FAQs on Peripheral Neuropathy and Treatment Options in Nashville & Murfreesboro TN

Peripheral nerves transfer information to and from the brain, and they carry signals from the spinal cord to the body. When the peripheral nerves are damaged and do not work properly, the condition is referred to as peripheral neuropathy. Usually, peripheral neuropathy is damage to a group of nerves, but it involve only a single nerve.

How common is peripheral neuropathy?

The prevalence of peripheral neuropathy is reported at 16.5 million, according to the American Neuropathy Association. However, some statistics report that more than 20 million people in the US have some type of neuropathy.

What causes peripheral neuropathy?

Neuropathy is quite common, and diabetes is the most common cause of this condition. High levels of blood sugary (glucose) damage the nerves over time. Other conditions that cause neuropathy are autoimmune disorders, chronic kidney disease, liver disease, metabolic disease, underactive thyroid gland, low levels of vitamin B12, and HIV.

What are the risk factors for peripheral neuropathy?

  • Diabetes
  • Broken bones
  • Long-term alcohol use
  • Taking certain drugs
  • Carpal tunnel syndrome
  • Being exposed to cold temperatures for long periods of time

What are the symptoms of peripheral neuropathy?

The symptoms of neuropathy depend on the nerve that is damaged. Symptoms include pain, numbness, and tingling, as well as muscle problems, which result in profound weakness. A person with neuropathy many have trouble moving a part of the body and fall because the legs buckle. Many people with peripheral neuropathy have trouble standing for long periods of time.

What are the treatment options for peripheral neuropathy?

The pain associated with neuropathy is treated with several options. However, the goal of therapy is to cure or control the underlying cause of the neuropathy. Treatment options include:

  • Medications – Several drugs are approved to treat the pain associated with neuropathy. Anti-seizure drugs are often used, including Gralise and Neurotin. Topical agents can be applied to the painful extremity, such as camphor, menthol, and capsaicin. Opioids are prescribed for severe pain that does not respond to other treatment options.
  • Ganglion impar block – In this procedure, the terminal sympathetic nerves are treated with a local anesthetic, and possibly, a corticosteroid. To do this, the doctor positions a small needle near the lower back region of the spine under x-ray guidance. A recent study of patients who had this block reported pain score decrease of 50% or more at the two-month follow-up visit.
  • Selective nerve root block (SNRB) – With this technique, the doctor inserts a tiny needle near the spinal cord and injects a long-acting numbing agent. The success rate of this block is 70%, according to clinical studies.
  • Epidural steroid injection (ESI) – The epidural space lies between the spinal cord and the epidural, a thin protective layer of tissue. With ESI, the doctor inserts a small needle into the epidural space and injects a steroid agent. In a recent study, the efficacy rate of ESI was found to be 90%.

Resources

Kotani N, Kushikata T, Hashimoto N, et al. (2000). Intrathecal methylprednisolone for intractable postherpetic neuralgia. N Engl Jour Med, 343:1514-1519.

National Institute of Neurological Disorders (2014). Peripheral neuropathy fact sheet. Retrieved from: http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm

Riew KD, Park JB, Cho YS, et al (2006). Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follow-up. J Bone Joint Surg Am, 88(8):1722-5.