What Is Peripheral Neuropathy
Peripheral neuropathy describes conditions that involve damage to the peripheral nerves, which are the nerves beyond the brain and spinal cord. Neuropathy may involve damage to only one nerve , two or more nerves in different areas , or may affect many or most of the nerves .
There are more than 100 types of peripheral neuropathy and symptoms vary depending on the type of nerves that are damaged:
- Motor nerves are those that control the movement of the muscles under conscious control, such as those used for walking, gripping objects, or talking
- Sensory nerves are those that transmit sensory information such feelings of touch, temperature, or pain
- Autonomic nerves are those that control the organs and regulate activities that are not consciously controlled, such as breathing, digestion, and heart function
Depression And Negative Emotions
Stress can be a trigger for any kind of pain, including sciatica. According to Dr. John Sarno, a Physician at the New York University Medical Center and Clinical Rehabilitation Medicine Professor at New York University School of Medicine, bodily pain can be a result of repressed emotions and stress.
Sciatica and Dr. Sarnos study on mind-body pain became topics of interest for people who suffer pain in their the lumbar area, buttocks, legs, and feet. For years, he has been advocating a different approach to determining the cause and managing back pain that is associated with emotions rather than those that are picked up through MRI scans or verified using a diagnostic injection.
Needless to say, not all medical professionals have been supportive of his straightforward yet patient-centric way on diagnosing and treating back pains.
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Epidural Steroid Injections Under X
Corticosteroids reduce inflammation and pain. If you need this level of relief, Dr. Shah injects the steroid directly into your spine near the sciatic nerve. Although not safe for long-term use, steroid injections are ideal for short-term pain relief that allows you to continue healing through physical therapy.
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What Is Diabetic Neuropathy
Neuropathy refers to any condition that damages nerve cells. These cells play a critical role in touch, sensation, and movement.
There are several different types of neuropathies. They include:
- peripheral: pain and numbness in the extremities, including arms, hands, legs, feet, and toes
- proximal: pain and numbness in the upper legs, specifically the buttocks, thighs, and hips
- autonomic: damage to nerves of the autonomic nervous system, which control sexual response, sweating, and urinary and digestive function
- focal: sudden loss of function in nerves causing pain and weakness of the muscles
Neuropathy is one of the common effects of diabetes. Its estimated that of people with diabetes will develop some sort of neuropathy throughout their lives.
Nerve damage from diabetes cant be reversed. This is because the body cant naturally repair nerve tissues that have been damaged.
However, researchers are investigating methods to treat nerve damage caused by diabetes.
While you cant reverse the damage from neuropathy, there are ways to help manage the condition, including:
- lowering your blood sugar
- treating nerve pain
- regularly checking your feet to make sure they are free of injury, wounds, or infection
To prevent damage to your feet or legs:
- topical medications, like capsaicin
How Can I Make The Neuropathic Pain Go Away
Neuropathic pain occurs biochemically, making it a very fluid system that can often be quickly modified, resulting in pain relief. Many different chemicals in your body may be involved in your pain, and therefore it is worth trying different types of medications to see which ones work best in your case.
For many, treating the nutritional and thyroid deficiencies and eliminating the muscle spasms, which are compressing your nerves, may be enough to eliminate your pain. Others may need to take medications to suppress the pain while we look for ways to eliminate the underlying cause.
The best way to tell which chemicals are involved in your nerve pain is to simply try different medications to see what eases your pain. Basically, it is like trying on different shoes to see what fits best. The good news is that we have a large assortment of “shoes” that you can try on and that are likely to help you.
It is, of course, critical to begin by eliminating the underlying causes of neuropathy and giving the nerves what they need to heal. This includes the nutritional support we’ve discussed. In addition, the involvement of free radicals in nerve excitation was found in 1995, supporting the use of antioxidants in nerve pain. Since that time, the antioxidant lipoic acid has been shown to be helpful in diabetic neuropathy and should be tried in other neuropathies as well. You will be amazed at how much benefit you may get over time simply from optimizing nutritional support.
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Can You Drive With Peripheral Neuropathy
If neuropathy affects sensation to your feet and ability to feel your feet on the pedals of your car, it is advised that you should not drive. You have an increased risk of losing control and getting in an accident. You may be involved in an accident due to the slow reaction in moving your foot from the accelerator to the brake pedal.
Does Nerve Pain Ever Go Away
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How Common Is A Pinched Nerve
Pinched nerves are common every year about 85 out of 100,000 adults in the United States are affected by pinched nerves. People of any age can experience pinched nerves, but those aged 50 and older are most likely to have them, due to arthritis and degeneration in the spine and other parts of the body.
Living With Neuropathic Pain
Pain is a very complex condition and each person is affected differently. It has many physical and psychological components and individuals can experience fatigue, anxiety, mood changes and depression.
