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SALEM COMMUNITY HOSPITAL...Living with peripheral neuropathy

October 29, 2012
Salem News

Over 20 million Americans suffer from peripheral neuropathy, which can occur at any age, but is more common among older adults. Often referred to as "nerve damage," this disease disrupts the nerves that connect the spinal cord to the muscles, skin, joints, or internal organs.

"The nerves of the peripheral nervous system send information to and from your brain and spinal cord, to other parts of your body," explained Neurologist Chaohua Yan, M.D. "Peripheral neuropathy occurs when the nerves outside of the brain and spinal cord are damaged."

Nerves that may be affected by peripheral neuropathy include:

- Sensory nerves that receive sensations such as heat, pain or touch.

- Motor nerves that control how your muscles move.

- Autonomic nerves that control body functions like blood pressure, heart rate, digestion and bladder function.


"The symptoms of peripheral neuropathy depend on several factors, such as which type of nerves are affected," Dr. Yan advised. "Motor nerve damage usually leads to symptoms that affect the muscles, such as muscle weakness, cramps, and spasms. It is not uncommon for this type of neuropathy to lead to a loss of balance and coordination.

"Sensory nerve damage can cause various symptoms, such as tingling, numbness, or sensitivity to touch. Pain from this type of neuropathy is often described as burning, freezing, or shooting; and many people report a sensation of wearing a thin stocking or glove. These sensations tend to be worse at night, and can become severe. However, some people experience a lessening or absence of sensation, where nothing is felt at all.

"Autonomic nerve damage affects internal organs and involuntary functions and can lead to abnormal blood pressure and heart rate, reduced ability to perspire, bowel or bladder problems and thinning of the skin."

Who Gets Neuropathy?

"People with diabetes, who poorly control their blood sugar levels, are very likely to suffer from neuropathy and about one half of all diabetics have this condition," Dr. Yan continued. "Autoimmune diseases such as lupus and rheumatoid arthritis also increase a person's chance of developing a neuropathy."

About 30 percent of neuropathy cases are considered idiopathic, which means they have no known cause. The remaining cases of neuropathy have several possible causes, including:

- Trauma or pressure on nerves, often from wearing a cast or performing repetitive motions

- Nutritional problems and vitamin deficiencies, such as a lack of B vitamins

- Alcoholism, often through poor dietary habits and vitamin deficiencies

- Autoimmune diseases like lupus, rheumatoid arthritis, or Guillain-Barre syndrome

- Tumors, which can press up against nerves

- Diseases and infections, such as kidney or liver disease, Lyme disease, HIV/AIDS, or an underactive thyroid (hypothyroidism)

- Exposure to toxins, such as heavy metals or certain medications


"It is very important to check with a neurologist as soon as you notice the symptoms, before this disease has a chance to cause too much permanent damage," Dr. Yan suggested.

"Some types of peripheral neuropathy can be cured, but most cannot. However, a neurologist can help patients feel more comfortable and their quality of life can be greatly improved. Most therapies are directed at treating the underlying disease and improving the symptoms with the right medications.

"There are a variety of treatments that range from medications and creams to special diets and therapies that can stimulate the nervous system," Dr. Yan said. "Antidepressants are a favored treatment for neuropathies and can relieve neuropathic pain in non-depressed persons."

Another class of medications commonly prescribed for neuropathy are called anticonvulsants, which block calcium channels on the neurons to limit pain. Opioid narcotic treatments for neuropathy are also used to treat this condition, but are less favored because of the risk of dependency.

Transcutaneous electrical nerve stimulation (TENS) may also help to relieve symptoms. In this type of therapy, adhesive electrodes are placed on the skin, and a gentle electric current is delivered through the electrodes at varying frequencies.

"There are several lifestyle remedies that can be used to manage neuropathy and prevent its symptoms," Dr. Yan concluded. "For example, take good care of your feet, especially if you have diabetes. Check your feet daily for signs of blisters, cuts or calluses. Tight shoes and socks can worsen pain and tingling, and may lead to sores that won't heal.

"In addition, ask your doctor about an exercise routine that's right for you. Regular exercise may help reduce neuropathy pain and can assist in controlling blood sugar levels. Massages of the hands and feet may also be helpful in stimulating nerves and temporarily relieving pain. Finally, don't keep your knees crossed or lean on your elbows for long periods of time. Doing so may cause new nerve damage."

For more information, contact board certified neurologist Chaohua Yan, M.D., Ph.D., at The Neurology Center of Salem, Inc., 2235 East Pershing Street, next to Salem Home Medical. Appointments with Dr. Yan may be scheduled by calling 330-337-4940.



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