Peripheral neuropathy 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.

Peripheral neuropathy is caused by nerve damage. It can result from such problems as traumatic injuries, infections, metabolic problems and exposure to toxins. One of the most common causes is diabetes.
In many cases, peripheral neuropathy symptoms improve with time, especially if it is caused by an underlying condition that can be treated. A number of medications are often used to reduce the painful symptoms of peripheral neuropathy.

Symptoms

Your nervous system is divided into two broad categories. Your central nervous system consists of your brain and spinal cord. All the other nerves in your body are part of your peripheral nervous system. Peripheral neuropathy affects those nerves, which include:

1) Sensory nerves to receive feelings such as heat, pain or touch
2) Motor nerves that control how your muscles move
3) Autonomic nerves that control such automatic functions as blood pressure, heart rate, digestion and bladder function

Most commonly, peripheral neuropathy may start in the longest nerves, the ones that reach to your toes.

Specific symptoms vary, depending on which types of nerves are affected. Signs and symptoms may include:

1) Gradual onset of numbness and tingling in your feet or hands, which may spread upward into your legs and arms
2) Burning pain
3) Sharp, jabbing or electric-like pain
4) Extreme sensitivity to touch, even light touch
5) Lack of coordination
6) Muscle weakness or paralysis if motor nerves are affected
7) Bowel or bladder problems if autonomic nerves are affected

Causes

It's not always easy to pinpoint the cause of peripheral neuropathy, because a number of factors can cause neuropathies. These factors include:

1) Trauma or pressure on the nerve. Traumas, such as motor vehicle accidents, falls or sports injuries, can sever or damage peripheral nerves. Nerve pressure can result from using a cast or crutches, spending a long time in an unnatural position, or repeating a motion many times, such as typing.

2) Diabetes. When damage occurs to several nerves, the cause frequently is diabetes. At least half of all people with diabetes develop some type of neuropathy.

3) Vitamin deficiencies. B vitamins; B-1, B-6 and B-12, are particularly important to nerve health. Vitamin E and niacin also are crucial to nerve health.

4) Alcoholism. Many alcoholics develop peripheral neuropathy because they have poor dietary habits, leading to vitamin deficiencies.

5) Infections. Certain viral or bacterial infections can cause peripheral neuropathy, including Lyme disease, shingles (varicella-zoster), Epstein-Barr, hepatitis C and HIV/AIDS.

6) Autoimmune diseases. These include lupus, rheumatoid arthritis and Guillain-Barre syndrome.

7) Other diseases. Kidney disease, liver disease and an underactive thyroid (hypothyroidism) also can cause peripheral neuropathy.

8) Inherited disorders. Examples include Charcot-Marie-Tooth disease and amyloid polyneuropathy.

9) Tumors. Growths can form directly on the nerves themselves, or tumors can exert pressure on surrounding nerves. Both cancerous (malignant) and noncancerous (benign) tumors can contribute to peripheral neuropathy.

10) Exposure to poisons. These may include some toxic substances, such as heavy metals, and certain medications — especially those used to treat cancer (chemotherapy).

Western Medicine Treatment

One goal of treatment is to manage the condition causing your neuropathy. If the underlying cause is corrected, the neuropathy often improves on its own. Another goal of treatment is to relieve the painful symptoms. Many types of medications can be used to relieve the pain of peripheral neuropathy:

1) Pain relievers. Mild symptoms may be relieved by over-the-counter pain medications. For more severe symptoms, your doctor may recommend prescription painkillers. Drugs containing opiates, such as codeine, can lead to dependence, constipation or sedation, so these drugs are generally prescribed only when other treatments fail.

2) Anti-seizure medications. Drugs such as gabapentin (Neurontin), topiramate (Topamax), pregabalin (Lyrica), carbamazepine (Tegretol) and phenytoin (Dilantin) were originally developed to treat epilepsy. However, doctors often also prescribe them for nerve pain. Side effects may include drowsiness and dizziness.

3) Lidocaine patch. This patch contains the topical anesthetic lidocaine. You apply it to the area where your pain is most severe, and you can use up to four patches a day to relieve pain. This treatment has almost no side effects except, for some people, a rash at the site of the patch.

4) Antidepressants. Tricyclic antidepressant medications, such as amitriptyline and nortriptyline (Pamelor), were originally developed to treat depression. However, they have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain. The serotonin and norepinephrine reuptake inhibitor duloxetine (Cymbalta) also has proved effective for peripheral neuropathy caused by diabetes. Side effects may include nausea, drowsiness, dizziness, decreased appetite and constipation.

5) Transcutaneous electrical nerve stimulation (TENS). In this therapy, adhesive electrodes are placed on the skin and a gentle electric current is delivered through the electrodes at varying frequencies. TENS has to be done frequently, but some people report this therapy improves their symptoms.

Adopted from mayoclinic.com