Peripheral Neuropathy Treatment & Diagnosis

Peripheral neuropathy can cause symptoms such as tingling, burning, pain or numbness in your feet or hands. Symptoms can vary in type and intensity. Some people may experience only a prickly feeling in their extremities. Others may experience more severe symptoms, such as muscular weakness. Still others may have trouble controlling their blood pressure or have problems with sexual function. And some may not be able to digest food normally, or may experience muscle-wasting, difficulty breathing, gland or organ dysfunction, and even paralysis.

What Causes These Symptoms?

• Damage to the peripheral nervous system causes these symptoms. The nerves that send information from the brain through the spinal cord to other parts of the body don't function properly. This could be the result of an injury or infection; or, as for many people with diabetes, a problem with the way the body metabolizes sugars.

Diagnosis

• Diagnosing peripheral neuropathy can be tricky, because symptoms vary so much among people and because it is not caused by a single disease but could have a number of causes.

  The first thing your doctor will do is take an extensive history of your symptoms. He will ask about any infections or exposures to toxins you may have experienced, whether you drink a lot of alcohol, or if there is a history of neurological disease in your family. Your muscle strength and motor skills will also be assessed.

Medical Tests

• Blood tests can be ordered to detect liver or kidney problems, metabolic disorders or vitamin deficiencies. The fluid that surrounds the brain and spinal cord may be examined as well. Other tests used to detect peripheral neuropathy include the following: computed tomography or CT scans, magnetic resonance imaging (MRI), electromyography (EMG) to differentiate whether the problem is a nerve or muscle disorder; nerve conduction velocity (NCV) to measure the degree of damage to the nerves; or a nerve biopsy or skin biopsy to examine the degree of damage to the nerves.

Treatment

• There is no cure for peripheral neuropathy, but there are treatments that can improve symptoms. The first and most important part of your treatment will be to determine what is actually causing the peripheral neuropathy and to treat the condition in order to control symptoms. The peripheral nerves may be able to heal and new damage be avoided if the underlying disease or illness is eliminated.

  The second part of your treatment will be to relieve pain and other symptoms. A number of medicines are used for this purpose, including over-the-counter or prescription pain relievers, anti-seizure medicines, a lidocaine (topical anesthestic) patch, and antidepressants such as Pamelor (nortriptyline and amitriptyline) or Cymbalta (duloxetine).

Prevention

• The most important thing you can do if you have peripheral neuropathy is to prevent future symptoms. If you have diabetes or a metabolic disorder, you need to control your blood sugar and manage your diabetes. If you have a problem with alcohol, get help through a treatment program. And eat a healthy diet rich in vitamin B-12, which includes foods such as lean meats, fish, eggs, low-fat dairy products and fortified cereals.