Neuropathy
Neuropathy is a condition in which the nerves in our body are damaged or not working correctly. There are several different types of neuropathies and many different ways to categorize. The type of nerve damage may distinguish different neuropathies, as well as, the cause of the nerve damage, or the pattern of nerve damage.Approximately 21 million Americans are affected by peripheral neuropathy. Altho ugh only 30% of neuropathy is caused by diabetes, diabetes still remains the leading cause of peripheral neuropathy. Please note that some form of neuropathies can be fatal.
Peripheral is a term used for the most distal (the nerves in your body, aside from your spinal cord and brain, further down) nerves in our body including those in our feet or hands.
A polyneuropathy is a neuropathy pattern, whereby the nerve damage initially starts in both feet and may progress to involve the feet, calves, and fingers/hands. Another word for this pattern is a Stocking and Glove Neuropathy. Many patients with polyneuropathy may not even have any symptoms; in this case the diagnosis is made by a physical examination or a laboratory test (electromyography (EMG) and nerve conduction velocity test (NCV)). Some patients with polyneuropathy have only numbness, “tingling,” and/or “pins and needles.” More often, unlucky patients with polyneuropathy experience some type of pain.
Signs & Symptoms
While every person’s experience with peripheral neuropathy can be as unique as the individual himself or herself, there are some common neuropathy signs and symptoms shared by most individuals. The symptoms of diabetic or peripheral neuropathy start in the toes and feet (right and left). In some patients the symptoms gradually rise up the calves and into the knees. This is called a stocking pattern. Then, in some the symptoms may also begin in the fingers and hands — causing a stocking and glove pattern. It cannot be predicted how any one’s symptoms will spread. In some patients, the pain does not spread beyond the toes or feet and there is no progression; in others, the progression to calves and hands occurs in months, rapidly; and yet in others the spread is very gradual, over many years. There are three categories of nerves and up to five specific peripheral nerves that may be affected, and symptoms depend on these nerves and their location:
Patients who develop pain with peripheral neuropathy describe the pain using a variety of words, including “burning,” “throbbing,” “deep ache”, “raw skin,” “skin sensitivity,” “tingling”, “sharp,” “electric-like,” “pins and needles,” “freezing cold,” “like walking on ground glass,” “itchy,” and others. Some patients say they don’t have pain but have unpleasant and irritating sensations (Allodynia), which may include “itching”, “buzzing,” “like bugs crawling,” “like leather or sand paper”, “hard ball on bottom of feet”, and “aching. Some people feel like they have socks on, even though they are barefoot. Over time, this feeling can spread to the legs and hands.
Patients may find it harder and harder to walk. Their legs feel heavy and they may have to drag them selves up the stairs. Some patients have constant pains, day and night, whereas others only have noticeable pain at bedtime. Often, patients may complain that the pain interferes with their sleep and they may develop Restless Leg Syndrome and or Insomnia (difficulty sleeping). As with all chronic pain, patients with painful peripheral neuropathy may also develop depression. Patients with advanced neuropathy may also have trouble with their sense of positioning; and therefore, have difficulty with their gait or balance.
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