Peripheral neuropathy is damage to the peripheral nerves. These are the nerves that connect your spinal cord to the rest of your body.
Peripheral Nerves of the Foot
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Many diseases and conditions can cause peripheral neuropathy. The damage may occur due to:
Diseases that can damage peripheral nerves include (but are not limited to):
Compression commonly occurs when nerves are pinched or trapped somewhere along their course, such as:
Toxins that can damage the peripheral nerves include:
Many medicines can lead to peripheral neuropathy. A partial list includes:
Other causes of peripheral nerve damage include:
Factors that may increase your risk of getting peripheral neuropathy include:
Damage to the peripheral nerves often results in sensory and motor symptoms in the:
Other parts of the body can also be affected. Symptoms depend on which nerves are involved. They can range from mild to severe and may seem worse at night. Sensations and pain may occur in the upper or lower limbs and move toward the trunk, such as from the feet to the calves.
If untreated, peripheral neuropathy can lead to:
If you have motor or sensory neuropathy, you may also have autonomic neuropathy. This is associated with symptoms such as:
The doctor will ask about your symptoms and medical history. A physical exam will be done. It may include examining:
Additional tests may also include:
Treatment may include:
Treating the underlying illness can decrease symptoms or make them go away. For instance, if it is caused by diabetes, controlling blood sugar levels may help. In some cases, neuropathy caused by medications or toxins is completely reversed when these substances are stopped or avoided. Correction of vitamin B12 deficiency often improves symptoms.
Certain exercises may help stretch shortened or contracted muscles and increase joint flexibility. In long-standing cases, splinting the joint may be required to protect and rest it, while maintaining proper alignment.
Orthotics, such as supports and braces, may help with:
Maintaining physical activity is also important.
Prescription and over-the-counter (OTC) pain medicines are often used to ease discomfort.
Drugs to treat depression and prevent convulsions sometimes relieve neuropathy symptoms. These medicines are often given at lower dosages. Commonly used antidepressants include:
Commonly used anticonvulsants may include:
For severe and potentially life-threatening cases, such as Guillain-Barre syndrome , treatment includes:
These therapies are aimed at reducing symptoms:
Surgery can relieve the pressure on nerves. For example, surgeons commonly release fibrous bands in the wrist to treat carpal tunnel syndrome .
American Chronic Pain Association
The Neuropathy Association
Canadian Diabetes Association
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12/20/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 2007 safety alerts for drugs, biologics, medical devices, and dietary supplements: Carbamazepine (marketed as Carbatrol, Equetro, Tegretol and generics). Medwatch. US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#carbamazepine .
10/5/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Feng Y, Schlösser FJ, Sumpio BE. The Semmes Weinstein monofilament examination as a screening tool for diabetic peripheral neuropathy. J Vasc Surg. 2009;50:675-682,682.
Last reviewed March 2013 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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