Neuropathy is a health disorder that occurs when damage or disease affects the nerves. This condition affects millions of people worldwide and has a wide range of causes. But what exactly is neuropathy? How is it diagnosed and treated? Read on to gain a better understanding of this common condition.

What is neuropathy?

Neuropathy refers to any condition that affects the nerves in our body. The nervous system is made up of two main parts: the central nervous system (brain and spinal cord) and the peripheral nervous system, which sends signals from our central nervous system to the rest of our body. When these nerves are damaged or otherwise not functioning properly, it is called neuropathy. Neuropathy can cause a range of symptoms, such as pain, tingling, and numbness in different parts of the body. Symptoms depend on which nerves are affected (NCI, 2023).

What are the different types of neuropathy?

There are over 100 different types of neuropathy, all with their own symptoms and treatments. Each neuropathy affects different parts of the nervous system and can be caused by different factors.

The simplest classification of neuropathy is based on the number of nerves affected and the type of nerves affected. Differentiation based on the number of nerves affected includes:

1. Mononeuropathy: In this case, a single nerve is affected. Mononeuropathy can be caused by injury, long-term nerve compression, or medical conditions such as stroke or multiple sclerosis.
2. Polyneuropathy: Polyneuropathy refers to a condition in which multiple peripheral nerves in the body are affected at the same time. It can be caused by a variety of causes, including certain infections, metabolic diseases (such as diabetes), and exposure to toxins. This is the most common form of neuropathy.

In addition, neuropathy can be classified based on the type of nerve affected. Here, a distinction is made between:

1. Sensory neuropathy: Sensory neuropathy involves the sensory nerves that transmit information from the sensory organs to the brain. Typical symptoms may include pain, numbness, tingling, or altered sensation to pain or temperature.
2. Motor neuropathy: Motor neuropathy affects the motor nerves that control muscles, causing affected individuals to have difficulty moving or controlling certain body movements. They can also cause muscle weakness or wasting, such as in amyotrophic lateral sclerosis (ALS), in which the motor nerves in the brain and spinal cord gradually die.
3. Autonomic neuropathy: This form of neuropathy affects the autonomic nervous system, which controls the body’s automatic functions, such as heartbeat, breathing, digestion, and blood pressure. It can be caused by a variety of conditions, including diabetes and Parkinson’s disease.
4. Mixed neuropathy: In many cases of neuropathy, multiple nerve types can be affected at the same time, resulting in a combination of sensory, motor, and autonomic symptoms.

The most common mixed neuropathies include:

Source: NIDDK, 2023

What are the causes of neuropathies?

The causes of neuropathy are varied and can be genetic or triggered by a variety of factors, including:

• Diabetes: Diabetes is among the most common causes of neuropathy. High blood sugar levels over extended periods of time can cause nerve damage that leads to diabetic neuropathy.
• Infections or viruses: Infections such as Lyme disease, hepatitis C, and HIV can cause neuropathy.
• Autoimmune diseases: Autoimmune diseases are conditions in which the immune system mistakenly attacks the body’s own cells. Neuropathy can occur due to autoimmune conditions such as rheumatoid arthritis, lupus, or celiac disease.
• Nerve injury: Neuropathy can also be caused by nerve injuries from trauma or medical procedures, such as compression, stretching, cutting, or crushing of the nerves. This type of neuropathy usually only affects the area where the injury or damage occurred.
• Alcohol abuse: Long-term alcohol abuse can severely affect nerve health. Alcoholic neuropathy is believed to be caused by both a direct poisoning of the nerve by alcohol, as well as vitamin deficiency associated with alcoholism. Alcohol abuse usually causes peripheral neuropathy.
• Vitamin deficiency: Sometimes a severe deficiency of specific vitamins can lead to nerve damage. In particular, a deficit of copper and vitamins B1, B6, B9, B12, folic acid (B9), and E may cause neuropathy.

Source: Cleveland Clinic, 2022

What are the risk factors for neuropathy?

• A history of diabetes, especially if blood sugar is not well controlled
• Genetic factors, as some types of neuropathy can be inherited
• Being over 40, as the risk for neuropathy increases with age
• Certain lifestyle factors, such as alcohol consumption and smoking, which can damage the nervous system

Source: Mayo Clinic, 2022

What are the typical symptoms of neuropathy?

The symptoms of neuropathy can vary and depend greatly on the type of nerves affected and the specific type of neuropathy.

Symptoms of peripheral neuropathy:

Peripheral neuropathy, most commonly caused by diabetes, primarily affects the extremities, especially the feet and hands. Symptoms can vary from person to person, but may include the following:

1. Pain and discomfort: Many people with peripheral neuropathy experience burning, stabbing or shooting pain. Sometimes, the pain can be chronic and significantly affect quality of life.
2. Numbness and tingling: There may be a feeling of “falling asleep” or “tingling” in the affected areas. This sensation may be occasional or permanent.
3. Muscle weakness: Some people may have difficulty making certain movements or grasping objects. This is due to impairment of the motor nerves.
4. Balance problems: Peripheral neuropathy can affect the nerves responsible for balance, which can cause unsteadiness when walking or standing.

