Peripheral neuropathy

Peripheral nerves carry information to and from the brain. They also carry signals to and from the spinal cord to the rest of the body. Peripheral neuropathy means these nerves don't work properly. Peripheral neuropathy may be damage to a single nerve. It may be damage to a nerve group. It may also affect nerves in the whole body.

Causes, incidence, and risk factors

Nerve damage is very common. There are many types and causes. Often, no cause can be found. ome nerves diseases run in families. !iabetes is the most common cause of this type of nerve problem. It happens when you have high blood sugar levels over a long time. Other medical problems that may cause neuropathy are"

#utoimmune disorders rheumatoid arthritis or lupus $hronic kidney disease Infections such as %I& and liver infections 'ow levels of vitamin ()* or other problems with your diet Poor blood flow to the legs +nderactive thyroid gland

!rugs and to,ins may damage nerves. One e,ample is heavy alcohol use. -lue, lead, mercury, and solvents may damage nerves. !rugs that treat infections, cancer, sei.ures, and high blood pressure may cause nerve damage. Pressure on a nerve near a body part may be a cause. #n e,ample is carpal tunnel syndrome. # bone fracture or other trauma may damage a nerve. (eing e,posed to cold temperatures for a long period of time may too. Pressure from bad/fitting casts, splints, a brace, or crutches can damage a nerve.

Symptoms
ymptoms depend on the nerve that is damaged. ymptoms also depend on whether the damage affects one nerve, several nerves, or the whole body. P#IN #N! N+0(N1

Tingling or burning in the arms and legs may be an early sign of nerve damage. These feelings often start in your toes and feet. 2ou may have deep pain. This often happens in the feet and legs. 2ou may lose feeling in your legs and arms. (ecause of this, you may not notice when you step on something sharp. 2ou may not notice when touch something that is too hot or cold. 2ou may not know when you have a small blister or sore on your feet. 0+ $'1 P3O('10 !amage to the nerves can make it harder to control muscles. It can also cause weakness. 2ou may notice problems moving a part of your body. 2ou may fall because your legs buckle. 2ou may trip over your toes. !oing tasks such as buttoning a shirt may be harder. 2ou may also notice your muscles twitch or cramp. 2our muscles may become smaller. P3O('10 4IT% (O!2 O3-#N People with nerve damage may have problems digesting food. 2ou may feel full or bloated and have heartburn after eating only a little food. ometimes you may vomit food that has not been digested well. 2ou may have either loose stools or hard stools. ome people have problems swallowing. !amage to the nerves to your heart may cause you to feel lightheaded, or faint, when you stand up. #ngina is the warning chest pain for heart disease and heart attack. Nerve damage may 5hide5 this warning sign. 2ou should learn other warning signs of a heart attack. They are sudden fatigue, sweating, shortness of breath, nausea, and vomiting. OT%13 20PTO0 O6 N13&1 !#0#-1 e,ual problems. 0en may have problems with erections. 4omen may have trouble with vaginal dryness or orgasm. ome people may not be able to tell when their blood sugar gets too low. (ladder problems. 2ou may leak urine. 2ou may not be able to tell when your bladder is full. ome people are not able to empty their bladder. 2ou may sweat too much. This may happen when the temperature is cool, when you are at rest, or at other unusual times.

Signs and tests

2our doctor will do a careful history of you. 2ou will also have a physical e,am. 2ou may have blood tests to look for causes of your nerve damage.

2ou may also have tests to" check activity in muscles, see how fast signals travel along nerves, and look at a sample of a nerve under a microscope.

Treatment
Treating the cause of nerve damage, if it is known, may improve your symptoms. People with diabetes should learn to control their blood sugar. If you use alcohol, stop. 2our medicines may need to be changed. 3eplacing a vitamin or making other changes in your diet may help. 2ou may need surgery to stop in7ury to a nerve. 2ou may have therapy to learn e,ercises to get better muscle strength and control. 4heelchairs, braces, and splints may improve movement or the ability to use an arm or leg with nerve damage. 1TTIN- +P 2O+3 %O01 afety is very important for people with nerve damage. Nerve damage can increase the risk of falls and other in7uries. 3emove loose wires and rugs from areas you walk through. !o not keep small pets in your home. 6i, uneven flooring in doorways. %ave good lighting. Put handrails in the bathtub or shower and ne,t to the toilet. Place a slip/ proof mat in the bathtub or shower. 4#T$%IN- 2O+3 8IN 4ear shoes at all times to protect your feet from in7ury. (efore you put them on, always check inside your shoes for stones, nails, or rough areas that may hurt your feet. $heck your feet every day. 'ook at the top, sides, soles, heels, and between the toes. 4ash your feet every day with lukewarm water and mild soap. +se lotion, petroleum 7elly, lanolin, or oil on dry skin. $heck bathwater temperature with your elbow before putting your feet in the water. #void putting pressure on areas with nerve damage for too long. T31#TIN- P#IN 0edicines may help reduce pain in the feet, legs, and arms. They usually do not bring back loss of feeling. 2ou may take pain pills. 0edicines used to treat other medical problems, such as sei.ures or depression, can also help manage the pain. +se the lowest dose possible to avoid side effects.

2our doctor may refer you to a pain specialist. Talk therapy may help you better understand how your pain is affecting your life. It can also help you learn ways to better cope with pain. T31#TIN- OT%13 20PTO0 4earing elastic stockings may help treat low blood pressure and fainting. o can sleeping with your head elevated. ome medicines may also help. 2our health care provider may give you medicines to help with problems going to the bathroom. 1ating small fre9uent meals may help. There are ways to help bladder problems. 2ou can learn e,ercises to strengthen your pelvic floor muscles. 2ou may need to use a thin tube that is inserted into your bladder :urinary catheter;. 2ou may take medicines. 0edicines can often help with erection problems.

Support Groups Expectations (prognosis)

The outcome depends on the cause of nerve damage. 4hen a medical condition can be found and treated, your outlook may be e,cellent. (ut, in severe neuropathy, nerve damage can be permanent, even if the cause is treated. $hronic pain can be a ma7or problem for some patients. Those with numbness in the feet can get skin sores that do not heal. They are also at risk for 7oint deformities. 3arely, numbness in the feet may lead to amputation. 6or most neuropathies passed down in families, there is no cure. ome of these problems do not interfere with daily life. Others get worse 9uickly and may lead to long/term, severe symptoms and problems.

Calling your health care provider

$all your health care provider if you have symptoms of nerve damage. 1arly treatment increases the chance of controlling symptoms and preventing more problems.

Prevention
2ou can prevent some causes of nerve damage. !rink alcohol in moderation. 6ollow a balanced diet. 8eep good control over diabetes and other medical problems. 'earn about chemicals used at your workplace.