Peripheral Neuropathy

What is peripheral neuropathy?

Peripheral neuropathy is a problem with the peripheral nerves. Your peripheral nerves send messages to and from your spinal cord and the rest of your body. Peripheral nerves control:

  • Your ability to touch and feel heat, cold, and pain
  • How your muscles move
  • Things that your body does without you thinking about it. For example, the regular beating of your heart, breathing, blood pressure, digestion, and sweating.

If any of these nerves are damaged, it can make it harder for them to send and receive messages.

When peripheral neuropathy decreases your ability to move one or more muscles, it is also called nerve palsy.

What is the cause?

Nerve damage can be caused by:

  • Diseases, such as diabetes, arthritis, and liver or kidney problems
  • Injuries
  • Infections such as herpes, shingles, or Lyme disease
  • Poisons and some medicines used to treat infections, cancer, seizures, and high blood pressure
  • Surgery
  • Pressure on a nerve caused by:
    • Tight clothing or bad fitting crutches, cast, or splint
    • Swelling from an injury or disease
    • Repetitive use (such as carpal tunnel syndrome)
    • A tumor
    • A bulging disk in your back pressing on a nerve
  • Long-term, heavy alcohol use
  • Not enough vitamin B-12 or folic acid in your diet

What are the symptoms?

The symptoms depend on which nerves are damaged. Possible symptoms include:

  • Muscle weakness or twitching
  • Loss of feeling, numbness, tingling, or pain
  • Being very sensitive to touch
  • Eating or swallowing problems
  • Leaking of urine
  • Bowel problems, such as constipation, diarrhea, or belly pain

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

  • X-rays
  • Blood tests
  • Nerve conduction studies, which use small wires that are taped to your skin to send mild electric signals and check how well your nerves work to carry signals to your muscles

Your healthcare provider may refer you to a specialist for some tests.

How is it treated?

The treatment depends on the cause. For example:

  • If the nerve is just bruised after an injury, the symptoms may go away in a few weeks or months without treatment.
  • If the neuropathy is caused by a disease, such as diabetes or lupus, you may need treatment that controls the disease better or controls your symptoms.
  • If the cause is a lack of vitamins, your healthcare provider may prescribe vitamin supplements.

To help relieve the pain, your provider may recommend or prescribe cream, skin patches, or medicines you take by mouth. The medicines can:

  • Treat swelling and irritation that is causing nerve pain
  • Block pain signals to the brain

You may also need treatment for other symptoms that happen with nerve pain, such as depression, tiredness, bowel or urinary problems, and muscle spasms.

Other treatments may include:

  • Physical therapy to help you stretch, relax, and strengthen the affected area. The therapist may also use ultrasound, ice, or heat to help reduce the pain.
  • A TENS unit, which relieves pain by sending small electrical impulses to your nerves through patches put on the skin. The electrical impulses block pain
  • Biofeedback, which is a way to learn to control your body’s responses with your mind
  • Counseling to help you learn ways to cope with the pain
  • Massage, acupressure, or acupuncture
  • Heat or cold on the painful area. One or both may be helpful. Sometimes switching between heat and ice may work the best for you:
    • Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the sore area every 3 to 4 hours for up to 20 minutes at a time.
    • Put moist heat on the sore area for up to 30 minutes to relieve pain. Heat includes heat patches or moist heating pads that you can buy at most drugstores, a warm wet washcloth, or a hot shower. To prevent burns to your skin, follow directions on the package and do not lie on any type of hot pad. Don’t use heat if you have swelling.

You may need to see a pain specialist if you need treatment such as:

  • Shots of medicine into or around the nerve to block pain signals or decrease inflammation
  • Surgery to block or remove part of the nerve that is causing pain

How can I take care of myself?

  • Take all medicines as directed by your provider or therapist. Talk to your provider if you have problems taking your medicine or if the medicines don’t seem to be working.
  • Pace yourself. Break tasks down into small steps that are easier to manage. Take frequent rest breaks during the day to relax or walk.
  • Get support. Talk with family and friends. Join a support group in your area.
  • Use positive self-talk. Negative thoughts can increase your stress and pain.
  • Practice good posture. Standing and sitting straight, and lifting and moving properly, can help prevent injury or flare-ups of pain. Avoid activities such as lifting heavy objects, twisting or bending while lifting, or sitting without support for a long time.
  • Keep a pain diary. Write down the date and time, where the pain is, what you are doing when it starts, and how long the pain lasts. Write down what you do to ease the pain, such as medicine, ice, or heat. Note what helps and what makes the pain worse. Take your diary with you when you see your healthcare provider or counselor.
  • A healthy lifestyle may help. Talk to your healthcare provider about your personal and family medical history and your lifestyle habits. This will help you know what you can do to lower your risk for complications of peripheral neuropathy. For example:
    • If you have diabetes, keep your blood sugar under control.
    • Eat a healthy diet. Ask your provider about the benefits of talking to a dietician to learn what you need in a healthy diet.
    • Drink enough liquids to keep your urine light yellow in color.
    • Try to keep a healthy weight. If you are overweight, try to lose weight to decrease the stress on your nerves.
    • Exercise according to your healthcare provider’s instructions
    • Learn ways to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example, take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed.
    • If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
    • If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.
    • Try to get at least 7 to 9 hours of sleep each night.

Ask your healthcare provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent peripheral nerve pain?

Ways to help prevent peripheral nerve pain include:

  • If you have a disease, such as diabetes, follow your healthcare provider’s advice about controlling your blood sugar. Be sure to take your medicines as prescribed.
  • Protect yourself from injury. Wear safety gear, such as a seatbelts when you drive and a helmet when you bicycle or ski. Home accident prevention is also important.
  • Pay attention to how you use a keyboard or computer mouse to help prevent carpal tunnel syndrome.
  • If you have problems with alcohol abuse, ask your provider for help to quit drinking.

You can get more information from:

Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-11-07
Last reviewed: 2014-11-07
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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