Symptoms of autonomic neuropathy:

Autonomic neuropathy affects the nerves responsible for controlling bodily functions that we do not consciously control, such as heartbeat, digestion, and bladder function. Symptoms can include:

1. Cardiovascular problems: Irregular heart rate, low blood pressure, or fainting.
2. Digestive problems: Nausea, vomiting, constipation, diarrhea, or difficulty swallowing.
3. Bladder and sexual function: Difficulty urinating, urinary incontinence and, in men, erectile dysfunction.
4. Temperature regulation: Difficulty regulating body temperature, which can lead to excessive sweating or heat intolerance.

Symptoms of diabetic neuropathy:

Because diabetic neuropathy is a form of peripheral neuropathy, many of the symptoms may be similar. However, it may also cause symptoms of autonomic neuropathy.

Signs of nerve damage usually develop slowly. As each type of neuropathy has different symptoms and treatment approaches, it’s important to seek medical advice if you experience potential symptoms. The duration of neuropathy can vary widely and depends on the underlying cause. In some people, symptoms may resolve within a few weeks or months after treatment of the underlying cause. In others, however, neuropathy can become chronic and last for years or even a lifetime.

Source: CDC,2022; Cleveland Clinic, 2020; Cleveland Clinic, 2022

How is neuropathy diagnosed?

Diagnosing neuropathy begins with a medical history and physical examination by a healthcare professional. Additional tests may include:

1. Neurological examination: During this exam, the physician checks reflexes, muscle strength and tone, ability to feel different sensations, and coordination. This exam may provide indications of the type, extent, and location of the nerve damage.
2. Blood tests: Blood tests can be used to identify vitamin deficiencies, diabetes, infections, and other underlying conditions that can cause neuropathy. If you would like to monitor some of these markers from home, Homed-IQ can help. The Vitamin Deficiency Test and Blood Sugar Test allow you to regularly monitor your vitamin status and blood sugar from home.
3. Nerve conduction velocity (NCV) tests: In these tests, electrodes are placed on the skin and small electrical pulses are administered to see how quickly nerves can transmit signals. Slowed conduction velocity may indicate neuropathy.
4. Electromyography (EMG): This test measures electrical activity in muscles during contraction and rest. Abnormal results may indicate damage to the nerve or the muscle itself.
5. Medical Imaging: this may include X-rays, CT scans or MRIs to identify other possible causes of symptoms.

Source: NHS, 2022

What are the treatment options for neuropathies?

Treatment for neuropathy usually focuses on treating the underlying cause and relieving symptoms. This may include:

• Controlling blood sugar: In diabetic neuropathy, it is important to keep blood sugar levels well controlled to prevent further nerve damage.
• Medication: Various medications may be used to relieve symptoms of neuropathy, including pain medications, antidepressants, and anticonvulsants (medication used to treat seizures).
• Physical therapy: Physical therapy can help improve muscle strength, coordination, and mobility in people with neuropathy.
• Healthy lifestyle habits: Eating a balanced diet, exercising regularly, and avoiding alcohol and cigarettes can help improve overall nerve health and relieve symptoms of neuropathy.
• Medical procedures: In some cases, medical procedures such as nerve blocks or pain pump implants may be needed to relieve severe pain.

Anyone who has neuropathy or is experiencing symptoms of neuropathy should speak to their doctor about the best treatment strategy (Mayo Clinic, 2022).

Summary

Summary Neuropathy is a complex condition that can take many different forms and cause a variety of symptoms. Although neuropathy can often be painful and debilitating, there are many effective treatment options to relieve symptoms and improve quality of life. If you think you may have neuropathy, speak to your doctor for further guidance.

References:

Definition of neuropathy – NCI Dictionary of Cancer Terms – NCI. (n.d.). National Cancer Institute. Retrieved July 5, 2023, from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/neuropathy

Diabetes and Nerve Damage | CDC. (n.d.). Centers for Disease Control and Prevention. Retrieved July 5, 2023, from https://www.cdc.gov/diabetes/library/features/diabetes-nerve-damage.html

Diabetic Neuropathy – NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved July 5, 2023, from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies

Dysautonomia: Symptoms, Causes, Types, & How to Live With. (2020, July 10). Cleveland Clinic. Retrieved July 6, 2023, from https://my.clevelandclinic.org/health/diseases/6004-dysautonomia

Peripheral neuropathy – Diagnosis and treatment. (2022, August 11). Mayo Clinic. Retrieved July 5, 2023, from https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/diagnosis-treatment/drc-20352067

Peripheral Neuropathy: What It Is, Symptoms & Treatment. (2022, October 14). Cleveland Clinic. Retrieved July 5, 2023, from https://my.clevelandclinic.org/health/diseases/14737-peripheral-neuropathy

Peripheral Neuropathy: What It Is, Symptoms & Treatment. (2022, October 14). Cleveland Clinic. Retrieved July 6, 2023, from https://my.clevelandclinic.org/health/diseases/14737-peripheral-neuropathy