Peripheral Neuropathy

What is Peripheral Neuropathy?

Peripheral neuropathy is the result of damage to the peripheral nervous system: a large communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body. Peripheral neuropathy affects millions of people in the U.S.

Peripheral nerves send various types of sensory information to the brain, such as the message that your foot hurts after stepping on a splinter. In peripheral neuropathy, nerve signaling can be disrupted in 3 ways:

• Signals that should be sent, but are not
• Signals that are sent when they should not be
• Errors that change the messages being sent

When peripheral nerves can not send and receive signals like they should, it can have consequences on the body, such as neuropathic pain.

Symptoms of Peripheral Neuropathy in Feet

• Pain (tingling and burning sensation)
• Inability to feel pain or changes in temperature (due to damage to small nerve fibers)
• Inability to feel vibrations and tough
• Loss of proprioception (position sense)
• Loss of reflexes

Common Causes of Neuropathy

Acquired peripheral neuropathies:

• Diabetic peripheral neuropathy - diabetes is the leading cause of peripheral neuropathy in the U.S. About ⅔ of people with diabetes have mild to severe nerve problems that can cause numbness, tingling, or burning feet
• Low Back issues (ie, scoliosis, arthritis, herniated disc, sciatica)
• Nutritional deficiencies
• Alcoholism
• Chemotherapy-induced
• Exposure to chemicals (ie, agent orange)
• Autoimmune diseases (ie, Multiple Sclerosis)
• Guillain-Barré syndrome
• Trauma-induced nerve damage
• Inherited Peripheral Neuropathies (ie, Charcot-Marie-Tooth disease)
• Idiopathic neuropathy - essentially, the cause of the neuropathy could not be identified

How to Diagnose Peripheral Neuropathy

• Medical History - your podiatrist will ask questions about your symptoms, social habits, family history, medical history, and more
• Physical Exam - evaluation of touch, vibration and temperature sensation
• Nerve conduction studies - electromyography and nerve conduction studies to evaluate how well nerves and muscles are functioning
• Small Nerve Fiber Biopsy - to examine quantity of nerve fiber endings

How we Treat Neuropathy at Performance Foot & Ankle

Treatment of peripheral neuropathy depends on the type and location of nerve damage, and the patient’s individual symptoms.

• Lifestyle changes
• Managing diabetes - maintaining safe blood glucose levels can reduce ongoing nerve damage, and
• improve neuropathic pain in the feet
• Over-the-counter or prescription topical creams/ointments/salves
• Over-the-counter or prescription medicated topical patches
• Referral(s) to the appropriate outside specialist for further evaluation and management
  I.e., Pain Management doctor for consideration of 10 k-Hz spinal cord stimulation"