain.
Ergonomic casts or splints
Ergonomic casts or splints can help you if your neuropathy affects your:
These casts provide support for the part of your body that’s uncomfortable. This can relieve pain. For example, a cast or splint that holds your wrists in a proper position while you sleep can relieve the discomfort of carpal tunnel syndrome.
Understanding the underlying cause of your pain is fundamental to tailoring the treatment plan that will work best for you. Our Pain Specialists take a proactive approach to diagnosing and treating a wide variety of pain-causing conditions, using the latest technologies and most advanced equipment.