The Basics of Peripheral Neuropathy

The brain and spinal cord contain nerves that send messages back and forth to each other. The body also contains nerves that carry messages to and from these nerves to and from the rest of the body – it is these nerves that are damaged or diseased in the case of peripheral neuropathy. 

As the nervous system is divided into two main areas – the central nervous system (the brain and spinal cord) and the peripheral nervous system (all other parts of the body) – peripheral neuropathy can be understood simply as a disease of the peripheral nervous system.

To outline the process of CNS-PNS communication, let’s take the example of someone accidentally touching a hot stove. The PNS sends signals to the CNS, which in turn sends signals back to the PNS causing a muscle reflex – the hand immediately pulls away from the hot surface.

In the case of peripheral neuropathy, nerve signalling can be disrupted in three ways:

Peripheral Neuropathy
  • Signals are lost in transmission (think of a message failing on a broken wire)
  • Inappropriate signals that shouldn’t be there (think of static on the radio)
  • Distorted signals (think of a wavy TV image)

Symptoms can range from mild numbness and tingling to severe discomfort in the form of burning, shooting, and throbbing pain. Motor function can also be negatively affected. This is all experienced in one or more of the following parts of the body:

  • Feet
  • Legs
  • Arms
  • Hands
  • Mouth
  • Face
  • Internal organs

In extreme cases, peripheral neuropathy can actually cut one’s ability to feel anything at all in a certain part of their body, leading to damage in that they don’t realize when they’ve been cut, burned, or bruised.

Forms

Peripheral neuropathy is really an umbrella term for a number of different neural disorders of the peripheral nervous system. Common forms include:

Mononeuropathy

This is when damage occurs to a single nerve (hence: “mono”) and is usually caused by a physical injury or trauma due to prolonged pressure on the nerve. Sitting too long in one place or lying too long in bed can cause this issue, as well as repetitive motions (carpal tunnel syndrome is a common form of mononeuropathy).

Polyneuropathy

This is the most common form of neuropathy and occurs when various peripheral nerves become damaged or diseased at one time. 

There are many possible causes of polyneuropathy, including:

  • Lack of nutrition
  • Cancer
  • Diabetes
  • Kidney failure
  • Alcohol abuse (too much alcohol can actually damage the nerves)

Diagnosis

Electromyography

Peripheral Neuropathy

This is a diagnosis by which the nerves are monitored to see how they send signals to your muscles and cause them to move. Electromyography involves the placement of a small needle into a muscle. Any small movement of the muscle will show the needle how much electricity is flowing through the muscle. 

This diagnostic is no more painful than getting a shot – it may be slightly uncomfortable and result in mild soreness for a few days after your appointment.

Nerve Conduction Study

Peripheral Neuropathy

This involves the placement of electrodes on the skin that send small electrical signals through the nerves. The doctor monitors the nerves to see if they are transmitting signals correctly. 

This diagnostic may be slightly uncomfortable while it’s being performed, but should result in no soreness or residual pain.

Treatment Options for Peripheral Neuropathy

Pain & Prescription Medications

These can include over-the-counter painkillers and nonsteroidal anti-inflammatory drugs. Prescription medications include:

  • Tramadol
  • Seizure medications
  • Cyclooxygenase-2 inhibitors
  • Corticosteroid injections
  • Antidepressants, specifically Cymbalta

Medical Treatments

Pain doctors can perform a number of different treatments depending on what type of peripheral neuropathy one has, including:

  • Transcutaneous electronic nerve stimulation (TENS) – This is a drug-free therapy involving the use of electrodes, which are placed on the skin and emit tiny pulses of electricity throughout the muscles. This disrupts the nerves and mitigates their ability to transmit pain signals to the brain.
  • Ergonomic casts or splints – If peripheral neuropathy is affecting the extremities, ergonomic casts can give one support and relieve pain. 

Other Treatments

There are a number of treatments one can do at home in a professional setting that can relieve the pain of peripheral neuropathy, including:

  • Yoga and meditation
  • Massage
  • Chiropractic work
  • Acupuncture

A combination of all of the above treatments often yields the best results.