Trauma to the peripheral nervous system, which includes all of the nerves located outside the brain and spinal cord, causes the painful condition known as peripheral neuropathy. These tissues branch out from the central nervous system to innervate the rest of the body.
Nonetheless, the damage might be done to these nerves. Harm to these tissues can result from trauma, illness, or toxic exposure. Let's learn more about your peripheral nervous system before we go into the many therapy choices for peripheral neuropathy.
It may be necessary to address the underlying cause and symptoms to treat peripheral neuropathy. Certain root issues may be more amenable to treatment. Maintaining good glucose management, for instance, may improve neuropathy or prevent its worsening.
Diagnosis
There are numerous potential root causes of peripheral neuropathy. In addition to a physical examination (which may involve blood tests), the following tests are typically performed to make a diagnosis:
Full medical history: The symptoms you've been experiencing, your lifestyle, exposure to pollutants, alcohol consumption, and family history of neurological illnesses will all be reviewed in your doctor's diagnosis.
Neurological examination: Your doctor may evaluate your muscular strength and tone, feeling, posture, and coordination, as well as your tendon reflexes.
Tests
Your doctor may order tests such as these:
- Blood tests: These aid in diagnosing disorders like diabetes, aberrant immunological function, and nutritional deficits that can lead to peripheral neuropathy.
- Imaging tests: Scans for herniated disks, pinched (compressed) nerves, tumors, and various vascular and skeletal abnormalities, as well as other conditions, can be performed using CT or MRI technology.
- Nerve function tests: Electromyography (EMG) is a technique used to identify nerve injury by recording electrical activity in the muscles. The electrical activity of a muscle during contraction is measured by inserting a tiny needle (electrode) into the muscle and reading its voltage.
An electromyogram is usually obtained with a nerve conduction examination performed by your doctor or EMG technician. Stimulating the nerves with a little electric current using flat electrodes placed on the skin. The doctor will monitor the reactions of your nerves to the electric current.
- Other never function tests: Some examples of such tests are the autonomic reflex screen, which documents the activity of the nerve fibers responsible for the autonomic nervous system; the sweat test, which quantifies the extent to which your body perspires; and the sensory tests, which document your sensitivity to touch, vibration, cooling, and heat.
- Nerve biopsy: A sample of nerve tissue, typically from a sensory nerve, is removed and examined for abnormalities.
- Skin biopsy: To check for a deficiency in nerve endings, your doctor will remove a small patch of skin from your body.
Treatment
The underlying disease and your neuropathy symptoms will be addressed throughout the treatment. If lab testing reveals no underlying cause for your neuropathy, your doctor may advise you to wait and see if your symptoms improve on their own.
Medications
Medicine used to treat disorders linked to peripheral neuropathy is not the same as medication used to treat the symptoms of peripheral neuropathy, which can include:
Pain relievers: pain relievers and NSAIDs, both of which are available without a prescription, can help with minor symptoms. Your doctor may recommend pain medication if your symptoms are severe. It is not common practice to provide opioid-containing medications like tramadol (Conzip, Ultram, others) or oxycodone (Oxycontin, Roxicodone, others) unless all other therapies have failed.
Anti-seizure medications: Nerve pain may be alleviated by medications like gabapentin (Gralise, Neurontin, Horizant) and pregabalin (Lyrica), which were initially created to treat epilepsy. You can feel sleepy and lightheaded as a side effect.
Topical treatments: Minor relief from peripheral neuropathy symptoms can be achieved using capsaicin cream, a chemical found in hot peppers. There may be some initial burning and irritation at the cream's application site, but this usually subsides. But there are those whose tolerance levels cannot be met.
Another topical option that may help with discomfort is a lidocaine patch. Drowsiness, dizziness, and numbness at the application site are possible adverse reactions.
Antidepressants: It has been discovered that the tricyclic antidepressants amitriptyline, doxepin (Silenor, Zonalon), and nortriptyline (Pamelor) can assist in alleviating pain by interfering with the brain and spinal cord chemicals that trigger pain perception.
Additionally, extended-release antidepressants such as venlafaxine (Effexor XR) and desvenlafaxine (Pristiq) may help relieve the discomfort of diabetic peripheral neuropathy. Dry mouth, nausea, fatigue, dizziness, hunger changes, weight gain, and constipation are possible side effects of antidepressants.
Therapies
Various procedures and therapies may be used to ease the pain caused by peripheral neuropathy.
Transcutaneous electrical nerve stimulation (TENS): A mild electric current of varied frequencies is delivered to the skin through electrodes. For the best results, TENS should be used for 30 minutes a day, 5 days a week for roughly a month.
Plasma exchange and intravenous immune globulin: The immunosuppressive effects of these techniques may help treat inflammatory disorders.
During plasma exchange, your blood is drawn, processed to remove antibodies and other proteins, and reintroduced to your body. High doses of proteins that act as antibodies are administered in immune globulin treatment (immunoglobulins).
Physical therapy: The use of physical therapy can aid in the recovery from muscle weakness and the subsequent restoration of functional mobility. You might also require the use of crutches, a walker, or even a wheelchair.
Surgery: Surgery to relieve nerve pressure, such as that caused by a tumor, may be necessary to treat neuropathies.