Neuropathies

Diabetic, alcoholic, or unknown cause
Peripheral neuropathy is a technical term used to describe a disorder of the peripheral nervous system, i.e., the nerves that branch out from the spinal cord to all parts of the body.

Peripheral neuropathy usually affects the long sensory nerve endings, especially to the body’s extremities – arms, hands, legs and feet – occasionally to the face and trunk. When peripheral nerves become damaged by neuropathy, they can create pain themselves, usually characterized as burning or pins and needles. These symptoms are usually accompanied by a marked sensitivity to touch of the affected region – very similar to a very severe sun burn  – and usually progress over time from the fingers and toes to more central locations such as calves/forearms. Usually more than one nerve is affected at the same time.

What are the causes of peripheral neuropathy?
Peripheral neuropathy may be caused by a number of factors. Diabetes is a major cause of peripheral neuropathy, affecting over 50% of all diabetics at some point during their disease process. Diabetics may develop nerve problems at any time, although the longer a person has diabetes, the greater the risk of neuropathy. The highest rates of diabetic peripheral neuropathy are among people who have had the disease for 20 years or longer.
Shingles (herpes zoster) and alcoholism are two other well-known causes of neurophathy. Other somewhat less common causes include AIDS, Lyme disease and certain toxins.
When a single peripheral nerve is involved, this suggests the likely cause is trauma or some type of repetitive activity that exerts pressure on a nerve. Extended periods of time spent typing at a keyboard, using a cast or crutches, or a tumor or bone spur can be responsible. Carpal tunnel syndrome is an example of a single peripheral neuropathy.
Many cases of peripheral neuropathy have no known cause.  When there is no apparent cause, the neuropathy is called “idiopathic.”

What treatment options are available?
Common treatment options include intermittent sympathetic nerve blocks (injections) medications such as antidepressants and anticonvulsants (used for their effects on pain processing), narcotics, physical therapy, nutritional therapy, acupuncture, and hypnosis. In advanced cases, implantable technology is a viable option (e.g., spinal cord / dorsal column stimulators and spinal pumps/catheters).