Peripheral Neuropathy

This is the lovely issue I have with both feet. It's great fun, kind of like my feet are on fire. Peripheral neuropathy, a result of nerve damage, often causes numbness and pain in your hands and feet.

People typically describe the pain of peripheral neuropathy as tingling or burning, while they may compare the loss of sensation to the feeling of wearing a thin stocking or glove.Yup, burning and tingling, if I don't take enough of the meds it becomes more burning than tingling.

Peripheral neuropathy can result from problems such as traumatic injuries, infections, metabolic problems and exposure to toxins. One of the most common causes is diabetes. Or in my case apparently just happen for no apparent reason.

In many cases, peripheral neuropathy symptoms improve with time — especially if the condition is caused by an underlying condition that can be treated. A number of medications often are used to reduce the painful symptoms of peripheral neuropathy.


Most commonly, peripheral neuropathy starts in the longest nerves — the ones that reach to your toes. Symptoms vary, depending on which types of nerves are affected. Signs and symptoms may include:

• Gradual onset of numbness and tingling in your feet or hands, which may spread upward into your legs and arms. Gradual my ass
• Burning pain
• Sharp, jabbing or electric-like pain
• Extreme sensitivity to touch, even light touch
• Lack of coordination
• Muscle weakness or paralysis if motor nerves are affected
• Bowel or bladder problems if autonomic nerves are affected Oh fabulous, so I can look forward to pissing myself? 

 

What causes neuropathy?

About 30% of neuropathy cases are considered idiopathic, which means they are of unknown cause. Another 30% of neuropathies are due to diabetes. In fact, about 50% of people with diabetes develop some type of neuropathy. The remaining cases of neuropathy, called acquired neuropathies, have several possible causes, including:

• Trauma or pressure on nerves, often from a cast or crutch or repetitive motion such as typing on a keyboard(This caused neuropathy in my hands which at this point seems to have improved greatly. Or just moved south)


• Nutritional problems and vitamin deficiencies, often from a lack of B vitamins


• Alcoholism, often through poor dietary habits and vitamin deficiencies


• Autoimmune diseases, such as lupus, rheumatoid arthritis, and Guillain-Barre syndrome


• Tumors, which often press up against nerves


• Other diseases and infections, such as kidney disease, liver disease, Lyme disease, HIV/AIDS, or an underactive thyroid (hypothyroidism)


• Inherited disorders (hereditary neuropathies), such as Charcot-Marie-Tooth disease and amyloid polyneuropathy


• Poison exposure, from toxins such as heavy metals, and certain medications and cancer treatments 

The only one of these that is a possible issue with me is the nutritional aspect. I've been upping my vitamin intake and even had the doctor test my levels. All is normal. I'm starting to wonder if it's not from sitting so much. Another reason to get off my ass and move.

How is neuropathy treated?
There are a variety of treatments available for peripheral neuropathy. They range from traditional pills and creams to special diets and therapies that stimulate the nervous system. Antidepressants, especially tricyclics and selective serotonin-norepinephrine re-uptake inhibitors (SNRI's), are a favored treatment for neuropathies. They will relieve neuropathic pain in non-depressed persons. Another class of medicines commonly prescribed for neuropathy is that of anticonvulsants. These medicines block calcium channels on neurons to limit pain. Opioid narcotic treatments for neuropathy are used as well to treat the condition, but are less favored because of the risk of dependency. However, opioids have been the most consistently effective in reducing pain.
The doctor has me on anticonvupsants. Gabapentin to be specific. It works, sort of. But the side effect is sleep. Exhaustion more accurately. The stuff puts me on my ass. Apparently some people actually use it as a sleep aid. So I'm trying to find the magic dose that allows me to stay awake and functional but keeps the pain to a minimum.
 
For some types of neuropathy, such as post-herpes neuralgia, physicians recommend treatment with a topical anesthetic such as lidocaine. Topical applications of capsaicin (the chemical that makes peppers hot) has also been used to treat neuropathic pain.

Alternative therapies for peripheral neuropathy include cannabinoids (an class of chemicals found in marijuana), Botulinum Toxin Type A (better known as Botox), NMDA antagonists (such as ketamine), dietary supplements (such as alpha lipoic and benfotiamine), chiropractic massages, yoga, meditation, cognitive therapy, and accupuncture.
I swear I'm about ready to start smoking pot. 
 
A final class of therapies for neuropathy are called neuromodulators. These include both implantable and non-implantable technologies (electrical and chemical) such as spinal cord stimulators, implanted spinal pumps, electrodes that stimulate the motor cortex of the brain, and methods called deep brain stimulation.
Ohhhh, those sound fun. OK, not. No implanting nothin, nope, aint happening. Though I will say, sometimes when the pain gets bad I start to think amputation wouldn't totally suck. Yes, the pain is that bad.

To explain. Imagine dousing your feet in gas and then lighting them on fire. That's what it feels like. Or sticking your feet in a scalding hot bath tub. And nothing really makes the pain go away.