Neuropathy is a progressive disease which occurs when the body’s nerves have become damaged. It can be caused by:
There are over one hundred types of neuropathy each with their own cause and symptoms.
When nerves become damaged, it affects the way they are supposed to work, which in turn will cause pain and discomfort for a person. Sensory nerves control sensation. When these nerves are damaged, loss of sensation will occur along with tingling, numbness, burning, and weakness—usually in the hands and feet. When motor nerves are affected, this inhibits power and movement in muscles, causing weakness, cramps, twitching, paralysis, and over a long period of time even muscle waste. Neuropathy can also only affect a body system such as the digestive system or cardiovascular system when the autonomic nerves are damaged. This can affect the blood pressure and heart rate causing dizziness, bowel and bladder function, and can also cause sweating, also sudden onset can occur like muscle atrophy of specific body parts.
Diabetic neuropathy is a type of peripheral neuropathy, where the nerve damage was caused by uncontrolled blood sugar levels. Neuropathy affects nearly 60% of the diabetic population and is a progressive disease that usually manifests in people over age forty, overweight, with high blood pressure, and those who have difficulty keeping their blood sugar levels steady. Developing neuropathy can depend on the how well a person controls their diabetes but it has also been found in those only exhibiting pre-diabetic symptoms. Symptoms of diabetic neuropathy start with the tingling and numbness in the hands, feet, and or legs but could eventually lead to indigestion, nausea, vomiting, diarrhea or constipation, problems urinating, erectile dysfunction, and vaginal dryness. In advanced cases of diabetic neuropathy, muscle weakness and loss of reflexes are very common, especially in the ankle.
A serious danger of diabetic neuropathy is the development of wounds. Because of the loss of sensation in the lower extremities, lesions and ulcers can easily become infected. Without the sensory nerves working properly, stepping on a sharp rock and cutting the foot could lead to an infected wound because of the inability to feel the pain when the injury happens. Diabetics are much more susceptible to infections because of how blood glucose levels affect the whole body. Their circulation is poor because blood vessels stiffen, restricting and/or cutting off blood flow when blood glucose levels are high. The immune system itself is decreased when the glucose is too high. The healing process in a diabetic is very slow and if not carefully watched it can worsen very quickly leading to infection, up to a possible amputation.
How is neuropathy diagnosed?
There are multiple evaluations a doctor can administer for diagnosing neuropathy. A neurological evaluation is an exam of neurological function, muscle strength, testing different sensations, as well as autonomic nerve function. Electrodiagnostic test which is most common to pinpoint a neuropathy diagnosis through electromyography (EMG) and nerve conduction velocity (NCV). These measure the electrical activity of the nerves and muscles which can show the extent and cause of the damage. A simple blood test can also tell a doctor if neuropathy is present. This test will show any vitamin deficiencies (B vitamins), toxic elements, or any abnormal immune responses.
Although there is no cure for this condition, there are ways to treat and prevent further nerve damage. Over the counter medications can be used to relieve discomfort and pain or prescriptions for severe cases. Maintaining a healthy weight with diet and exercise is helpful to keep blood sugar levels down. Physical therapy may be recommended to regain or to maintain muscle strength. It is important to utilize safety measures to compensate for the loss of sensation in the lower extremities including special care of feet. Check for any sores or redness, wear sensible shoes, and keep clean. The type of neuropathy will determine what type of treatment the doctor may advise.