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Neuropathy: Getting to the Nerve of the Problem
Omar P. Haqqani, MD
Midland Daily News
October 30, 2016
Stabbing or burning pain in your hands and feet, numbness, muscle fatigue, muscle twitching, decreased reflexes, and heat intolerance – these are the signs of neuropathy. Neuropathy is the term used to describe a problem with the peripheral nerves that communicate with the central nervous system – the brain and spinal cord. It is a common condition affecting upwards of 20 million Americans and is particularly prevalent in those people who have diabetes.
Neuropathy may affect a single nerve or a nerve group. It can also affect nerves in the whole body.
The problems caused by neuropathy depend on the type of nerves that are affected, as the term covers a wide area and many nerves, including autonomic nerves, motor nerves, and sensory nerves. Symptoms of neuropathy tend to start gradually, and then worsen over time.
Damage to nerves can be due to a number of reasons. In diabetes the high glucose circulating in the blood can attach to key components of nerves causing them to not send vital messages to the brain. In so doing, these nerves begin to malfunction and can cause a number of symptoms depending on the type of affected nerve fiber.
When autonomic nerves – nerves that control nearly every organ of the body – are affected, patients may lose the inability to sweat normally and develop a heat intolerance. An inability to properly regulate blood pressure is also common, which can lead to dangerous drops in blood pressure causing dizziness and fainting spells.
When motor nerves – nerves that control muscle movement – are affected, patients often experience muscle fatigue. Painful cramps, muscle twitching, muscle atrophy, and decreased reflexes are also common. Motor nerve damage often leads to inactivity and the health problems associated with a sedentary lifestyle.
When sensory nerves – nerves that control sensation – are affected, patients can experience a variety of symptoms because sensory nerves serve a broad range of functions. The most common symptoms include loss of sensation, loss of reflexes, and inability to coordinate complex movements, such as fastening buttons.
Loss of sensation can lead to failure to sense a cut or a wound that is becoming infected and is a particularly serious problem for people who have diabetes, contributing to the high rate of limb amputations among diabetes sufferers.
Neuropathic pain is another common symptom of sensory nerve damage. This is often associated with an oversensitization of pain receptors in the skin causing people to feel severe pain from stimuli that are normally painless. Neuropathic pain is often worse at night and can disrupts sleep – imagine experiencing pain from the light touch of your bed sheets.
Neuropathy can be inherited, acquired through disease processes, or be the result of trauma. However, in about thirty percent of cases, a specific cause cannot be identified – this is referred to as idiopathic.
Most commonly, autoimmune diseases such as lupus and rheumatoid arthritis can cause neuropathy. Diabetes, however, is most closely associated with the condition. In fact, more than half the people with diabetes develop some form of neuropathy. Testing for neuropathy should be a routine part of your diabetes care.
Beyond family history or disease, other key risk factors for developing neuropathy include smoking, alcohol abuse, vitamin deficiency (particularly B vitamins), exposure to toxins, repetitive motions (such as those performed at your job), and kidney, liver, or thyroid disorders.
While there is no specific treatment for neuropathy, its underlying causes can be targeted.
Addressing any contributing causes such as infection, exposure to toxins, vitamin deficiencies, autoimmune disorders, or compression that can lead to neuropathy is often the first step in treating the condition.
Incorporating healthy lifestyle habits can also prove beneficial. This can include smoking cessation, maintaining optimal weight, exercising, eating a balanced diet, and limiting or avoiding alcohol consumption.
Smoking cessation is particularly vital because smoking constricts the blood vessels that supply nutrients to the peripheral nerves which can worsen neuropathic symptoms.
Regular exercise can prevent muscle wasting, improve muscle strength, and reduce cramps. Various dietary strategies can prevent vitamin deficiencies. Partner with your healthcare provider to determine the appropriate exercise regimen and diet for you.
Self-care practices such as mindful foot care and careful wound treatment in people with diabetes can alleviate symptoms and improve quality of life. Strict control of blood glucose levels can also reduce neuropathic symptoms and help people with diabetes avoid further nerve damage.
Various drugs and procedures are available to address inflammatory and autoimmune conditions leading to neuropathy. This may include immunosuppresives such as prednisone, or plasmapheresis – a procedure in which blood is removed, cleansed, and then returned to the body.
If you have neuropathy, it is vitally important – particularly if you have diabetes – that you partner with your physician to ensure any underlying causes are being addressed, and that you have a plan in place to make the appropriate lifestyle changes. Doing this will significantly reduce the chances of complications that can lessen your quality of life.
Dr. Omar P. Haqqani, MD is the Chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.
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