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Peripheral Neuropathy: Symptoms, Treatment, Prevention

separator Peripheral neuropathy occurs when there’s damage to the nerves in the fingers and toes.
For a person with diabetes, there’s a 50 percent chance of developing peripheral neuropathy, also called diabetic neuropathy, over a 25-year span of time. And 7.6 percent of people already have the condition when they are diagnosed with diabetes.

For most people, peripheral neuropathy causes numbness and tingling in the hands and feet. For some people, it can be quite bothersome, causing severe pain and burning. Some people don’t have symptoms right away, and they aren’t aware they have the condition until they have an examination by a doctor.

Peripheral neuropathy can be caused by anything that irritates the nerve. Diabetes is one of the most common causes, but it can also be caused by thyroid abnormalities, kidney and liver disease and failure to absorb vitamin B12. According to Dr. Joanne Rogin, a neurologist at the Minnesota Clinic of Neurology, “That’s why it’s important to see your doctor to rule out any other causes of nerve damage that we could be treating.”

If you have peripheral neuropathy, it’s important to do everything you can to keep it from getting worse. Dr. Rogin explains, “Having peripheral neuropathy makes people more susceptible to infections, injury and ulcerations, which can all lead to amputation eventually. The condition can also affect your ability to carry out activities of daily living.”

People who have peripheral neuropathy can become depressed or anxious. They also may have trouble at work, difficulty maintaining a social life and difficulty sleeping

Exercise helps prevent progression
One of the best ways to keep peripheral neuropathy from getting worse is to get regular exercise. “This can be a vicious cycle,” says Dr. Rogin, “because when you’re in pain, sometimes the last thing you want to do is exercise. Pool exercises are beneficial—even walking in a pool can be very good.” There are also belts you can get, sometimes called “aqua joggers,” that allow you to remain upright in the water as you move your arms and legs for exercise.

If you have diabetic neuropathy but are finding it difficult to get out and exercise, talk with your doctor or other healthcare provider about ways to start. They can help you create a program that will give you the benefit of exercise without causing you a lot of pain.

Drug treatment is available
Peripheral neuropathy is a challenging pain to treat, explains Dr. Rogin. “We’re currently finding out that neuropathic pain is different—the receptors are different than for other types of pain.”

Currently, the goal of treatment is to relieve the pain. “We have some pain relief medication now that has few side effects and can be quite effective. We sometimes give people narcotics, but in most cases we prefer not to do this. There are drugs primarily used for epilepsy that can sometimes treat neuropathy as well. And in some cases, we prescribe patches or topical capsaicin creams.”

Good blood sugar control the best prevention
“We don’t know yet exactly how diabetes causes neuropathy,” says Dr. Rogin. “But we do know that, as always, good control of blood sugar is the best way to prevent it. The Diabetes Control and Complications Trial showed that lowering blood sugar and practicing tight control can reduce the risk of diabetic neuropathy by 60 percent over five years. So people really do need to work with their healthcare team to get their sugar under control, not only to prevent neuropathy, but even to slow its progression.”

Dr. Rogin has a lot of hope that new treatments for diabetic neuropathy are on the horizon. “I’m very optimistic that no only will we find more drugs to treat the pain, but also to prevent the development of neuropathy in the first place. For now, prevention is the best treatment. And be sure to see your doctor regularly, so we can detect neuropathy as early as possible.

Joanne Rogin, MD, Neurologist, Minnesota Clinic of Neurology
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