Physical therapy helps, especially for chronic neck and low back pain. Counseling may help deal with psychologic issues that make pain worse. Medicines used for treatment of painful neuropathy include antidepressants, antiepileptics, and analgesics. Vitamin B 12 supplements can help with vitamin B 12 deficiency. For example, better control of blood sugar (glucose) can lower the risk of diabetic neuropathy. Symptoms often improve with time, especially if causes can be treated. The health care provider may suggest seeing specialists (neurologist, physical therapist, pain management specialist) for additional evaluation and treatment. Laboratory tests, magnetic resonance imaging (MRI) of the brain and spinal cord and special tests including nerve conduction studies and electromyography (EMG), nerve biopsy, and lumbar puncture may be done to confirm the diagnosis and determine the cause. The health care provider makes a preliminary diagnosis from the medical history and physical examination. Spinal cord involvement may mean the urinary bladder and bowel problems. Muscle tissue may be lost (muscle atrophy) if the neuropathy has been present for a prolonged period.
Extreme sensitivity to even light touch can occur. People may have burning, hot or cold, “icy hot,” pins and needles, stinging, shooting (lancinating), or sharp feelings.
Numbness and tingling in feet and hands may start slowly and spread to legs and arms. Symptoms depend on the nerves and fibers affected. What Are the Signs and Symptoms of Peripheral Neuropathy? Alcohol, chemotherapeutic drugs, isoniazid, metronidazole, and heavy metals (arsenic) are other causes of neuropathy. Rare cancer of nerves can also cause neuropathy. Infectious causes are HIV/AIDS, herpesvirus, varicella-zoster virus (postherpetic neuralgia), Lyme disease, leprosy, and syphilis. Inflammatory causes are lupus, Sjögren’s syndrome, polyarteritis nodosa, acute and chronic inflammatory demyelinating polyneuropathy, sarcoid, and multiple sclerosis.
Metabolic causes include diabetes mellitus, malnutrition, and porphyria. Many causes exist, including direct injury and pressure on nerves. From 1.6% to 8.2% of the general population have neuropathy. Allodynia is pain caused by something that’s not normally painful. The first is called hyperalgesia the second, hyperesthesia. Damage may mean being more sensitive to things that are painful (such as pinpricks) or not painful (such as light touch). Peripheral nerves take messages from the brain and spinal cord to muscles, organs, and other body tissues. Nerves are made of fibers that affect pain sensation, movement, and balance. Neuropathy, also called neuralgia, means nerve disease or damage.
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