Peripheral Neuropathy: Symptoms, Causes, Tests, and Treatments

Peripheral neuropathy (PN) is a widespread yet often overlooked condition that can significantly impact the quality of life for millions of people. This broad term encompasses disorders of the nervous system that disrupt the communication between the brain and the body's extremities. With diabetes as its most common cause, PN primarily affects the feet, but the condition can also develop due to numerous other factors.

Recent studies indicate that the prevalence of peripheral neuropathy in adults with diabetes ranges from 6% to 51%, influenced by age, diabetes duration, glucose control, and the distinction between type 1 and type 2 diabetes. Not exclusive to diabetic individuals, PN also affects around 11% of adults aged 40 and over without diabetes, with this figure more than doubling after the age of 70.

Stages of Peripheral Neuropathy

The stages of peripheral neuropathy start small, as a nagging annoyance that you can brush off. But the disease can progress quickly if no intervention is attempted.

• Stage 1: Occasional subtle numbness, pain, and discomfort in the foot, which many people may ignore without realizing something is wrong and requires treatment.
• Stage 2: You begin to notice the symptoms more regularly and consistently. There is no timeline for when stage 1 progresses to stage 2. It happens when you become aware of the pain and numbness more often and will hopefully prompt you to book an appointment with your doctor.
• Stage 3: Daily, severe pain that's unresponsive to medications and numbness in the feet or lower legs, potentially leading to unnoticed injuries and infections.
• Stage 4: Progression to stage 4 involves constant numbness. The pain recedes at this stage, but that indicates that your nerves are dying. PN begins with the disintegration of small nerve fibers, but now the large ones are also becoming damaged. While some improvement is still possible, most of the nerve damage is permanent at this stage, and you may have great difficulty balancing and walking.
• Stage 5: The last and final stage consists of a total loss of feeling in your lower legs and feet. There is no pain at this stage because your nerves are incapable of sending pain signals to the brain. It will be very difficult to walk, and you may have to use a wheelchair at this point. Any small cut, bruise, or burn to your feet will likely become infected and can even lead to amputation of your foot.

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Common Symptoms of Peripheral Neuropathy

The development and progression of peripheral neuropathy depend on its underlying cause. While injury-induced neuropathy can emerge within minutes or hours, other types may take months or even years to manifest. For those severely impacted by PN, disability benefits may be available if specific work and medical requirements are met.

The symptoms of peripheral neuropathy can be motor, sensory, or autonomic.

• Sharp pain in the extremities
• Extreme sensitivity to touch
• Numbness and tingling
• Muscle atrophy and weakness
• Uncontrolled muscle movements
• Foot problems such as infections, ulcers, and joint and bone damage
• Reduced ability to feel temperature changes or pain
• Drastic drops in blood pressure, especially when standing up
• Sweating too much or too little
• Loss of balance and clumsiness
• Bowel and bladder control issues
• Changes in skin color
• Blurry vision and changes to the eye pupil

Causes of Peripheral Neuropathy

Peripheral neuropathy is commonly associated with diabetes, but there are many other potential causes of this condition:

• Type 2 diabetes: As previously mentioned, this is the most common cause. If high blood sugar remains unmanaged for an extended period, it can damage peripheral nerves. This damage can lead to a loss of feeling in the feet and lower legs of people with type 2 diabetes.
• Vitamin deficiencies: Nerve damage can result from deficiencies in Vitamin B, particularly Vitamin B6. However, it is crucial to monitor your vitamin intake carefully, as excessive intake of this vitamin can also cause peripheral neuropathy.
• Injuries: Nerve damage can occur due to trauma or medical procedures. Swelling and stretching of vulnerable nerves can also cause long-term or permanent damage.
• Medications: Chemotherapy and certain other medications can cause peripheral neuropathy. Contrary to popular belief, not all statins contribute to this condition. Pitavastatin, pravastatin, and rosuvastatin have little or no association with peripheral neuropathy.
• Infections: Nerve damage can occur after infections with viruses such as HIV, Lyme disease, and shingles.
• Autoimmune disorders: Diseases like rheumatoid arthritis, lupus, and Sjögren's syndrome can damage nerves.
• Tumors: Both malignant and benign tumors can cause nerve damage.
• Alcohol abuse: Excessive alcohol consumption can lead to peripheral neuropathy.

Diagnostic Tests for Peripheral Neuropathy

Your doctor may perform various tests to diagnose peripheral neuropathy and identify its underlying causes. These tests may include blood tests to help detect immune system problems that may contribute to peripheral neuropathy, and diagnostic nerve ultrasounds to identify minimal changes in nerve size. A nerve biopsy may also be performed to analyze nerve tissue, and electromyography can measure how well your nerves respond to stimuli. MRI scans can provide clear images to pinpoint nerve damage, helping guide treatment to prevent further harm.

Treatment Options

Treatments for peripheral neuropathy vary widely and are tailored to each individual based on the cause and severity of the condition.

• Medication: Various medications can help alleviate the symptoms of peripheral neuropathy. These may include injections, pills, skin patches, and other forms of administration.
• Surgery: Surgical intervention may involve reconnecting damaged nerves or relieving pain caused by trapped nerves.
• Physical therapy: Focused on restoring function after addressing the underlying cause of peripheral neuropathy, physical therapy can help patients recover from injuries, improve pain symptoms, enhance balance, gait, and strength, among other benefits.
• Devices: Braces, canes, walkers, and prescribed footwear, such as shoe inserts and orthopedic shoes, can provide comfort and support to those suffering from peripheral neuropathy.

Try Insoles to Relieve Peripheral Neuropathy Pain

Peripheral neuropathy can significantly affect your daily life. Insoles may provide a helpful solution by offering cushioning, support, and promoting nerve stimulation or isolation for improved healing. Check out Footora's dedicated page showcasing the top insoles designed to assist with peripheral neuropathy.