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Dental Care and Surgery

Neuropathy

Neuropathy is the medical term for nerve damage. Neuropathy is a common complication of Type 1 and Type 2 Diabetes; up to 26 percent of people with Type 2 Diabetes have evidence of nerve damage at the time that diabetes is diagnosed.

Other types of neuropathy can also affect people, but the most common type of Neuropathy is Polyneuropathy.

Signs and symptoms of Neuropathy include loss of sensation and/or burning pain in the feet. Early detection of Diabetes and strict control of blood sugar levels may reduce the risk of developing Neuropathy.

Treatments for Neuropathy are available and include several elements: control of blood glucose levels, prevention of injury, reversal of causative factors and control of painful symptoms.

  • Diabetes
  • Coronary artery disease
  • Increased triglyceride levels
  • Being overweight (a body mass index >24)
  • Smoking
  • High blood pressure

The most common symptoms of neuropathy include pain, burning, tingling, or numbness in the toes or feet, and extreme sensitivity to light touch. The pain may be worst at rest and improve with activity, such as walking. Some people initially have intensely painful feet while others have few or no symptoms.

Neuropathy can affect both sides of the body. Symptoms are usually noticed first in the toes. If the disease progresses, symptoms may gradually move up the legs; if the mid-calves are affected, symptoms may develop in the hands. Over time, the ability to sense pain may be lost, which greatly increases the risk of injury.

Potential complications

As you lose the ability to sense pain or sensitivity to hot and cold, your risk of injuring your feet increases. Injuries that would normally cause pain (e.g, stepping on a splinter, wearing shoes that create a blister, developing an ingrown toenail) do not necessarily cause pain if you have Neuropathy.

Examination

During an examination, there may be signs of nerve injury, including:

Loss of the ability to sense vibration and movement in the toes or feet (E.g. when the toe is moved up or down)

  • Loss of the ability to sense pain, light touch, and temperature in the toes or feet
  • Loss or reduction of the Achilles tendon reflex
  • More extensive testing, including Nerve Conduction Studies, Nerve Biopsy, or Imaging Tests (such as X-ray or CT scan), is not usually needed to diagnose Neuropathy.
  • Care for the feet to prevent complications.

Control of pain caused by Neuropathy

Control pain — Neuropathic pain can be difficult to control and can seriously affect your quality of life. Neuropathic pain is often worse at night, seriously disrupting sleep.

Fortunately, only a small percentage of people with Neuropathy experience pain. Pain resolves without treatment in some people over a period of weeks to months, especially if the episode of pain developed after a sudden change in health (E.g. an episode of ketoacidosis, a significant weight loss, or a significant change in blood glucose control).

Symptoms of Neuropathy

Neuropathy causes a range of symptoms, depending on the location and severity of your peripheral nerve damage. For example, some of the common symptoms of Neuropathy include:

  • Numbness and tingling in your extremities
  • Pain or burning sensations
  • Lost coordination and balance
  • Inability to grip or hold objects
  • Reduced reflexes
  • Feeling like you’re wearing gloves or socks when you aren’t

You might also develop symptoms like muscle spasm or cramping, problems walking, or paralysis. If your autonomic nerves are affected, your blood pressure may change, or you could develop abnormal sweating, bowel movements, or sexual dysfunction.

You could also develop neuropathy from infections and autoimmune disorders, physical trauma, vascular health problems, and vitamin imbalances. Alcoholism and exposure to certain chemicals and medications can also cause neuropathy.

Treatment for Neuropathy

There are several medications that are useful for the treatment of Neuropathy and have been approved by the FDA, including Duloxetine and Pregabalin. Other medications are also useful, including Tricyclic medications (E.g. Amitriptyline), Gabapentin, Tramadol, and Alpha-Lipoic Acid.

For example, if you have Diabetes, Dr. Herekar offers advice on managing your disease or a referral to an endocrinologist to help you control your diabetes. At the same time, he might recommend physical therapy to help you improve your balance and reduce your risk of falling or other injuries. Dr. Herekar can also recommend dietary changes and nutritional supplements to support nerve health.

If you have severe nerve pain, Dr. Herekar might suggest nerve blocks or nerve ablation treatments to disrupt the pain signals and alleviate your symptoms.

Around 20 million Americans have Neuropathy. At the Advanced Neurology Epilepsy and Sleep Center, Aamr Arif Herekar MD Neurology, in El Paso, Texas, diagnoses and manages Neuropathy with customized treatment plans to relieve your symptoms and help you reclaim your life. If you have pain, numbness, or other neuropathy symptoms, then call Dr. Herekar, to make an appointment today for customized neurological care to address Neuropathy.

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