Peripheral Neuropathy Pain

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Condition: Peripheral neuropathy refers to damage to the nerves in the peripheral nervous system, most commonly the arms and legs. These are the nerves that transmit messages between the central nervous system (the brain and spinal cord) and the rest of the body.

Background: Approximately 20 million Americans have peripheral neuropathy. It can be inherited, develop as a result of a disease or happen after an injury or exposure to a toxin. In many cases, though, a specific cause cannot be found.

Risk Factors: There are multiple risk factors such as: having a chronic disease, an injury; abusing alcohol; performing repetitive motions; having an infection, and exposure to toxins. People with diabetes have the highest risk of peripheral neuropathy.

History and Symptoms: To better understand this condition, it helps to understand how the peripheral nerves work. For instance, they can route messages regarding sensation to the brain and spinal cord, such as a message that the hands are cold. They also route messages from the brain and spinal cord to the muscles, instructing them to move. People with peripheral neuropathy can experience a variety of symptoms, like pain, weakness, tingling, pricking sensations and numbness, often in the hands and feet.  This commonly occurs in a pattern known as stocking- glove distribution.

Physical Exam: Physicians will usually examine the patient’s muscle strength and reflexes, as well as his or her ability to sense vibrations, light touch, position and temperature.  They may also evaluate posture and gait.

Diagnostic Process: Physicians may order blood tests, CT or MRI scans, nerve function tests and nerve or skin biopsies to diagnose peripheral neuropathy and determine its cause.

Rehab Management: Once the underlying cause is identified, the first step is to see if it can be removed or mitigated. If it can’t, medications for neuropathic pain are available.  A physical medicine and rehabilitation (PM&R) physician may also prescribed physical therapy to improve balance, orthotics to protect the feet from skin problems, occupational therapy to compensate for loss of hand function or assistive devices to insure safe mobility.

Other Resources for Patients and Families: The Foundation for Peripheral Neuropathy can help. They are the leading national nonprofit organization providing peripheral neuropathy patient support and education.