What Causes Neuropathy, Its Different Types, And Treatment Options

One of the common mistakes people make when attempting to treat pain is that they assume all pain is the same. As such, they tend to treat any pain they experience using the same methods, whether acute or chronic. However, doing so will never solve the problem; it only provides temporary relief. This is especially the case regarding neuropathy, which can cause multiple symptoms, including mild to severe pain in various forms. The tricky thing about neuropathy is that there are several forms of neuropathy that can lead to many kinds of symptoms. Not to mention, there are many potential underlying causes.

The following is a guide to understanding what neuropathy is, what can cause it, the different types of neuropathy, and the treatment options available.

Neuropathy

Neuropathy is a condition in which various symptoms are experienced as a result of nerve damage. This nerve damage can be caused by numerous diseases, conditions, and even injuries. It occurs when the body’s nerves malfunction, leading to pain, numbness, tingling, and even paralysis.

Neuropathy can affect any system of the body that relies on the nervous system, such as muscles and internal organs. Because neuropathy is complex, it can be challenging to understand what causes the disorder and how to treat it. As such, understanding the basics of the nervous system and its different types, as well as their accompanying symptoms and treatment options, is crucial.

Neuropathy And Our Nervous System

The nervous system is a complex and essential system of the body that helps us control our movements, interpret sensations, and even think. It is comprised of two parts:

• Central Nervous System: The central nervous system is responsible for processing and interpreting incoming sensory information. It includes the brain and spinal cord, forming a communication network between the body and the environment.
  
• Peripheral Nervous System: The peripheral nervous system is responsible for controlling bodily functions, such as movement and the function of organs. The peripheral nervous system connects the central nervous system to the body’s other systems, such as the muscles and internal organs. The peripheral nervous system is divided into two parts:
  
  • Somatic Nervous System: The somatic nervous system is responsible for voluntary movements, such as writing and walking.
  • Autonomic Nervous System: The autonomic nervous system is responsible for involuntary activities like digestion and heart rate.

4 Types Of Neuropathy

Neuropathy is caused by damage to or malformation of the nerve fibers in the peripheral nervous system. When this happens, it can cause various symptoms depending on which nerves are affected. There are four types of neuropathy. Each type has its own set of symptoms. These include the following:

1. Peripheral Neuropathy

Peripheral neuropathy is a disorder that affects your peripheral nerves. These nerves connect your brain and spinal cord to your muscles, internal organs, and skin. Causes of peripheral neuropathy can include injury, infection, or exposure to certain toxins.

It’s estimated that over 20 million people in the U.S. have some sort of peripheral neuropathy. However, because symptoms can sometimes be mild and can be confused with other conditions, many people with peripheral neuropathy are not diagnosed with the disorder.

Signs And Symptoms

Symptoms and signs of peripheral neuropathy include:

• Numbness and tingling in the feet or hands
• Burning sensations
• Loss of coordination
• Weakness in the limbs
• Muscle cramps and spasms
• Loss of reflexes
• Chronic pain

2. Autonomic Neuropathy

Autonomic neuropathy is a disorder that affects your autonomic nervous system. Autonomic nerves control your involuntary bodily functions such as digestion, heart rate, respiration, perspiration, and urination. Damage to the autonomic nerves can be caused by diseases such as diabetes, alcoholism, or any condition affecting the blood vessels. It can also occur on its own. It’s said to affect more than 70 million people worldwide.

Signs And Symptoms

Signs and symptoms of a damaged autonomic nervous system include:

• Diarrhea/constipation
• Nausea and/or vomiting
• Bloating
• Heartburn or acid reflux
• Lightheadedness
• Trouble controlling body temperature
• Sexual dysfunction
• Dizziness or fainting when standing up
• Blurred vision or other vision changes
• Dry mouth and eyes
• Excessive sweating or lack of sweating
• Incontinence
• Slowed digestion or digestive issues
• Difficulty swallowing

3. Focal Neuropathy

Focal neuropathy is a disorder where only one nerve, or group of nerves, is damaged. It can affect any part of your body and can cause a range of symptoms. It’s most commonly seen in older adults, especially those with diabetes or other metabolic disorders. Entrapments, or nerve compression due to trauma, can also cause focal neuropathy.

