Peripheral neuropathy typically begins in the ends of the longest nerves, such as the sensory nerves in the toes and feet. However, peripheral neuropathy can affect other nervous systems, and the symptoms will depend on what functions the nerves control. For example, if the autonomic nervous system is involved, bowel and bladder problems may be present.
If peripheral neuropathy progresses to the autonomic nerves that control organs, it can change bowel and bladder functions. It may also affect breathing, swallowing, digestion, and vision. It can cause impotence in men. Fainting or dizziness can occur if blood pressure is affected.
Your examination will include a clinical neurological exam, which includes reflex and sensation testing. Electromyography (EMG) and nerve conduction studies may be used to assess the speed and strength of nerve signals to certain muscles. A nerve biopsy may be used to identify abnormalities. In some cases, imaging scans may be used to help determine if there is pressure on a nerve.
Several types of medications or combinations of medications may be recommended. Over-the-counter or prescription pain relievers, anti-seizure medications, antidepressants, and local anesthetic patches may be prescribed.
Physical and occupational therapy may help improve muscle strength, coordination, and range of motion. Your therapists may recommend braces or splints to position your joints. Ambulation devices, such as a walker, cane, or crutches can increase mobility. Your therapists may use transcutaneous electrical nerve stimulation (TENS) to deliver a small electrical current to nerves to relieve pain. A home evaluation performed by your therapists can ensure that your living space is as safe as possible.
Lifestyle changes can help peripheral neuropathy. Examine your feet regularly and report any changes to your doctor. He can recommend the best types of shoes for you. Exercise regularly, quit smoking, avoid alcohol, and eat healthy balanced meals. Your doctor can make specific recommendations for you.
You may prevent complications from peripheral neuropathy by managing its underlying cause. Follow your doctor’s advice and attend all of your appointments. Bring any new changes to your doctor’s attention promptly.
Am I at Risk
Risk factors for peripheral neuropathy:
• Pressure from nerve compression
• Diseases, such as diabetes, cancer, thyroid disease, or kidney failure
• Infections, such as HIV/AIDS, rheumatoid arthritis, or hepatitis
• Vitamin B deficiency
• Exposure to toxins or poisons
Decreased sensation and coordination in the feet or toes increases the risk of falls. Your therapists can work with you on a fall prevention program.