What is neuropathy? Peripheral neuropathy is decreased function of the peripheral nerves which results in a multitude of symptoms such as numbness, tingling, pain, creepy crawly sensation, or muscle cramping. Neuropathy can affect both upper or lower extremities. These symptoms typically occur in a stocking and glove pattern meaning they can extend from the feet up to the knees or the fingers up to the elbows. Although not as common, neuropathy can affect one extremity. This occurs when nerve injury is the cause of the damage. Symptoms also may start very subtly in the fingertips or toes and then progress upwards. Another commonly reported symptom is imbalance. Symptoms may worsen over time although very slowly taking months to years to be significantly disabling.
What are the causes of neuropathy? There are multiple causes of neuropathy and in some cases the cause may be unknown. Common causes are uncontrolled blood sugar, chemotherapy, trauma, injury, or alcohol use. Elevated blood sugar causes damage to the small nerve fibers resulting in permanent injury to the nerves.
How is neuropathy diagnosed? Neuropathy is diagnosed at an in-office exam as well as nerve condition study (EMG). An EMG is a short test that determines how well the nerves are functioning using electrical stimulation. The second portion of the test uses a probe to determine how well nerves and muscles function together.
Can neuropathy be cured? There are no cures for neuropathy, but it can be effectively managed. If neuropathy is caused by elevated blood sugar, tight blood sugar control is essential in preventing neuropathy from worsening. Prevention of worsening preserves function as well as prevents the risk for falls in the future. Exercise is important for the treatment of neuropathy as it improves balance as well as strengthens the muscles where the nerves are not as functional as before. Medications are an adjunctive treatment to exercise as they can decrease the painful symptoms associated with neuropathy.
Are over the counter treatments effective? Over the counter treatments such as lotions, creams, oils, or vitamin supplements could be used after discussion with your health care provider. For mild symptoms, some lotions or creams can decrease discomfort or numbness associated with neuropathy. Vitamin B12 is also helpful as it improves nerve transmission or how quickly nerve signals are transmitted throughout the body.
Lacey Lyle, FNP
Neurology and Sleep Associates of Suffolk
References:
Rosett. J. & Hu, F. Nutritional Strategies for Prevention and Management of Diabetes: Consensus and Uncertainties. Diabetes Care ( 727-730). 2019.
Gupta, L., Lal, P. & Knandelwal, D. Optimizing Macronutrients in People with Diabetes. Novonordisk Education Foundation (65-71). 2018.