Signs And Symptoms

Focal neuropathy can occur suddenly, and the symptoms can last anywhere from a few days to a few weeks. However, when caused by chronic conditions like diabetes or HIV/AIDS, it can persist for much longer. Common signs and symptoms of focal neuropathy include:

• Pain
• Numbness
• Weakness
• Tingling
• Loss of sensation
• Paralysis in the affected area

4. Cranial Neuropathy

Cranial neuropathy is a disorder that affects the nerves in your brain. It can affect any of the 12 cranial nerves, which control different functions in your body. Various conditions, such as diabetes, tumors, trauma, infections, or toxins, can cause it. There are several types of cranial neuropathy, and the symptoms can vary depending on which nerves are affected. These types include the following:

Microvascular Cranial Nerve Palsy

Microvascular cranial nerve palsy (also known as ischemic cranial neuropathy) is the most common form of cranial neuropathy. It is caused by the narrowing or blockage of small blood vessels that supply oxygen to the cranial nerves in your brain, leading to nerve damage and a range of possible symptoms. Common signs and symptoms include:

• Double vision
• Facial numbness
• Drooping eyelids
• Loss of taste
• Slurred speech
• Difficulty swallowing or speaking

Bell’s Palsy

Bell’s palsy is another form of cranial neuropathy. It is caused by inflammation in the facial nerve, which can lead to temporary paralysis of the affected side of your face. Common signs and symptoms include:

• Drooping on one side of the face
• Sudden loss of facial movement
• Pain around your ear
• Uncontrollable blinking of one eye
• Difficulty smiling or frowning on one side
• Sensitivity to sound on one side
• Headache pain in the affected area.

Third, Fourth, And Sixth Nerve Palsy

Third, fourth, and sixth nerve palsy are other types of cranial neuropathies. They involve damage to the oculomotor, trochlear, and abducens nerves. Common signs and symptoms include:

• Double vision
• Headaches
• Crossed eyes (strabismus)
• Loss of peripheral vision
• Trouble focusing on near objects
• Drooping eyelids.

What Neuropathic Pain Feels Like

Neuropathy can cause many symptoms, many of which depend on the type of neuropathy and what is causing it. However, one of the common symptoms of neuropathy is nerve pain or neuropathic pain. This type of pain is normally described as a burning, tingling sensation, but it can also feel like a shooting, stabbing, or electricity-like sensation. The following examples are of conditions that can cause such neuropathic pain:

• Postherpetic neuralgia: Postherpetic neuralgia is a complication of herpes zoster (more commonly referred to as shingles) and can cause burning, aching, and sharp pain in the area where the rash appeared. It can last for months or even years after the rash has cleared.
  

• Trigeminal neuralgia: Trigeminal neuralgia causes sharp, shooting pain in the face and jaw. It is caused by damage or irritation to the trigeminal nerve. This nerve is responsible for delivering sensation from the face to the brain. It often feels like a stabbing or electric shock and can be triggered by the slightest touch or movement.
  

• Diabetic neuropathy: Diabetic neuropathy occurs in people with diabetes. It develops because of high blood sugar and can cause various symptoms, including burning, numbness, tingling, or shooting pain in the hands and feet.
  

• HIV-associated peripheral sensory neuropathy: HIV-associated peripheral sensory neuropathy is caused by nerve damage due to HIV infection. HIV infections can damage the nerves by attacking the myelin sheath, which is the nerve fibers’ protective coating. This can lead to burning sensations, numbness, tingling, and shooting pain in the hands, feet, and other areas of the body.
  

• Leprosy: Leprosy is an infection caused by the Mycobacterium leprae bacteria. Leprosy can cause nerve damage as a result of inflammation and tissue damage. The nerve damage lead to a burning, tingling sensation and numbness in the affected area. Other symptoms may include weakness or paralysis of the face and other parts of the body.
• Peripheral nerve injury pain: Peripheral nerve injury pain is caused by peripheral nerve damage, which can result from trauma, surgery, tumors, or radiation. It can cause burning, stabbing, and shooting pain in the affected area.
  

Other Symptoms That Accompanies Neuropathic Pain

The following are additional symptoms known to be associated with neuropathic pain:

• Paresthesia: Paresthesia is the sensation of prickling, tingling, burning, or numbness in the skin. It can result from damage to the nerves that carry sensations from the body to the brain.
• Allodynia: Allodynia occurs when a person feels pain from something that wouldn’t usually cause it. It can occur after nerve damage and can cause a person to experience pain from stimuli that wouldn’t normally be painful, such as light touch or even the air passing over the skin.
• Hyperalgesia: Hyperalgesia is a condition in which pain is felt more intensely than usual. It can be caused by nerve damage and can make even mild sensations of pain feel more intense.
• Dysesthesia: Dysesthesia is a painful sensation that can occur without any stimulation. This means that it can be experienced without anything touching the skin. It commonly affects the hands, feet, and other areas of the body and can cause sensations of burning, itching, stinging, or electric shock.

