Peripheral neuropathy affects the peripheral nerves that connect the muscles, skin and internal organs to the spinal cord. It affects the hands and feet most often causing weakness, numbness, tingling, and pain. It is a common disorder affecting about 20 million Americans, most of them older. Despite affecting so many people, it has not received much attention possibly because it is often thought to be just a secondary effect from some other disease such as diabetes or cancer. As a result new treatments are slow to be developed.

There are about 100 different types of neuropathies known. About a third of cases are caused by diabetes. In another third the cause is not known. Autoimmune disorders, tumors, infections, toxins, nutritional deficiencies and heredity also cause neuropathies. Most cases cannot be cured. Peripheral neuropathy can affect all three types of peripheral nerves: sensory nerves that affect sensation, motor nerves that affect muscles, and autonomic nerves that affect internal organ function. Individual symptoms can vary but some symptoms are more common. Early symptoms include numbness, tingling or pain in the feet. Some describe the feeling like having socks or gloves on when they do not. The feeling may spread to the legs and hands. It may become more difficult to walk normally or grip objects. Neuropathy can be so severe as to be debilitating or fatal. Neuropathy awareness is very low. Patients are often told there is nothing that can be done or that their symptoms are imagined and not real.

Treatment of neuropathy is determined by the cause. Early control of blood glucose levels in diabetes can prevent or minimize neuropathy. Vitamin deficiencies can be corrected. Medications are aimed at reducing neuropathic pain. Pain relievers, antidepressants and anti-seizure medications are used to relieve pain. Newer medications Lyrica and Cymbalta have been approved certain neuropathies. Lidocaine, an anesthetic, injected or by topical patch can also offer relief.

A healthy lifestyle including maintaining an ideal body weight, avoiding toxins, a supervised exercise program, a balanced diet, adequate vitamin intake, and limited alcohol intake can help minimize symptoms. B vitamin deficiencies, especially vitamin B-12, are associated with neuropathy. The antioxidant alpha lipoic acid is being studied as helpful to prevent or treat diabetic neuropathy. Early diagnosis and referral to a neurologist is important to maximize treatment and minimize symptoms.

References: http://www.neuropathy.org/site/PageServer?pagename=About_Facts, http://www.umm.edu/altmed/articles/alpha-lipoic-000285.htm, http://nybc.wordpress.com/2009/01/07/using-b-vitamin-supplements-for-peripheral-neuropathy/.

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