As pain cannot be seen, it is hard to explain to someone exactly what it feels like and therefore it is hard for others to understand just how much it can affect everyday life. The organisation Pain Concern provides information and support to people affected by pain.
This information was last checked in November 2016. Due for review in November 2019.
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Myth : Medication Is The Best Way To Provide Relief From Sciatica
Fact: You might think that taking an analgesic or anti-inflammatory drug could ease the pain of sciatica, but in fact, a systematic review and meta-analysis published in February 2012 in the BMJ found a lack of evidence of the efficacy of drugs including NSAIDs, corticosteroids, antidepressants, and opioidanalgesics.
There is at best only low-quality evidence to judge the efficacy and tolerability of drugs commonly prescribed for the management of sciatica in primary care, the authors concluded.
But short-term treatment with an anti-inflammatory or acetaminophen can be helpful for some people.
For people with persistent severe symptoms that dont respond to analgesics or improve with activity modification, other treatment options include taking oral steroids or receiving epidural steroid injections injections into the epidural space around the spinal cord.
But as Patel notes, Epidural steroid injections are typically indicated for acute radiculopathy . They do not typically help for chronic sciatica.
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When Is Surgery Considered
Spinal surgery is usually not recommended unless you have not improved with other treatment methods such as stretching and medication, your pain is worsening, you have severe weakness in the muscles in your lower extremities or you have lost bladder or bowel control.
How soon surgery would be considered depends on the cause of your sciatica. Surgery is typically considered within a year of ongoing symptoms. Pain that is severe and unrelenting and is preventing you from standing or working and youve been admitted to a hospital would require more aggressive treatment and a shorter timeline to surgery. Loss of bladder or bowel control could require emergency surgery if determined to be cauda equine syndrome.
The goal of spinal surgery for sciatic pain is to remove the pressure on the nerves that are being pinched and to make sure the spine is stable.
Surgical options to relieve sciatica include:
Microdiscectomy: This is a minimally invasive procedure used to remove fragments of a herniated disk that are pressing on a nerve.
- Laminectomy: In this procedure, the lamina that is causing pressure on the sciatic nerve is removed.
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Myth : Sometimes Nothing Helps Sciatica
I commonly hear patients worry that there is no cure or that nothing can be done to improve their symptoms. I also hear patients worry that surgical treatment might not be successful, Tolhurst says. Fortunately, very high quality scientific studies have repeatedly shown that most symptoms improve and that, if needed, surgery is highly effective.
Spotting The Warning Signs Of Nerve Damage
Nerve damage is commonly thought of as a complication of diabetes, but it can also result after an injury. Nerve damage is also known as peripheral neuropathy. The nerves that are most likely to be damaged tend to be in your arms, feet, and hands, although other parts of the body may also be affected.
When youre injured or have surgery, the nerves no longer get the signal from your brain to transmit sensation. Sometimes, nerves that are only partially damaged can heal themselves. Dr. Jonathan Shults at Coastal Empire Orthopedics offers this guide to help you recognize the warning signs of nerve damage and the next steps you should take.
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Can Surgery Alleviate Sciatica Pain
Some cases of sciatica may call for surgical interventions. An example of this would be patients who have nerve pinching because of bone overgrowth, a side effect of osteoarthritis.
The outlook of surgery for sciatica varies from one patient to another, so we strongly recommend consulting with your doctor whether its a practical choice for your condition. You can also look for non-invasive techniques that can provide long-term resolution of your main sciatica symptoms.
How Long Will It Take To Go Away
There are two types of sciatica, acute and chronic. An acute sciatica needs one and two weeks to recover. But there is a case when people have a sciatic episodes. The pain comes several times in a year. Each episode of this pain needs one and two weeks to go away.
How about the chronic sciatica? Chronic sciatica is a life-long pain. People with chronic sciatica may feel the pain for a very long time. But, the sore is often less severe than the acute form.
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What Are The Risk Factors For A Pinched Nerve
Anything which increases pressure around a nerve can cause a pinched nerve. Common causes include body position such as leaning on elbows, habitually crossing legs, or poor posture. Over time this may lead to pressure injury to nerves in these regions.
- Disc herniation or bulging discs and arthritis in the spine can cause pressure on nerve roots which leads to the nerve pain or discomfort associated with a pinched nerve.
- Weight gain or water retention can predispose people to developing pinched nerves thyroid disease can contribute to both water retention and weight gain and can increase the risk of certain types of pinched nerves.
- Pregnancy, which is associated with increased weight and occasionally associated with water retention, is also a common risk factor for developing certain types of pinched nerves.
- Repetitive activities can also increase swelling around specific nerves and lead to symptoms of a pinched nerve.
Treating The Underlying Cause
There are many different causes of peripheral neuropathy, some of which can be treated in different ways.