Causes Of Neuropathy

Even though neuropathy refers to a wide range of symptoms that are caused by damage to the nerves, the underlying cause of nerve damage can vary. In fact, many different things can trigger different types of neuropathy. The following are the common denominators that can lead to neuropathy as well as some of their sub-causes:

Health Conditions

Many different health conditions can lead to nerve damage, thereby causing neuropathy. The following are some of the health conditions known to lead to neuropathy:

Poorly Managed Diabetes

If you don’t manage your diabetes effectively, it can lead to nerve damage and the subsequent development of neuropathy. If your blood sugar levels are too high for too long, it can lead to small blood vessel damage which may cut off oxygen and nutrients to your nerves. This can lead to nerve damage since the nerves no longer receive the oxygen and nutrients they need to remain healthy. As a result, it should come as no surprise that people with diabetes are more prone to developing neuropathy.

Idiopathic Neuropathy

Although many different things can cause neuropathy (including the health conditions listed here), there are times when no underlying cause can be identified. When this is the case, the condition is called idiopathic neuropathy.

Chronic Alcoholism

Chronic alcoholism interferes with the normal functioning of the nerves, leading to nerve damage and neuropathy. This is because chronic alcohol use can lead to malnutrition and can have a toxic effect on the nerves.

Cancer

Certain types of cancer can lead to nerve damage and the subsequent development of neuropathy. For example, people with lymphoma may experience paraneoplastic neuropathy, which is caused by the cancer cells attacking and damaging the nerves.

HIV/AIDS

HIV/AIDS is a condition that prevents the body from fighting off infections due to a weakened immune system. As a result, HIV/AIDS can lead to nerve damage and neuropathy because it increases the risk of infections that can affect the nerves.

Dietary Causes

Certain dietary deficiencies can sometimes lead to nerve damage and neuropathy. This is because deficiencies in specific vitamins and minerals can make it difficult for the body to repair damaged nerves properly. The following are some of the more common dietary causes that can lead to neuropathy:

Vitamin B12 Deficiency

One of eight B vitamins, vitamin B12 is essential to cell metabolism (meaning how cells use energy), red blood cell formation, and nerve function. If you don’t have enough vitamin B12 in your diet, it can lead to a condition known as pernicious anemia. This form of anemia can cause nerve damage by preventing the body’s red blood cells from carrying oxygen to the nerves.

Copper Deficiency

Copper is a mineral vital for the normal functioning of nerve cells because it helps insulate the outer sheath of nerve cells. Without an adequate amount of copper in your diet, your nerves become more vulnerable to damage.

Excess Nutrient Consumption

Although deficiencies in certain vitamins and minerals can lead to nerve damage and neuropathy, consuming too much of some nutrients can also be problematic. For example, an excess of vitamin B6 can cause nerve damage because it can interfere with the body’s production of neurotransmitters.

Exposure To Toxins In Foods

Certain foods, such as shellfish and other seafood, contain toxins that can lead to nerve damage. These toxins include ciguatoxin, maitotoxin, and okadaic acid. Eating foods that contain these toxins can lead to nerve damage by interfering with the normal functioning of nerve cells.

Diagnosis Of Neuropathy

When you consider the different types of neuropathy, all the different symptoms neuropathy can cause, and all of the potential underlying conditions, diagnosing neuropathy and its cause is no simple matter. As such, there are a variety of medical tests and procedures used to diagnose neuropathy, such as the following:

Electrodiagnostic Testing

Electrodiagnostic testing involves using electrodes to measure the electrical signals sent by nerve cells. By recording these signals, doctors can look for abnormalities indicating nerve damage and neuropathy.

Blood Tests

Blood tests are used by doctors to look for certain conditions, such as diabetes, vitamin deficiencies, and infections that could be causing nerve damage. Examples of blood tests used to diagnose neuropathy include complete blood count (CBC) and comprehensive metabolic panel (CMP).

Skin Biopsies

Skin biopsies are a type of procedure used to take a small sample of skin. Skin biopsies can help doctors to identify certain types of nerve damage, such as sensory neuropathy. By looking at nerve fibers under a microscope, doctors can look for signs of damage or disease.

Quantitative Sensory Testing (QST)

Quantitative sensory testing is a procedure used to measure how sensitive a person’s skin is to different stimuli. For example, this test can identify nerve damage by looking for differences in how a person’s skin responds to light touch, pinpricks, and heat.

