Neuropathy

Cause

The damage to the nerves in case of neuropathy may be the result of:

• Diabetes.
• Alcoholism.
• Toxins.
• Infections.
• Autoimmunity.
• Diseases, such as kidney failure or kidney cancer.
• Injuries.

Symptoms

The signs and symptoms of neuropathy are:

• Sharp or stabbing pain.
• Burning sensation.
• Dull feeling.

These symptoms are most common in hands and feet.

Diagnosis

Because there are several conditions underlying neuropathy, the diagnosis also varies from case to case. A doctor may order an MRI or CT scan or other examination in order to find out the cause of the pain.

Treatment

There are numerous forms of pain treatment for people suffering from chronic pain. Some options are:

• Medication. Medicines are often the first choice of the doctor. For pain medication, universal painkillers such as aspirin and paracetamol, steroid anti-inflammatories and stronger drugs may be prescribed.
• Physical therapy. With physical therapy is tried to strengthen or restore the muscles, so that patients are able to move more freely again and with less pain.
• Psychotherapy. Chronic pain can cause physical and mental stress, which affect the patient and his or her environment. There are specific treatments by a psychologist, in which a person learns to relax, to better deal with the pain and to monitor borders.
• Corrective surgery. Examination may indicate that a person can benefit from surgery.
• Nerve blockage by means of local injections. In this treatment, injections of a local anesthetic and/or steroids are given at the site where the pain occurs. Local injections usually offer only temporary relief of pain. If the pain doesn’t diminish after multiple injections, the doctor may consider other treatments.
• Medical implantable devices for pain relief. These are, for example, neurostimulators and drug pumps, which suppress pain signals before they reach the brains. During an operation, they are placed into the body. These treatment forms are, in contrast to the majority of surgical procedures, reversible: the doctor can turn off or remove the system. Moreover, the patient can first try these systems for a while, before they are implanted permanently.
• Neuroablation. With neuroablation, the doctor interrupts (usually by means of heating) the neural pathways that pass pain signals to the brains. Neuroablation is often a last resort, when other treatments didn’t help.

Prognosis

The prognosis of neuropathy is highly dependent on the moment when the treatment was started. The sooner the treatment starts, the better the prognosis. Once existing neuropathy recovers slowly and not always completely.

Considerations

• People with neuropathy of the legs are at higher risk of developing wounds at the feet that are difficult to heal. People with a decreased sensitivity of the skin must be more alert and mitigate the numbness with precautions. Think for example of checking the water temperature with hand or elbow before stepping into bath.
• Always check shoes on stones or rough spots that could damage the feet. Shoes should fit well, be made of soft material and have no stitching. Synthetic and tight socks should be avoided.
• Foot care is of great importance. Patients with decreased feeling should regularly check their feet on color differences, sores, blisters, inflamed nails and other injuries that might otherwise go unnoticed. These may cause serious infections.
• Muscle weakness, poor coordination, balance disorders and decreased feeling in the feet increase the risk of falling. Thus, patients hurt themselves more often. Measures to prevent falling incidents (fall prevention) are important. Examples include proper lighting, non-slip flooring in the bathroom and removing loose mats and carpets in the house.
• Keep doing plenty of exercise. If necessary, physical therapy can provide support.

Facts

• The term neuropathy literally means ‘nerve pain’.
• The prevalence of neuropathy is 4%.