Neuropathy

What is neuropathy?

Neuropathy is when nerve damage leads to pain, weakness, numbness or tingling in one or more parts of your body.

The nerve damage may be because of disease, infection, injury, medicines, long-term alcohol abuse or another reason. Sometimes no cause is found.

What are the different types of neuropathies?

There are many different types of neuropathies. Neuropathies are usually named according to the body part affected, the cause of nerve damage or the number of nerves affected.

Autonomic neuropathy occurs when there is damage to the nerves that control your body’s automatic functions, such as digestion, blood pressure and bladder function.

Diabetic neuropathy is caused by diabetes. It most commonly affects the nerves of your hands and feet. It can also affect the nerves controlling automatic functions of the body (autonomic neuropathy). It sometimes affects the nerves in the hips and thighs.

Peripheral neuropathy affects the nerves in the outer (peripheral) parts of the body such as your feet, legs, hands and arms.

Focal or mononeuropathy affects only one nerve. Examples include carpal tunnel syndrome and Bell’s palsy.

Polyneuropathy affects several nerves. Most people with neuropathy have polyneuropathy.

What are the symptoms of neuropathy?

The symptoms depend on the nerves involved.

Neuropathy can cause abnormal sensations in your affected body area, such as:

• pain, which is often worse at night
• numbness
• tingling, or ‘pins and needles’
• a burning sensation
• electric shock-like sensations

Neuropathy can also cause:

• muscle weakness
• a loss of movement or function
• problems with balance

Autonomic neuropathy can cause problems with:

• digestion (for example, feeling full faster when eating)
• bowel function (including diarrhoea or constipation)
• bladder function
• sexual response (for example, erectile dysfunction)
• sweating
• feeling light-headed

What causes neuropathy?

There are many known causes of neuropathy, including:

• diabetes
• Guillain-Barre syndrome
• certain infections, including HIV infection and AIDS
• long-term alcohol abuse
• chemotherapy and radiotherapy
• vitamin deficiencies
• some medicines
• tumours
• pressure on a nerve
• thyroid problems

Sometimes, a cause can’t be found.

When should I see my doctor?

See your doctor as soon as possible if you have any symptoms of:

• numbness
• a tingling or prickling feeling in your skin
• a feeling of extra sensitivity to light touch
• weakness
• trouble with your co-ordination
• pain that feels like burning or electric shock-like sensations

How is neuropathy diagnosed?

Your doctor will ask you questions about your symptoms, and whether anything makes them worse or better. They will want to know how long you have had symptoms. They will also ask about other conditions you have and any medicines or other therapies you are taking.

They will examine you to work out if there is a problem with one or several nerves. They will also look for signs of the cause of the nerve problem.

You might be asked to have tests called nerve conduction studies. This type of test can measure the electrical activity in your nerves.

Your doctor may also recommend blood tests to help find the cause of neuropathy.

Your doctor may refer you to a specialist doctor for further tests and treatment.

How is neuropathy treated?

Treatment for neuropathy depends on the cause. If the cause is a medicine you are taking, you may need to change your medicine.

Medicines may be needed to treat nerve pain.

Can neuropathy be prevented?

Some types of neuropathies may be prevented, such as neuropathy associated with alcohol abuse or very restrictive diets.

You can reduce your risk of developing neuropathy associated with diabetes by keeping your blood glucose levels well controlled.