Neuropathy, of all types, is one of the most common disabling forms of chronic pain that we see and treat.

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FAQs about peripheral neuropathy 

 

 

1. What is peripheral neuropathy? 

 

Peripheral neuropathy refers to damage or dysfunction of the peripheral nerves, which transmit signals between the central nervous system (brain and spinal cord) and the rest of the body, including muscles, skin, and organs. But it doesn’t stop there. Peripheral neuropathy affects the tiniest structures of our bodies as well. This is because these nerves also transmit signals to our sweat glands, capillaries, and sebaceous glands, among other things. This has important consequences. 

 

2. What are the symptoms of peripheral neuropathy? 

I have been practicing for 24 years and I am pretty sure I have seen all the symptoms. The symptoms I see and treat on a daily basis are:

  • Numbness or tingling in the hands or feet 
  • Burning or sharp pain 
  • Muscle weakness 
  • Loss of coordination or balance 
  • Reduced sensation to touch 
  • Reduced ability to feel temperature changes 
  • Tingling 
  • Electric shocks 
  • Loss of perspiration of the feet 

 

Less common symptoms include: 

  • The sensation of bugs crawling on the skin 

  • The soles feeling like sandpaper or cardboard 

  • The feet feeling like bricks 

  • The sensation of tight bands around the toes, foot, ankle or leg. 

  • Neuropathy can be severe enough to even cause slowing of the movement of our digestive system, called gastroparesis. 

 

3. What causes peripheral neuropathy? 

 

There are literally dozens of underlying causes of peripheral neuropathy. 

 

• Diabetes is the most common cause of neuropathy. This disease deserves a whole course on how and why this happens but that's a discussion for another day.

• Alcoholism is also a frequent cause of peripheral neuropathy due to the effects of alcohol on our nervous system but also due to malnutrition, as noted in the next bullet.

• Vitamin deficiencies, in particular B Vitamins. Certain diets and disease states can prevent people from getting enough B vitamins which are essential for normal nerve function. 

• Autoimmune diseases like Hashimotos disease and many others. Hashimotos thyroiditis is a hypothyroid condition caused by our immune systems attacking our thyroid. These same autoimmune processes can attack our nervousous system, causing neuropathy.

• Infections (e.g., Covid, Lyme disease, shingles, leprosy, syphillis to name a few) 

• Exposure to toxins or medications. Here are just a few:

-Chemotherapy treatments for cancer such as Vincristine, Paclitaxel. 

-Covid Vaccine.

-Metformin, used for treating diabetes!!

-Ciprofloxacin and metronidazole antibiotics.

-Anti-seizure medications like phenytoin and carbamazepine.

-Cholesterol medications atorvastatin and simvastatin.

-Amiodarone use for cardia arrhythmias. 

• Trauma or injury such as a crush injury to a nerve.  

• Genetic conditions like Charcot-Marie Tooth Disease, Fabry's disease ( a metabolic genetic disorder), porphyrias ( which affect the production of heme in your red blood cells), Huntinton’s disease ( a neurodegenerative disorder caused by a gene mutation). This is not an exhaustive list by any means. 

 

4. Do I have to be diabetic to get diabetic neuropathy?

The answer is simply "No." This may sound like a silly question but when I am talking with a patient about their symptoms and history of their condition, I ask if they are diabetic. If they say no, I then ask if they are pre-diabetic. It turns out they often are. The effects of diet on physiology starts long before someone becomes diabetic. And so neuropathy can occur before the diagnosis of diabetes or when you are "Prediabetic."

5. Can peripheral neuropathy be cured? 

 The treatment depends on the underlying cause. Some types, like diabetic neuropathy, can be managed and sometimes reversed with certain treatments. Others, caused by reversible factors, such as vitamin deficiency, can improve with treatment of the deficiency. Chemotherapy induced neuropathy sometimes resolves or improves on its own. Many neuropathies can be improved with medical foods which have been proven to benefit patients.. Some treatments are mere band aids for symptomatic relief. A thorough discussion about your neuropathy  with Dr. Biesinger is the best way to determine what treatment is best for you. We don’t use a cookie cutter formula to try to help you. We focus on tailored treatment plans for each individual 

 

If you are having symptoms of peripheral neuropathy, don't delay. The sooner we can address the condition and find the cause, the sooner treatment can be started. This may prevent worsening or even resolve your discomfort.  Call us for a thorough consultation!