This is a disorder of the nerve(s) apart from the brain and spinal cord. Patients with peripheral neuropathy have tingling, numbness, unusual sensations, burning pain or weakness in the affected area.
Peripheral neuropathy involves different nerve types including sensory, motor, and autonomic nerves. Peripheral neuropathy also can be categorized by the size of the nerve fibers involved, small or large.
Sometimes, peripheral nerve entrapments, for example carpal tunnel syndrome, can be considered peripheral neuropathies. When this happens, pressure on the nerve rather than a disease, leads to nerve malfunction.
Symptoms of Neuropathy
The symptoms include numbness, weakness, pain of different types, or loss of balance, depending on the type of nerve involved. Oftentimes, the symptoms are symmetrical and involve both hands and feet. Because the symptoms are often in the areas covered by gloves or stockings, peripheral neuropathy is sometimes described as having a “glove and stocking” distribution of symptoms.
Causes of Neuropathy
Diabetes and postherpetic neuralgia are the most common causes of peripheral neuropathy, but often times no cause is found. If this is the case, it is referred to as idiopathic peripheral neuropathy.
The first step in treatment is to look for the cause, if a specific treatment isn’t available, the pain can usually be controlled with medications. At Lumin PainCARE we begin with the most conservative approach – an over-the-counter (OTC) medication, such as aspirin, acetaminophen or ibuprofen. Tricyclic antidepressants such as amitriptyline (Elavil) or nortriptyline (Pamelor) and antiseizure medications, such as carbamazepine (Tegretol) have also been used to relieve the pain of neuropathy. Capsaicin is available over-the-counter as a cream to help relieve the pain as well. Pregabalin (Lyrica) is a medication that is used to treat postherpetic neuralgia and diabetic peripheral neuropathy, while duloxetine (Cymbalta) has been approved to treat diabetic peripheral neuropathy. In some instances, opioids may be used to help control the pain that can be associated with peripheral neuropathy.