Neuropathy is damage to the nerves outside the brain and spinal cord, and it often begins as numbness, tingling or burning in the feet or hands. Get medical care right away for those symptoms. Tingling or weakness that spreads quickly up the body, or trouble breathing, needs 911 or the emergency room.
How Neuropathy Can Start
Mayo Clinic describes a feeling of wearing socks or gloves that are not there. Pain can come from a blanket resting on your feet, and a stumble may have no clear reason. It usually builds slowly.
So many conditions can damage nerves that the first question is what is behind it. The answer shapes what comes next, including which doctors you need.
Peripheral Neuropathy Explained
Peripheral neuropathy, often just called neuropathy, is damage to the nerves outside the brain and spinal cord. More than 100 types have been identified. It usually brings numbness, weakness or pain in the hands and feet. The symptoms depend on which nerves are hurt and how badly.
Most neuropathy involves many nerves at once, which doctors call polyneuropathy. Symptoms tend to show up first in the feet, the part of the body farthest from the brain, and can spread upward. One nerve can also be affected alone, as with carpal tunnel syndrome at the wrist.
Sensory nerves
These carry messages about touch, temperature and pain. Damage can bring tingling, burning, numbness or a lost sense of where your feet are.
Motor nerves
These move your muscles. Damage can bring weakness, cramps, twitching or shrinking muscles.
Autonomic nerves
These run things you do not think about, such as blood pressure, sweating, digestion and bladder control. Damage can bring heat intolerance or dizziness when you stand.
The National Institute of Neurological Disorders and Stroke's guide to peripheral neuropathy says symptoms may develop over days, weeks or years, and range from mild to severe.
Neuropathy Symptoms to Notice
- Numbness, prickling or tingling that builds gradually in the feet or hands
- Burning, stabbing or throbbing pain
- Pain from a light touch
- Symptoms that are worse at night
- Muscle weakness or cramps
- Poor coordination or falls
- Sweating too much or being unable to sweat
- Bladder, bowel or digestive trouble
Neuropathy Warning Signs
Call 911 or go to the ER for tingling or weakness that spreads quickly or climbs from your feet, trouble catching your breath, shortness of breath when lying flat, or choking on saliva. These can signal Guillain-Barre syndrome, a rare nerve condition that can get worse fast and needs a hospital.
Emergency care is also needed for
- Sudden numbness or weakness in your face, an arm or a leg, especially on one side
- Sudden confusion or trouble speaking
- New bladder or bowel problems with low back pain or leg weakness
- Numbness in your upper legs or buttocks
Get medical care right away for
- Tingling, weakness or pain in your hands or feet that is new or has not been checked
- A blister, cut or sore on a numb foot
- Any other new foot problem if you have diabetes
Mayo Clinic's page on Guillain-Barre syndrome says weakness and tingling in the hands and feet are usually the first symptoms.
What Can Damage Peripheral Nerves
Diabetes and metabolic syndrome
These are the most common causes. Over time, high blood sugar and high levels of fats in the blood can harm nerves.
Cancer treatment and other medicines
Chemotherapy is the best known example, and symptoms can continue long after it ends. Some drugs for HIV, the heart, infections or seizures can occasionally cause it too. Talk with a doctor before you stop any medicine.
Low vitamin levels and alcohol
A shortage of vitamin B-12 is a known cause, and so is too much B-6. Heavy drinking can harm nerves and also lower vitamin levels.
Autoimmune conditions
In lupus, rheumatoid arthritis and Sjogren syndrome, the immune system can attack nerves directly, or tissue around them can press on the nerves.
Infections
Shingles, Lyme disease, hepatitis B and C and HIV are among the infections that can affect nerves.
Injury or pressure on a nerve
A car accident, a fall or a sports injury can damage a nerve. So can steady pressure from a cast, crutches or a motion repeated all day, such as typing.
Kidney, liver and thyroid problems
Kidney and liver disorders can leave toxins in the blood that harm nerve tissue. An underactive thyroid is another possible cause.
Mayo Clinic's overview of peripheral neuropathy says more than half of people with diabetes develop some type of it.
Tumors, inherited conditions and toxins such as lead can also cause it. Sometimes no cause is found, which doctors call idiopathic neuropathy.
How We Approach Neuropathy in Towson
Care may look for the root cause first, and a cause such as diabetes or low vitamins also needs your own doctor. Services like these may be recommended depending on your condition, based on our comprehensive evaluation.
Class IV Laser Therapy
The laser is a handheld, noninvasive device that emits light. It may be used for peripheral neuropathy, including nerve pain and numbness, tingling or burning in the hands and feet.
Your evaluation covers your health history, including any implanted device, pregnancy or medicines, to determine if you are a candidate. Tell us if the area is numb, as part of your evaluation.
Chiropractic
A chiropractor may use spinal adjustment as one strategy once the root cause has been looked at.
The chiropractor carefully evaluates each condition to determine if you are a candidate for gentle chiropractic treatment. Numbness, tingling or weakness is carefully screened, including orthopedic and neurologic testing, to isolate the cause and how your symptoms present.
Where Neuropathy Care Can Come From
Treatment depends on the type of nerve damage and what caused it. This table is not a full list, and most of it happens outside our clinic. Your doctor or a neurologist can talk through others.
| Option | What it involves | Who provides it |
|---|---|---|
| Treating the cause | Managing diabetes, correcting low vitamin levels or treating the condition behind the nerve damage. | Your doctor or a specialist |
| Medicine for nerve pain | Certain antiseizure medicines and antidepressants, which can cause drowsiness or dizziness. | Your doctor or a neurologist |
| Creams and patches | Lidocaine applied to the skin over a painful area. | You, after asking your doctor or pharmacist |
| Braces and walking aids | Hand or foot braces, orthopedic shoes, a cane or a walker for weakness or balance trouble. | Your doctor can advise you |
| Class IV laser therapy | A handheld device that emits light. | This clinic, if recommended |
| Chiropractic adjustments | Hands-on work on the joints of the spine. | A chiropractor at this clinic, if recommended |
| Surgery | The National Institute of Neurological Disorders and Stroke says surgery does not help most neuropathy. Pressure on a nerve, such as from a tumor, may need it. | A surgeon |
When to See Your Doctor or a Neurologist
Numbness, tingling or nerve pain should be checked, and your primary care doctor is the usual place to start. You may then be referred to a neurologist, a doctor trained in nervous system conditions.
Expect questions about your symptoms, alcohol use, toxin exposure and family history. An exam checks your reflexes, strength, feeling and balance. Your doctor or neurologist may order blood work, an MRI or CT scan, or electromyography with a nerve conduction study.
Looking after numb feet
You may not feel a blister or a cut on a numb foot. Check your feet every day, wear soft socks and padded shoes that fit well, and get small injuries looked at early.
The National Institute of Diabetes and Digestive and Kidney Diseases' page on diabetic peripheral neuropathy says foot sores and infections can lead to the loss of a toe, a foot or part of a leg.
Seeing Us About Neuropathy on E Joppa Rd
A first visit may open with detailed questions about your history. If your own doctor or a neurologist already treats you, care here may be combined with that treatment, and the team may send you to another provider for anything it cannot help with.
Parkville, Hillendale and Idlewylde
Parkville lies about 2 miles southeast of the clinic, and Carney is farther out to the east, about 3 miles. Closer in to the south, Hillendale is nearby at about 1.3 miles, with Idlewylde at about 1.6 miles.
Schedule a Neuropathy Evaluation
It helps to note where your symptoms started, whether you have diabetes and every medicine you take, including past chemotherapy. Bring any test results you already have. Call the clinic with questions about cost or insurance.