An estimated 20 million Americans in the United States suffer from peripheral neuropathy, a degenerative condition characterized by numbness, tingling, or burning in the hands and feet. This article will explore some of the causes and available treatments for peripheral neuropathy.
Etiology (Causes) of Neuropathy
Neuropathy is the result of nerve damage in the hands and feet. Damage typically begins at the tips and progresses through the rest of extremity. In some instances the nerve endings are destroyed and in other circumstances the nerves demyelinate. Demyelination occurs when the outer portion of the nervous cell is damaged and is metaphorically like stripping the plastic insulation off of electrical wiring, which results in short-circuiting.
Damage to nervous tissue can be caused by physiologic conditions surrounding the nerve or external stimuli. Nervous cells are more sensitive to environmental changes than are other cells and require a constant stream of oxygen and sugar in order to survive. As a result, our bodies are designed to shunt nutrients and blood flow to protect the bulk of our nervous tissues, which reside in our brain and core. This is the reason why hypothermia, and neuropathy, begin in the extremities. As a result, people with anemia, diabetes, or are otherwise unable to provide a constant level of oxygen (alcoholics) and sugar (hypoglycemics) are more likely to develop neuropathy.
Aside from physiologic conditions, external forces or the lack there of can result in neuropathy. Trauma is often associated with neuropathy for the initial damage caused to the nerves but also for resulting lack of stimuli to the nervous system. The human body is incredibly efficient in that anything that is not used is shut down. As muscles atrophy when not used, nerves also start to atrophy when they do not receive regular input.
Progression of Neuropathy and Inherent Risks
If nothing is changed to improve oxygenation, blood-sugar concentration, or stimulation, all feeling will eventually be lost. Additionally, because the brain can no longer feel that the extremity exists, blood flow will begin to be shunted away and the number of capillaries in the extremity will decrease.
A loss of feeling and lack of blood flow is a recipe for disaster and eventual loss of limb. Typically a person in this condition will sustain a cut on the foot that they can’t feel and because of the poor circulation the cut will become infected and gangrenous. Therefore, meticulous hygiene and inspection of the affected extremities is of the utmost importance.
Available Treatments (The Good News)
For years it was believed that once a nerve was dead, it was lost forever. Recent studies have shown however that nerves can regenerate under certain circumstances. These recent insights inspire the bulk of our unique treatment philosophy at The Neuro Clinic.
The treatment protocol for neuropathy, based on the premise that nerves cannot regenerate, is to dampen the burning and tingling sensations with drugs. You may recall that a lack of stimulus is one of the contributing factors to neuropathy, so dulling sensation is something we recommend only as a last resort.
We start treatment with a thorough neurologic exam to determine the extent of the disease and the amount of nerve function that remains. Treatment consists of a multi-faceted approach aimed at restoring the remaining nerve function utilizing all of the tools available to us including: nervous stimulation, reducing nerve impingements, dietary change, gaining control of the physiologic conditions that contribute to neuropathy, and improving blood oxygen saturation with hyperbaric therapy. Additional neurologic exams are conducted at regular intervals to evaluate progress and compared against the baseline established with the initial exam.