Different Treatments For Neuropathy

There are several neuropathy treatments available, depending on the kind of neuropathy you have, the types of symptoms you’re experiencing, the severity of the symptoms, and the underlying causes. These include

Medications

Medications such as antidepressants, anticonvulsants, and opioids are commonly prescribed to manage the pain associated with neuropathy. Antidepressants can help to reduce nerve pain by affecting the transmission of signals between nerves. Nonsteroidal anti-inflammatory drugs (NSAIDs) — for example, ibuprofen and naproxen — can reduce inflammation and nerve pain. Opioids such as codeine, oxycodone, and fentanyl can be prescribed for severe neuropathic pain.

Although these medications can help alleviate some of the symptoms of neuropathy, you should understand their potential risks. Some medications are known to be addictive and can also cause side effects. These side effects vary but can include drowsiness, nausea, constipation, dizziness, and more. On top of that, medications won’t address the underlying cause of neuropathy — they’ll only mask the symptoms.

Surgery

In some cases, a more conventional doctor might recommend surgery to treat neuropathy. For example, if the nerve damage is caused by spinal stenosis (narrowing of the spine) or a herniated disc, surgery can help release pressure on the affected nerves. In other cases, such as carpal tunnel syndrome, releasing pressure on compressed nerves in the wrist by cutting away any extra tissue can help to alleviate symptoms.

Of course, like pain medications, surgery comes with its share of risks. Surgery is invasive, which means there is a chance of complications, such as infection, allergic reaction, and nerve damage. Additionally, the recovery time can be long, depending on how complicated the surgery was. Not to mention, there’s no guarantee that the surgery will be successful.

Nerve Stimulation

Electrical stimulation (e-stim) treatments are another option for treating neuropathy. Transcutaneous Electrical Nerve Stimulation (TENS) is one type of nerve stimulation therapy that uses low levels of electrical currents that stimulate the nerves and reduce pain. However, TENS is generally only effective for providing short-term relief. In the case of chronic pain, electroanalgesia is more appropriate.

Electroanalgesia uses a high pulse rate (up to 10,000 pulses per second) to deliver electrical currents deeper into the nerves than TENS is capable of doing. As a result, electroanalgesia can provide long-term relief by stimulating the release of endorphins, blocking pain signals to the brain, increasing circulation, and reducing inflammation. Electroanalgesia is an FDA-cleared therapy that is a critical component of our Relatyv protocol, which uses a whole-person approach to treating chronic pain.

Alternative And Complementary Therapies

In addition to more traditional treatments, there are alternative and complementary therapies that may help manage neuropathy. Alpha lipoic acid, for example, is an antioxidant found to reduce nerve pain in some people with peripheral neuropathy. Acetyl-L-carnitine is another supplement that may help reduce nerve pain, as well as other symptoms associated with the condition.

However, speak with a medical professional before you take any supplements, as some may interact with medications or other treatments negatively. Additionally, it’s vital to ensure that any supplements you take are of high quality and reliable.

In addition to supplements, yoga, massage, acupuncture, and biofeedback are some of the many alternative therapies that may help reduce nerve pain or other neuropathy symptoms. Discussing the various options with your doctor before pursuing any of these therapies is best.

Diet And Proper Nutrition

Eating a balanced diet is a critical part of managing neuropathy. Eating foods rich in essential nutrients, like B vitamins and Omega-3 fatty acids, can help to decrease inflammation and improve nerve health. Additionally, it’s essential to avoid foods that may be inflammatory or can cause blood sugar fluctuations, as these can worsen neuropathy symptoms. Finally, staying hydrated is crucial, as dehydration can exacerbate neuropathy symptoms.

Prognosis Of Neuropathy

The prognosis of neuropathy depends on the underlying condition causing it and how quickly it progresses. In some cases, such as diabetic neuropathy, you can manage the condition with certain lifestyle changes. In these cases, symptoms may improve over time, and the prognosis is generally good. However, in other cases, such as neuropathy caused by a tumor or traumatic injury, the outlook may be more serious, and a more aggressive treatment plan may be necessary.

No matter what the cause, managing neuropathy requires a combination of lifestyle changes and treatments that focus on addressing the underlying cause to help provide long-term relief.

Seek The Most Effective And Safest Neuropathy Treatment

Neuropathy is a complicated condition to treat, and it’s vital to have an experienced team of experts dedicated to finding the most effective and safest treatment option. At Relatyv, we use a whole-person approach to treating chronic pain, which includes electroanalgesia, IV therapy, and lifestyle counseling. We address each patient’s individual needs by developing personalized treatment plans that may help provide long-term pain relief.