Peripheral Neuropathy is a disorder of the nerves in the extremities (arms or legs.) Neuropathy can present as either numbness and tingling, burning pain, or a combination of both. The symptoms of neuropathy are generally worse during periods of rest, and neuropathy should be suspected if you have pain that wakes you up at night, or keeps you from sleeping.
Today, the most common cause of peripheral neuropathy is diabetes, but other conditions such as alcoholism, chemotherapy treatment, and spine surgery can lead to neuropathy. There is a large percentage of patients with peripheral neuropathy that may never have an accurate explanation of the cause, known as idiopathic neuropathy. (And no, the term "idiopathic" is not used to describe all of your doctors as "idiots", for not being able to identify the source!)
Nerve disorders, such as peripheral neuropathy, can be difficult to diagnose with 100% confidence, and it is often a diagnosis of exclusion. This means the diagnosis is rarely positively confirmed, but it remains the most likely diagnosis after other potential causes are excluded.
Evaluation
The clinical history and physical examination are the most important tools for diagnosis. X-rays are routinely utilized to rule out any other potential source of pain, such as broken bones, arthritis, or other deformities. Additional testing, such as nerve function tests, blood testing, nerve biopsy, and MRI may be necessary to assist in diagnosis.
Potential Causes of Peripheral Neuropathy:
- Diabetes
- Inflammatory Nerve Disorders (CIDP)
- Chemotherapy Treatment
- Spine Surgery
- Idiopathic (Unknown Cause)
- Alcoholism
- Syphilis
Treatment
When treating peripheral neuropathy, it is important for you to work with your physicians as part of a comprehensive treatment team. Podiatrists are usually at the forefront of establishing the correct diagnosis, as well as assisting in early treatment. Neurologists can be extremely helpful in diagnosis and treatment, especially with more complex cases. Rheumatologists can help to exclude any type of arthritis that may be causing symptoms. Primary care, or family physicians are often in charge of managing and monitoring treatment medications. It is important to have good communication between you and your doctors to ensure the highest level of care.
Treatments for Peripheral Neuropathy:
- Oral Medication (Gabapentin, Lyrica, Cymbalta)
- Topical Medication (Cream or Patch)
- Oral B-Vitamin Supplements
- Narcotic Pain Medication
In addition to diagnosis and treatment of peripheral neuropathy, podiatrists play a pivotal role in preventing complications of neuropathy. Patients with neuropathy, especially diabetic neuropathy, are at higher risk of developing foot ulcers and infections, which can lead to amputations or worse. Our goal is to prevent those potential complications, and proper education about the disease is the most powerful prevention tool. We will spend the time to answer your questions and establish a game plan to help you live your life while managing peripheral neuropathy.
If you think you may have peripheral neuropathy, call us at 512-593-2949 or schedule an appointment online.