Peripheral Neuropathy

In this article we will discuss :

What is peripheral neuropathy?

Causes of peripheral neuropathy.

Symptoms of peripheral neuropathy.

Problems caused by peripheral neuropathy.

Peripheral neuropathy diagnosis.

Diagnosis of peripheral neuropathy..

How can you prevent the problems caused by peripheral neuropathy?

Treatment of peripheral neuropathy.

What is peripheral neuropathy?

Peripheral neuropathy is a kind of nerve damage that typically affects the extremeties as feet and legs and sometimes it affects the hands and arms.

This is avery common type of neuropathy. Up to 50% of people with diabetes have peripheral neuropathy.

Causes of peripheral neuropathy.

As time passes, high blood glucose level,  and high levels of fats, as triglycerides, in the blood from diabetes can damage your nerves and small blood vessels that nourish your nerves, which leads to generation of peripheral neuropathy.

Symptoms of peripheral neuropathy.

If you are suffering from peripheral neuropathy, you may experience some signs in feet, legs, hands, or arms as:

• burning sensation
• tingling, like “needles or pins”
• numbness
• pain
• weakness
• You may experience extreme pain in your feet, legs, hands, and / or arms, even if they are touched lightly. You may also feel sensing pain or temperature in these parts of your body.

If you experience peripheral neuropathy, you may feel burning or tingling, like “needles or pins,” in your feet.

Symptoms are often worsening at night. You may have symptoms on both sides of your body or only on one side.

If you have peripheral neuropathy, you may experience other signs:

• changes in your way you in walking
• your balance will be affected, the thing that could make you fall more often
• loss of the muscle tone in your hands and /or feet
• pain when walking
• sensation problems in movement or position
• swollen feet or hands

Problems caused by peripheral neuropathy.

Peripheral neuropathy can cause foot blisters and sores. If peripheral neuropathy affects feeling in your feet, you may not notice pressure or injuries that lead to blisters and sores. Diabetes can delay the healing of these wounds and increase the chance of developing infections. These infections and sores can lead to the loss of a toe, foot, or part of the leg. Treating foot problems early can lower the chances of developing serious infections.

This type of diabetes-related nerve damage may also lead to changes to the shape of your feet and toes. Some people with diabetes may suffer from rare condition which is Charcot’s foot, in which the bones and tissue in the foot are damaged.

Peripheral neuropathy can make you more likely to feel unbalanced and fall, which can increase the chance of fractures and other injuries. The peripheral neuropathy chronic pain can also lead to grief, anxiety, and depression.

Peripheral neuropathy diagnosis.

Diagnos of peripheral neuropathy is based on your symptoms, family and medical history, a physical examination, and tests. A physical examination will include a neurological exam and a foot exam.

Examination for neuropathy

If you have diabetes, you should test how you feel in your feet and legs at least once a year. During this kind of examination, your doctor will search for signs of problems and check the blood flow , feeling, or sensation, in your feet by

• putting a tuning fork against your great toes and higher on your feet to check if you can feel vibration
• nylon strand touching to each foot and some toes to test if you can feel it this procedure is called a monofilament test
• reviewing the patterns you make when you walk
• testing your balance
• checking temperature changes feelings in your feet.

Diagnosis of peripheral neuropathy.

A blood test to check for thyroid problems, or kidney disease, or low vitamin B12 .

If low B12 levels are found, your doctor will ask you for additional tests to determine the cause.

If B12 deficiency is due to metformin, metformin can be continued with B12 supplementation.

How can you prevent the problems caused by peripheral neuropathy?

• The best way to prevent the problems caused by peripheral neuropathy is by managing your diabetes, which means managing your blood glucose level, blood pressure, and cholesterol concentration. Staying close to your goal numbers can keep nerve damage from worsening.
• If you have diabetes, check your feet daily for any problems that may arise and take good care of your feet.
• If you notice any foot problems, call your doctor right away.
• See your doctor for a foot examination once a year at least but if you have foot problems. Your doctor may recommend a podiatrist to you.

Treatment of peripheral neuropathy.

Doctors may prescribe treatments for nerve pain such as certain types of

antidepressants, including:

• tricyclic antidepressants
• other types of antidepressants:

as Duloxeprin® which contains Duloxetine as selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI).

• anticonvulsants—medicines that are designed to treat seizures—such as gabapentin.
• other medications as skin creams, patches, or sprays, such as lidocaine.

Although these medicines can help with the pain, they do not change the case of the nerve damage. 

Ask your doctor about the side effects of any medicines that you may take. Doctors will recommend some medicines according to your health problems, such as having chronic illness as heart disease, this will have certain restrictions in dosage and usage of medicines.

Some doctors recommend to avoid over-the-counter pain medicines , such as acetaminophen and ibuprofen. Because these medicines may not work well for treating most nerve pain and may have side effects.

Other treatments for nerve pain

• physical therapy to improve your balance and strength of your muscles
• some precautions to keeps sheets and blankets off your legs and feet while you sleep

Diabetes experts physicians have not made special recommendations about supplements for people with diabetes.

For safety reasons, ask your doctor before using supplements or any complementary or alternative medicines or medical practices.

References

https://medlineplus.gov/lab-tests/diabetic-foot-exam/

https://www.niddk.nih.gov/health-information/diabetes/overview/preventin...

https://www.uofmhealth.org/health-library/footp