Neuropathy is a condition that affects nerves. When nerves are damaged, the motor and sensory nerve information do not properly reach the brain. The symptoms of neuropathy depend on which nerves are damaged as well as what type of neuropathy occurs. There are three categories of neuropathy: mononeuropathy, multiple mononeuropathy, and polyneuropathy.
Categories of Neuropathy
There are three broad categories of neuropathy. These are based primarily on the number of nerves that are affected by damage, and they include:
- Mononeuropathy – This occurs when there is a single nerve that is affected. Mononeuropathy most often occurs as a result of a local cause, such as compression, trauma, or entrapment. Examples of this type of neuropathy are radial nerve palsy and carpal tunnel syndrome.
- Multiple mononeuropathy – This type of neuropathy occurs when two or more nerves are affected individually.
- Polyneuropathy – This occurs when there is generalized nerve damage that affects several peripheral nerves. Examples of polyneuropathy are Guillain-Barre syndrome and diabetic neuropathy.
Types of Neuropathy
There are several types of neuropathy. These include:
- Peripheral neuropathy – This is the most common type of neuropathy, and it occurs when the nerve damage happened outside the brain and spinal cord. Peripheral neuropathy affects the body’s extremities, like the feet, legs, toes, hands, fingers, and arms.
- Proximal neuropathy – This term has been categorized for nerve damage that has affected the hips, buttocks, and/or thighs. Sciatica is a type of proximal neuropathy, and the pain shoots from the lower back and down the leg (on one side).
- Cranial neuropathy – This takes place when one of the twelve cranial nerves becomes damaged. Optic neuropathy and auditory neuropathy are the two kinds of cranial neuropathy.
- Autonomic neuropathy – This type of neuropathy takes place when the nerves of the involuntary nervous system (autonomic nerves) are damaged. These nerves affect circulation, the heart, the bowels, digestion, the bladder, and the sexual organs.
- Focal neuropathy – This neuropathy occurs when nerve damage is restricted to one specific nerve or a group of nerves. Focal neuropathy affects a certain area of the body.
Treatment for Neuropathy
The first step in treating neuropathy is to address any contributing causes, such as toxin exposure, medications, infection, hormone deficiencies, vitamin deficiencies, and autoimmune disorders. Peripheral nerves regenerate axons, which can lead to recovery. The adoption of a healthy lifestyle is often required, which includes eating a balanced diet, avoiding alcohol, and exercising. Smoking cessation is often necessary because nicotine leads to constricted blood vessels, which inhibits proper blood flow to the nerves. If diabetes is contributing to the problem, improving glucose control is required.
Symptom management often involves medications for nerve-related pain. Neuropathic pain is often a burning, searing, aching sensation, and it can be difficult to control. Nonsteroidal anti-inflammatory drugs are used for many patients. Drugs that have been found to modulate the chemicals associated with nerve pain are anticonvulsants and antidepressant drugs. Gabapentin, topiramate, pregabalin, and carbamazepine are some of the anticonvulsant drugs prescribed for neuropathy, and tricyclic antidepressants work by changing the brain’s perception of pain.
For severe neuropathy, the pain management specialist may prescribe a transcutaneous electrical nerve stimulation (TENS) device. This is a battery-powered unit that is worn outside the body. The electrodes connect to the skin on the body, and wires extend from the unit to the electrodes. Mild electric current is transmitted, which interferes with pain signal transmission. Some patients also benefit from interventional pain management procedures, such as nerve blocks. This involves instilling an anesthetic onto certain nerves to block pain signals.