- diabetes can sometimes be controlled by lifestyle changes, such as stopping smoking, cutting down on alcohol, maintaining a healthy weight and exercising regularly
- vitamin B12 deficiency can be treated with B12 injections or tablets
- peripheral neuropathy caused by a medicine you’re taking may improve if the medicine is stopped
Some less common types of peripheral neuropathy may be treated with medicines, such as:
- steroids powerful anti-inflammatory medicines
- immunosuppressants medicines that reduce the activity of the immune system
- injections of immunoglobulin a mixture of blood proteins called antibodies made by the immune system
But the underlying cause may not always be treatable.
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Help Is Available For Phn
Fortunately,early treatment for shingles can lower your chances of getting PHN.
For some people, the pain becomes refractory, or resistant to treatment, explains Dr. Rosenquist. So we want to treat shingles as fast as we can ideally as soon as somebody feels a tingling or burning sensation, even before a rash develops.
Sheadds that whenever nerve pain is involved, some people respond to treatment andsome dont.
However,medications taken orally or injected that can target the affected nerves may beable to stun the nervous system into behaving properly. That meanstransmitting the appropriate signal to the brain.
What Is Neuropathic Pain
Neuropathic pain is caused by damage or injury to the nerves that transfer information between the brain and spinal cord from the skin, muscles and other parts of the body.
The pain is usually described as a burning sensation and affected areas are often sensitive to the touch. Symptoms of neuropathic pain may also include excruciating pain, pins and needles, difficulty correctly sensing temperatures and numbness. Some people may find it hard to wear thick clothes as even slight pressure can aggravate the pain.
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How Can I Ease The Pain Of Neuropathy
There are different ways you can ease the pain of neuropathy. These include:
Exercise Engaging in regular exercises, such as walking can help reduce neuropathy pain and improve muscle strength.
Over-the-counter pain relievers Taking over-the-counter nonsteroidal anti-inflammatory drugs such as acetaminophen, ibuprofen, and naproxen can help relieve neuropathic pain.
Opioids If over-the-counter pain relievers dont relieve your pain, taking medications containing opioids, such as tramadol or oxycodone can help relieve neuropathic pain. However, these medications are addictive and should be taken for a short time.
Anti-seizure medications Anti-seizure medications such as gabapentin and pregabalin may relieve nerve pain.
Antidepressants Taking tricyclic antidepressants, such as amitriptyline, doxepin and nortriptyline can help relieve pain.
Myth : A Specific Event Brings On Sciatica
Fact: People often think if they didnt lift that suitcase, sit on a long flight, or help a friend move they would not have pain, said , the director of pain medicine and endoscopic lumbar surgery for the department of rehabilitation medicine at Mount Sinai in New York City and an assistant professor at the Icahn School of Medicine at Mount Sinai.
Most of the time, the intervertebral disk has a small defect and is ready to herniate, and not necessarily caused from that specific event, Dr. Spinner says.
According to Loren Fishman, MD, an assistant clinical professor at Columbia Medical School and the medical director of Manhattan Physical Medicine and Rehabilitation, most people have isolated or, occasionally, repeating episodes of sciatica its major when it happens, but overall its a minor part of their lives.
After all, 80 percent of Americans have back pain or sciatica at one point or another, so its really part of being normal, says Dr. Fishman.
While a specific event may not lead to sciatica, certain jobs may. A study published in European Spine Journal in June 2017 found that physically demanding work is a strong risk factor for sciatica. For men, the jobs associated with higher risk included metal, machine, and other industrial work. For women, the risk was higher among nurses, sales workers, and industrial workers.
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Signs You Might Have Nerve Damage According To Doctors
Numbness, tingling, and muscle weakness are just a few symptoms to keep on your radar.
There are billions of nerves in your body. Most of them, your peripheral nerves, are like branches of a tree that spread out all over and transmit messages back to the trunkyour brain and spinal cord. When everything goes smoothly, your brain gets the info it needs so that you can move your muscles, recognize pain, and keep your internal organs working properly.
But when peripheral nerves get damaged, its another story: Walking could become challenging, you might experience unrelenting pain, or you could end up with a serious injury because you had no idea how hot that stove was.
An estimated 20 million Americans suffer from peripheral nerve damage, a.k.a. neuropathy, according to the National Institute of Neurological Disorders and Stroke. Diabetes is the number one cause. Bad luck is number two. Repetitive motion and Lyme disease follow, says Andrew Elkwood, M.D., a surgeon who specializes in nerve reconstruction at The Institute for Advanced Reconstruction in New York and New Jersey.
Other causes include sudden trauma , aging, vitamin deficiencies, heavy exposure to toxins , and infections and autoimmune disorders like hepatitis C, diphtheria, HIV, Epstein-Barr, rheumatoid arthritis, and Guillain-Barré Syndrome. In some cases, theres no known cause.