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Peripheral neuropathy is a disorder of the peripheral nerves. These nerves send messages between the central nervous system, the brain and the spinal cord, and the rest of the body.

Peripheral neuropathy is a general term that describes many conditions caused by damage to the peripheral nervous system, which is responsible for sending sensory information to and from the central nervous system. For example, the peripheral nerves can tell the body when the hands are cold.

Peripheral neuropathy affects more than 20 million people in the United States. In general, the condition can cause a loss of normal nerve signals, or cause inappropriate or distorted signals.

The condition can affect a range of different nerves, so it can impact a variety of locations in different ways. It can affect a single nerve or several nerves at the same time.

Examples of peripheral neuropathy include:

Symptoms of peripheral neuropathy may vary according to the type of neuropathy. Researchers have identified 100 different types of neuropathy.

Generally, the types are classified into three categories, each with its own set of symptoms. They are:

This affects the sensory nerves, which impact the sensations of pain, touch, and temperature.

The person may have:

Especially in cases when the cause is diabetes, sensory neuropathy can also lead to foot and leg ulcers, infection, and gangrene.

This affects the muscles that the brain controls consciously.

Symptoms include:

The affects body processes that the brain controls involuntarily. Symptoms may include:

Treatment either targets the underlying cause, or it aims to provide symptomatic pain relief and prevent further damage. Treatments may include:

Medications that may help relieve symptoms, but do not cure the problem, include:

A persons choice of treatment should take into account any medications that person is taking for other conditions in order to avoid unwanted interactions.

When a persons neuropathy happens as a result of compression of a single nerve, treatment is similar regardless of which nerve is involved. The approach depends on whether the compression is fixed or transient.

A palsy of the ulnar, radial, or peroneal nerve may be temporary and reversible if a person simply avoids the cause of the nerve compression. For example, a person with ulnar nerve palsy should not lean on the affected elbow.

The person may need to rest, use heat, or take a limited course of drugs to reduce inflammation.

In carpal tunnel syndrome, conservative therapy includes splinting the wrist and taking oral or injected corticosteroid drugs.

If a single-nerve neuropathy does not respond to these measures, surgery may be an option in rare cases. Surgery may also be necessary if the nerve compression is fixed, for example when the cause is a tumor.

A doctor should consider referring a person to pain specialist or a relevant clinical specialty at any stage if:

Non-drug measures for peripheral neuropathy can include using warm or cold packs, unless heat or cold makes the symptoms worse.

Stress relief and other complementary therapies include meditation, relaxation techniques, massage, and acupuncture. These may help a person cope with pain from the condition.

Some people find that using a transcutaneous electrical nerve stimulation (TENS) machine helps. This device interrupts nerve messages by delivering a small electric current. Research has not confirmed the effectiveness of this treatment.

Many types of neuropathy are idiopathic, or of unknown cause, but a number of conditions can trigger the problem. These include:

Other causes can include:

Disorders of the small blood vessels can reduce blood supply to the nerves, resulting in nerve tissue damage. Certain benign tumors can also affect nerve tissue and lead to neuropathic pain.

Diabetes is the most common cause of chronic peripheral neuropathy in the U.S. About 60-70 percent of people with diabetes will have some form of damage to their sensory, motor, or autonomic nerves. Many will have foot problems and ulcers.

High blood sugar levels cause damage to the walls of the tiny blood vessels that supply oxygen and nutrients to the nerves in the ends of the hands and feet, and the essential organs in the body, such as the eyes, kidneys, and heart. Whenever skin becomes damaged, the loss of sensation further increases the risk of damage.

Peripheral neuropathy causes a variety of symptoms with many possible causes.

A doctor will usually begin by taking a persons medical history. This includes gathering information about all the symptoms, but also details about a persons life, potential environmental exposures, and any risks of infectious or neurological diseases.

The next step should be a physical and neurological exam that will help the doctor identify any nerve damage. Potential tests a doctor may perform include nerve conduction velocity (NCV) and electromyography (EMG). These tests measure nerve signal strength and electrical activity.

A doctor may also do a nerve biopsy. In cases of suspected autonomic peripheral neuropathy, a person can get a QSART test, which measures their ability to sweat.

For some types of neuropathies, like nerve compression, a person can also get a magnetic resonance imaging (MRI) scan or a computed tomography (CT) scan. Another option is a muscle and nerve ultrasound, but this is not common.

If the doctor confirms that neuropathy is present, the doctor will look for the cause. The doctor may then send the person to get blood tests in order to check for diabetes and other potential underlying conditions.

The doctor may check for vitamin deficiencies, liver or kidney dysfunction, infections, metabolic disorders, or any immune cells that may indicate an immune disorder. In some cases, the doctor may order a test to rule out a genetic disorder.

If none of these tests can point to a cause, a doctor may conduct additional tests.

The outlook for peripheral neuropathy varies depending on the underlying cause, and which nerves have been damaged.

Some cases may improve with time if the underlying cause is treated, but in others, the damage may be permanent or gradually worsen over time.

Peripheral neuropathy describes many different conditions that damage the peripheral nervous system. Many underlying conditions can cause neuropathies, which result in impairments to a persons nerve signals.

A persons symptoms will vary depending on the affected nerves and the type of neuropathy. The condition affects more than 20 million people in the U.S.

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Peripheral neuropathy: Symptoms, causes, and treatment - Medical News Today

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