Peripheral Neuropathy
Common to people over 55

More than 20 million Americans suffer from pain and numbness due to nerve problems known as peripheral neuropathy. Peripheral neuropathy often affects people with diabetes and autoimmune diseases such as rheumatoid arthritis and lupus.

Peripheral neuropathy describes the damage done to the peripheral nervous system. This system is the highway which transmits information from the brain and spinal cord to every part of the body. Peripheral nerves send sensory information back to the brain and spinal cord such as a message that the feet are cold or a finger is burned. Damage to the peripheral nervous system interferes with these vital connections.

There are actually more than 100 types of peripheral neuropathy, each having its own characteristics and set of symptoms. Since every peripheral nerve has a highly specialized function in a specific part of the body, a wide array of symptoms can occur when nerves are damaged.

Some people experience temporary numbness, tingling and pricking sensations, sensitivity to touch or muscle weakness. Others may suffer more intense symptoms including burning pain, muscle wasting, paralysis or organ or gland dysfunction. Those suffering from diabetes may suffer any combination of the above symptoms.

Peripheral neuropathy is either inherited or acquired. Acquired peripheral neuropathy can be caused by a physical injury to nerves, tumors, toxins, nutritional deficiencies, alcoholism and vascular and metabolic disorders. They are caused by systemic disease, trauma, from external agents or infections or autoimmune disorders affecting nerve tissue. Inherited forms of peripheral neuropathy are caused by inborn mistakes in the genetic code or by new genetic mutations.

Neuropathies range from carpal tunnel syndrome of the hands to those affecting the feet. They are especially common to diabetics and people over 55.

Muscle weakness is the most common symptom of motor nerve damage. Other symptoms may include painful cramps, uncontrolled muscle twitching visible under the skin, muscle loss, bone degeneration and changes in the skin, hair, and nails. These more general degenerative changes also can result from sensory or autonomic nerve fiber loss.

Sensory nerve damage causes a more complex range of symptoms because sensory nerves have a wider, more highly specialized range of functions.

Damage to large sensory fibers lessens the ability to feel vibrations and touch, resulting in a general sense of numbness, especially in the hands and feet. People may feel as if they are wearing gloves and stockings even when they are not. Many patients cannot recognize by touch alone the shapes of small objects or distinguish between different shapes. This damage to sensory fibers may contribute to the loss of reflexes (as can motor nerve damage). Loss of position sense often makes people unable to coordinate complex movements like walking or fastening buttons, or to maintain their balance when their eyes are shut.

Neuropathic pain is difficult to control and can seriously affect emotional well-being and overall quality of life. It is often worse at night, seriously disrupting sleep and adding to the emotional burden of sensory nerve damage.

Damage to smaller sensory fibers can interfere with the ability to feel pain or changes in temperature. People may fail to sense that they have been injured from a cut or that a wound is becoming infected. Others may not detect pains that warn of impending heart attack or other acute conditions. Loss of pain sensation is a particularly serious problem for people with diabetes, contributing to the high rate of lower limb amputations among this population.

Autonomic nerve dysfunction can become life threatening and may require emergency medical care in cases when breathing becomes impaired or when the heart begins beating irregularly. Common symptoms of autonomic nerve damage include an inability to sweat normally, which may lead to heat intolerance; a loss of bladder control, which may cause infection or incontinence; and an inability to control muscles that expand or contract blood vessels to maintain safe blood pressure levels. A loss of control over blood pressure can cause dizziness, lightheadedness, or even fainting when a person moves suddenly from a seated to a standing position.

Gastrointestinal symptoms frequently accompany autonomic neuropathy. Nerves controlling intestinal muscle contractions often malfunction, leading to diarrhea, constipation, or incontinence. Many people also have problems eating or swallowing if certain autonomic nerves are affected. Until recently there were very few medical treatments that could alleviate symptoms. New, pioneering nerve decompression medical treatments are now available to restore sensation in your hands and feet.

For more information, contact your primary care physician or University Health System, at the University of Nevada School of Medicine at www.UHSNevada.org