March 24, 2024
As a nurse who specializes in the care of feet, I've seen firsthand the challenges and discomforts faced by individuals with neuropathy. This condition, which affects the peripheral nerves, often manifests in the feet, leading to symptoms like numbness, weakness, and pain. My experience has provided me with a comprehensive understanding of both the causes of neuropathy and the wide array of treatments available, including alternative therapies and recent advances.
Peripheral neuropathy can arise from various causes, with diabetic peripheral neuropathy being one of the most common. This specific type of neuropathy is a frequent complication of diabetes, affecting a significant portion of the diabetic population. The damage to peripheral nerves in individuals with diabetes is often due to high blood sugar levels, leading to symptoms that can severely impact a person's quality of life. These symptoms include pain, foot ulcers, and, in severe cases, an increased risk of lower limb amputation.
Causes and Disordered Pain of Neuropathy
Neuropathy can occur due to myriad causes, including:
Peripheral nerve dysfunction occurs in the long nerves that travel to the legs and hands and contain tiny blood vessels. These tiny vessels are prone to damage or injury and can become dysfunctional if they’re stretched, cut, or compressed, dying off and causing neuropathy.
Diabetes may lead to neuropathy because high blood sugar can weaken blood vessels over time. Weak, damaged blood vessels damage nerves, making them less able to send impulses efficiently throughout the body.
Nutritional deficiencies or excesses, such as deficiencies in several B vitamins like B1, B6 and B12. Low levels of folic acid (vitamin B9) and micronutrients, such as copper, zinc, and magnesium, can lead to nerve damage. An excessive intake of vitamin B6 can also cause neuropathy, as the vitamin is found in a number of foods.
Chemotherapy can cause damage to the peripheral nervous system, often in the fingertips and toes (known as chemotherapy-induced peripheral neuropathy).
Physical injury, such as a gunshot wound or cut, can lead to damaged nerves.
Inflammatory conditions, such as COVID-19, HIV/AIDS, autoimmune hepatitis, and Lyme disease. An example, Lyme disease bacteria can attack the peripheral nervous system, and HIV can cause tissue damage that may trigger neuropathic inflammation.
Autoimmune diseases, such as lupus, celiac disease, rheumatoid arthritis and Sjögren’s syndrome, can make the body attack and damage nerves.
Chemical or drug exposure, such as lead, insecticides, or pesticides, are neurotoxins that can damage or kill nerve cells, causing neuropathy.
Kidney disease can lead to high levels of toxic substances in the blood that can damage nerve tissue.
Excess alcohol consumption, which can destabilize nerve endings and cause erosion of the stomach lining, possibly leading to nutrient malabsorption.
Specific types of disordered pain that may be experienced in neuropathy include:
Allodynia, pain from what is normally a non-painful touch, such as being stroked by a feather
Dysesthesia, an unpleasant feeling, which is not actually painful per se
Hyperpathia or Hyperalgesia, prolonged or severe pain from a lightly painful incident, such as a pinprick
Paresthesia, unusual sensations, such as pins and needles or a burning sensation
Treatment for neuropathy typically focuses on managing the underlying condition that's causing nerve damage, such as diabetes, and alleviating the symptoms. Conventional treatments include medications like pain relievers, anti-seizure medications, and antidepressants, which can help control nerve pain. However, it's not just traditional medicine that offers hope. Alternative therapies have also shown promise in managing neuropathy symptoms.
One alternative therapy that has gained attention is acupuncture. This traditional Chinese medicine technique, which involves inserting thin needles into specific points on the body, has been found to help reduce neuropathy pain in some patients. Additionally, physical therapy can help improve muscle strength and reduce the discomfort associated with neuropathy.
In recent years, studies have shed light on the effectiveness of some treatments. For instance, research published in leading medical journals has explored the impact of lifestyle changes, such as diet and exercise, on managing diabetic peripheral neuropathy. These studies suggest that maintaining a healthy weight, engaging in regular physical activity, and consuming a balanced diet can help control blood sugar levels and, by extension, mitigate the symptoms of neuropathy.
Advancements in medical research have led to the exploration of new therapies, such as the use of capsaicin cream and electrical nerve stimulation. Capsaicin cream, derived from chili peppers, can reduce pain sensations when applied to the skin. Electrical nerve stimulation, on the other hand, uses a mild electrical current to relieve pain by interrupting pain signals sent to the brain.
As a nurse, my role extends beyond administering treatments; it involves educating patients about their condition and empowering them to take an active role in their care. It's essential for individuals with neuropathy to understand the importance of foot care, including regular inspection for injuries, proper footwear, and maintaining good hygiene.
Neuropathy is a condition with far-reaching effects, but with the right combination of treatments, including alternative therapies and lifestyle changes, many individuals can find relief from their symptoms. As healthcare professionals, it's our duty to stay informed about the latest advancements in treatment and to provide comprehensive care that addresses both the physical and emotional aspects of neuropathy.
References:
BMJ. (2002). "Peripheral Neuropathy: A Practical Approach to Diagnosis and Symptom Management." Retrieved from https://www.bmj.com/content/324/7335/466
Springer. (2019). "Recent Advances in Diabetic Peripheral Neuropathy." Retrieved from https://link.springer.com/article/10.1007/s11892-019-1212-8
Forbes. "Neuropathy: Causes, Symptoms, and Treatments." Retrieved from https://www.forbes.com/health/conditions/neuropathy/#:~:text
National Institutes of Health (NIH). "Peripheral Neuropathy Fact Sheet." Retrieved from https://www.ninds.nih.gov/health-information/disorders/peripheral-neuropathy
Johns Hopkins Medicine. "Peripheral Neuropathy." Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/peripheral-neuropathy
Mayo Clinic. "Peripheral Neuropathy." Retrieved from https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/diagnosis-treatment/drc-20352067
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