Neuropathy

Neuropathy is a medical term for diseases of the nerves. Neuropathy can be caused by a variety of problems. Diabetes is the most common. Other diseases such as rheumatoid arthritis, syphilis, alcoholism, multiple sclerosis and vitamin deficiencies such as thiamine and B12 can also cause neuropathy. A relatively common hereditary form of neuropathy is Charcot-Marie-Tooth Disorder. A large number of people with neuropathy do not seem to have a specific cause for their neuropathy. This is called idiopathic neuropathy.

Symptoms of neuropathy also often vary. Commonly, people will complain of a tingling, dead sensation, but sometimes it is described as tight, sunburnt, burning, or stinging. The pain is more intense at night and when swollen. These symptoms can get to be significant enough to require pain medication. The nerves to the muscles, skin, and blood vessels are usually just as damages as the sensory nerves. Damage to the motor nerves can cause weakness, easy fatigability, joint stiffness and deformities. The autonomic nerves or nerves to the skin and blood vessels when they are injured can cause the skin become dry, cool and prone to injury such as cracking. Sometimes, neuropathic feet change colors easily when they are not elevated.

The most important treatment is directed to the underlying cause of the neuropathy. Diabetes should be strictly controlled. Nutritional deficiencies should be corrected. Unfortunately, some underlying medical conditions are impossible to cure and so treatment is symptomatic.

Protection of extremities that do not have sensation is crucial to avoiding ulceration. Shake your shoes out prior to putting them on. Check your feet several times a day. Avoid shoe wear that is made from materials that do not break-in. Wear thick, white, seamless socks to protect the feet and that clearly show drainage so that ulceration can be identified immediately. Never go barefoot especially outside. Avoid open-toed shoes or sandals because rocks and other debris can get into them and cause injury. See your physician for any sign of ulceration, unexplained swelling, deformity, or color changes.

Certain medications can be useful in treating pain associated with neuropathy. Anti-inflammatory drugs such as Motrin, Aleve, and Celebrex and acetaminophen are the initial medication. Anti-epileptic medications such as gabapentin (Neurontin), duloxetine (Cymbalta), topimate (Topamax) and pregabapentin (Lyrica) can help. Anti-depression medications such as amitriptyline are also sometimes used. Narcotic pain medication is only used rarely.