Thursday, 4 July 2013

See Your Doctor If You Have Neuropathy Symptoms

Today's post from (see link below) is another general description of neuropathy but it is important to realise that every different explanation of neuropathy brings a slightly different approach to the table and often new snippets of information. Particularly important is the advice to see a doctor as soon as you begin to notice the symptoms and if further investigation and/or treatment is necessary, then find a doctor who has knowledge of nerve damage and is also someone you trust. Very many doctors covered neuropathy at a basic level  in their training but have not necessarily kept up with the subject since then. That's not an accusation it's a fact of life and no doctor can be expected to have in-depth knowledge of every aspect of human health, which is why, it's important to be referred to a neurologist, or doctor with experience of the variations of neuropathy.

LIFELONG HEALTH- Peripheral Neuropathy Requires Watchful Care   

Written by Dr. David Lipschitz Friday, 28 June 2013

Peripheral neuropathy is a major cause of distressing pain and disability.

To understand the condition, begin with the name. The body has two main nervous systems: the central nervous system, including the brain and the spinal cord, and the peripheral nervous system, including nerves that link the brain and spinal cord to everything else — arms and hands, legs and feet, internal organs, joints and so forth. "Neuropathy" means damage to nerve cells, muscle movement and strength.

Peripheral neuropathy involves damage to the nerves in the hands and the feet. These nerves control sensation, including pain, heat, cold and touch, as well as motor nerves that regulate muscle movement. Occasionally nerves responsible for balance, blood pressure and bowel function may be affected.

Earliest symptoms are numbness and tingling in the toes and fingers that gradually worsen, causing burning, sharp pain that feels like electricity and increased sensitivity to touch. Simply touching the soles of the feet can cause unbearable discomfort.

Loss of nerve supply to muscles leads to weakness, impaired gait and balance and even paralysis. In the worst cases, bowel and bladder problems develop, and difficulties in regulating blood pressure can occur.

The two most common causes — by far — are long-term alcohol abuse and diabetes.

Alcohol can damage nerves directly or indirectly by poor diet and malnutrition. Diabetes causes damage to tiny arteries throughout the body. This is referred to as diabetic microangiopathy, and it leads to impaired blood supply to the nerves in the hands and the feet and hence, the peripheral neuropathy that affects half of all diabetics.

Rarer causes of peripheral neuropathy include chemotherapy induced damage to nerves, exposure to toxins, such as heavy metals and certain infections, including HIV, Lyme disease, infectious mononucleosis and chronic hepatitis.

Peripheral neuropathy can also occur when nerves are damaged by injuries or benign or malignant tumors. Liver or kidney disease and impaired thyroid function can lead to peripheral neuropathy, as can deficiencies of vitamins B-1, B-6 and B-12. Sometimes an immune reaction causes peripheral neuropathy.

The most common is Guillain-Barre syndrome, in which inflammation causes damage to nerves resulting in weakness that can be life threatening. Most individuals recover completely.

Occasionally, an inherited illness can cause damage to peripheral nerves; the most common is Charcot-Marie-Tooth disease. In addition to severe pain and weakness, a serious effect of peripheral neuropathy is complete loss of sensation in the soles of the feet and lower legs. Because of an inability to feel temperature or pain, any minor injury can lead to serious wounds.

This is a particular concern in diabetics, where the associated impaired blood supply makes wound healing very difficult. These wounds can become large, involve the underlying bone and frequently become infected. They require extensive care in specialized wound clinics, and if not diligently cared for can lead to loss of a limb.

Anyone who develops symptoms should see his physician as soon as possible. If a potentially correctable cause is identified, symptoms can be rapidly improved. Even when total eradication of symptoms is not possible, stopping drinking or compulsive treatment of medical problems such as diabetes or hypothyroidism can lead to improvement or, at least, no worsening of symptoms. While every effort should be directed at identifying a cause, in as many as 50 percent of cases, the disease is labeled as "idiopathic" as no illness can be identified.

Treatment centers on pain control and minimizing the effects of muscle weakness. Common pain pills such as Tylenol, Aleve or more powerful prescription pain medications offer little benefit. Narcotics should be avoided as pain is amplified and the need for drugs increases as tolerance to the pain medication occurs.

There are a number of medications that appear to essentially "soothe the nerves" and reduce the painful sensations such as severe burning and tingling.

These include gabapentin (Neurontin), pregabalin (Lyrica) and a class of antidepressants called tricyclics (amitriptyline hydrochloride). More commonly used antidepressants are often prescribed. These do not have any effect on the nerves but improve the effectiveness of specific pain medications.

Local anesthetic injections and patches can also offer some relief. Every effort must be made to reduce injuries. Patients should never walk barefoot, and special shoes are often needed for diabetics.

Braces can help movement caused by muscle weakness, and physical therapy to improve the function of muscle that isn't affected is critically important. As with any chronic disease, try not to become frustrated by failures during the search for a treatment.

Stick with a physician who is an expert, one you trust. Become as knowledgeable as possible about the cause and manifestations of neuropathy as this insight will help your ability to cope.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz visit

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