Nuropathy

Hello Anon

Thank you for writing.

Peripheral neuropathy (sometimes just called neuropathy) is damage to the peripheral nerves. These are the nerves that connect your spinal cord to the rest of your body.

Many diseases and conditions can cause peripheral neuropathy. The damage may occur due to:

Malnutrition
Compression
Cancer
Trauma
Inflammation
Infection
Toxins
Medications
Hereditary syndromes
Unknown causes

Damage to the peripheral nerves often results in sensory (feeling) and motor (strength) symptoms in the:

Arms
Legs
Hands
Feet
Other parts of the body can also be affected. Symptoms depend on which nerves are involved. They can range from mild to severe and may seem worse at night. Sensations and pain may occur in the upper or lower limbs and move toward the trunk (eg, from the feet to the calves).

Symptoms include:

Numbness or reduced sensation
Tingling
Pain, often a burning or sharp, cutting sensation
Sensitivity to touch
Muscle twitches
Muscle weakness
Muscle cramping
Difficulty with walking
Loss of coordination or balance
Paralysis
If untreated, peripheral neuropathy can lead to:

Loss of reflexes and muscle control
Muscle atrophy (loss of muscle bulk)
Foot deformities
Foot ulcers
Injuries to the feet that go unnoticed and become infected
Autonomic dysfunction (sweating, bowel and bladder dysfunction, cardiovascular effects)
Difficulty breathing

Anon - you need to seek medical advice for the pain and discomfort you're in. The doctor will ask about your symptoms and medical history. She will also do a physical exam, which may include:

Muscle strength
Reflexes
Balance
Coordination
Ability to feel vibration, temperature, and light touch
Semmes-Weinstein monofilaments test—measures sensation in the feet using a fine flexible wire
Additional tests may also include:

Blood tests (including glucose, vitamin B12 level, and thyroid function tests)
Electromyography (EMG) —measures and records electrical activity generated in muscle in response to nerve stimulation
Nerve conduction studies (NCS) —measures the speed and degree of electrical activity in a nerve to determine if it is functioning normally
Serum/urine electrophoresis (protein analysis)
Genetic testing
Evaluation of family members
Spinal tap (lumbar puncture, LP)
Nerve or muscle biopsy (rarely)
Treatment
Treatment may include:

Treatment for the Underlying Illness or Exposure
Treating the underlying illness can decrease or eliminate symptoms. For instance, if it is caused by diabetes, controlling blood sugar levels may help. In some cases, neuropathy caused by medications or toxins is completely reversed when these substances are stopped or avoided. Correction of vitamin B12 deficiency often improves symptoms.

Physical Therapy
Certain exercises may help stretch shortened or contracted muscles and increase joint flexibility. In long-standing cases, splinting the joint may be required to protect and rest it, while maintaining proper alignment.

Orthotics (supports and braces) may help with:

Deformities
Balance issues
Muscle weakness
Maintaining physical activity is also key.

Medications
Prescription and over-the-counter (OTC) pain medicines are often used to ease discomfort.

Drugs to treat depression and prevent convulsions sometimes relieve neuropathy symptoms. These medicines are often given at lower dosages. Commonly used antidepressants include:

Amitriptyline (Elavil)
Nortriptyline (Pamelor)
Desipramine (Norpramin)
Imipramine (Tofranil)
Duloxetine (Cymbalta)
Commonly used anticonvulsants may include:

Gabapentin (Neurontin)
Carbamazepine (Tegretol)
According to the Food and Drug Administration (FDA), patients of Asian ancestry who have a certain gene, called HLA-B*1502, and take carbamazepine are at risk for dangerous or even fatal skin reactions. If you are of Asian descent, the FDA recommends that you get tested for this gene before taking carbamazepine. If you have been taking this medication for a few months with no skin reactions, then you are at low risk of developing these reactions. Talk to your doctor before stopping this medication. *¹
Pregabalin (Lyrica)—recently approved for peripheral neuropathy
For severe and potentially life-threatening cases (such as Guillain-Barre syndrome ), treatment includes:

Steroids (such as prednisone )
Intravenous immunoglobulins
Other Therapies
These therapies are aimed at reducing symptoms and may include:

Relaxation training
Biofeedback
Walking
Exercise
Yoga
Warm baths
Massage
Acupuncture
Transcutaneous electronic nerve stimulation

Please seek medical advice. I hope this has helped and that you feel better soon.
Susan