Updated 2 September 2022 | Approved By Dr. Umberto Russo
What is Peripheral Neuropathy?
Peripheral neuropathy is a group of conditions caused by injury and/or damage to the peripheral nerves located outside the brain and spinal cord. Peripheral nerves send signals between the body and the brain. They are responsible for bodily functions, such as the ability to move and provide sensation. According to the Australian Family Physician, around 7-8% of Australians experience neuropathic or nerve pain, a common symptom of this condition [1]. Those between the ages of 45 and 64 are most likely to experience peripheral neuropathy. Many conditions can cause peripheral neuropathy; some conditions are temporary, while others can become chronic. Below is a list of conditions that can lead to symptoms of peripheral neuropathy.- Inflammatory conditions (e.g. shingles, hepatitis, etc.)
- Autoimmune disorders (e.g. celiac disease, rheumatoid arthritis, etc.)
- Nutritional deficiencies
- Side-effects of medications
- Piriformis syndrome
- Spinal conditions
- Diabetes
- Tumours
- Carpal tunnel syndrome
- Cancer
Peripheral Neuropathy Symptoms
Symptoms of peripheral neuropathy can vary depending on the condition and the area that has been affected. The leg, arms, hands and feet are common areas where these symptoms can occur. Examples of symptoms that are commonly associated with peripheral neuropathy include:- Paraesthesia (also known as pins and needles)
- Radicular pain (also known as a burning feeling)
- Shooting pain
- Tingling
- Numbness
- Weakness
- Loss of muscle
- Poor coordination
- Changes in sensitivity
- Loss of balance
Peripheral Neuropathy Causes
Peripheral neuropathy is caused by nerve damage to the peripheral nervous system (PNS). The PNS has three main sections, including the motor, sensory and autonomic nervous systems. They support the body through voluntary (e.g. ability to feel and move) and involuntary (e.g. heartbeat, sweating, etc.) actions. There are many different causes of injury and damage to the peripheral nerves, including:- Inflammation
- Autoimmune problems
- Trauma
- Genetic conditions passed down by your family
- Repetitive injuries
- Poor blood flow
Is Peripheral Neuropathy Contagious?
There is a range of conditions that can lead to peripheral neuropathy. Many are not contagious and/or spread related symptoms to other people. However, certain diseases, such as shingles and Hepatitis C, are infectious and can spread symptoms related to peripheral neuropathy to those infected.Tests and Diagnosis
Depending on your symptoms and medical history, your GP may recommend undergoing specific tests. The purpose of the tests will be to find a diagnosis that could be responsible for the symptoms that you are experiencing. There are many types of peripheral neuropathy conditions with similar symptoms. As a result, several tests may be available to help find a diagnosis [3].Blood Tests
Blood tests are recommended to detect certain conditions, imbalances and body changes related to your peripheral neuropathy. After a blood sample has been drawn, it will be taken to a laboratory for analysis. Your GP will be able to make a judgment about what could be causing your symptoms based on these findings.Imaging
Imaging examinations, such as x-rays, MRIs and CT scans, provide detailed images to detect any changes or abnormalities inside the body. They may be able to identify physical conditions, such as spinal conditions, nerve entrapments or tumour growth responsible for your symptoms.Electrodiagnostic studies
Electrodiagnostic studies measure the electrical activity in your muscles and nerves. Results from these studies can determine whether there are any abnormalities or injuries to the affected nerve(s). Different types of electrodiagnostic studies, such as nerve conduction studies and electromyography tests, can provide information that can help identify why you have symptoms.Nerve Biopsy
A nerve biopsy involves taking a small sample of nerve to look for abnormalities that could contribute to your symptoms.Skin Biopsy
A skin biopsy takes a sample of the skin and smaller nerve endings to look for any abnormalities that could contribute to your symptoms.Cerebrospinal Fluid Analysis
A sample of the fluid around your brain and spinal cord can be taken for further analysis. It may be able to help diagnose certain conditions related to your peripheral neuropathy, such as Guillain-Barré Syndrome.Peripheral Neuropathy Treatment
Treatment for peripheral neuropathy will focus on controlling the relevant condition and managing the symptoms [3]. The GP will provide different therapies depending on the individual and the diagnosed condition. Below will be a list of treatments that may be offered.Pain Medication
Medications can be provided to treat the underlying condition and manage symptoms like pain. Different options may be available, so your doctor may follow up with your medication progress.Therapies
Your GP may also recommend therapies to help you manage symptoms related to your peripheral neuropathy. For instance, physiotherapy may help restore muscle weakness associated with nerve damage. Additionally, they may help recommend aids to regain movements, such as crutches and frames. Other types of therapies include:- Plasma exchange
- Alternative medicines
- Massage
- Meditation
Lifestyle Strategies
Healthy lifestyle practices can help the body preserve its health and physical function. There are also peripheral neuropathy conditions that can be successfully treated through specific healthy habits. For instance, regular exercise and reducing sugar intake can help prevent neuropathic pain in those with type 2 diabetes. Other examples include:- Quit smoking
- Reducing alcohol consumption
- Regular physical activity
- Eating healthily
- Managing your stress
Medical Specialists
Depending on the condition responsible for your peripheral neuropathy, your doctor may refer you to a medical specialist. They may be able to work with your GP to provide a more specialised assessment and treatment. Examples of medical specialists include:- Neurologists
- Neurosurgeons
- Immunologists
- Orthopaedic specialists
- Endocrinologists
Recovery
Recovery from peripheral neuropathy will vary depending on your condition and general health. Some conditions, such as disc herniations, will recover over time as the injury begins to heal. However, more chronic conditions, such as autoimmune disorders, have no cure. Although, treatment can be provided to help control symptoms.Complications
If left untreated, symptoms from peripheral neuropathy can worsen. This can impact your capacity to perform routine day-to-day tasks, such as working, exercising or even walking. Below is a list of complications that can occur if your peripheral neuropathy is left unchecked:- Worsening pain
- Muscle weakness
- Muscle loss
- Reduce sensation
- Worsening pins and needles
- Loss of fitness
- Foot ulcers and gangrene (especially in the case of diabetic neuropathy)
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References
- https://www.racgp.org.au/getattachment/1e9d0dbf-c9d1-4818-b625-16f39e513474/Neuropathic-pain.aspx
- Perrin, B. M., Allen, P., Gardner, M. J., Chappell, A., Phillips, B., Massey, C., ... & Skinner, T. C. (2019). The foot-health of people with diabetes in regional and rural Australia: baseline results from an observational cohort study. Journal of foot and ankle research, 12(1), 1-9.
- https://www.aafp.org/pubs/afp/issues/2010/0401/p887.html