Understanding Neuropathy

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Neuropathy is a condition where the nerves outside the brain and spinal cord become damaged, leading to symptoms such as pain, tingling, and numbness. Causes include diabetes, traumatic injuries, infections, or prolonged exposure to toxins. Today, it is estimated that up to 10% of the general population^[1] experience neuropathic pain to some extent.

Often, neuropathy is chronic and progresses over time, significantly impacting quality of life and overall health. Each individual’s experience with neuropathy is unique, making personalized care essential. At Compass Pain and Wellness, we specialize in addressing the whole person rather than just the symptoms. Our tailored treatments empower patients to navigate their unique paths toward improved quality of life.

What Is Neuropathy?

The peripheral nervous system refers to the nerves located outside of the brain and spinal cord. It connects the central nervous system (CNS)—or the nerves in the brain and spinal cord—to limbs and organs, playing a crucial role in transmitting signals throughout the body.

It comprises three primary types of nerves:

Motor nerves: Enable muscle movement by transmitting signals from the brain and spinal cord.
Sensory nerves: Transmit sensory information like temperature, pain, and touch.
Autonomic nerves: Control involuntary bodily functions such as heart rate and digestion.

Neuropathy occurs when these nerves are damaged, interrupting communication between the CNS and the rest of the body. It is a common condition, affecting millions of people in the US alone^[2].

Symptoms can vary in location and intensity depending on the type of nerve affected and the root cause of neuropathy. Typically, patients experience:

Tingling or numbness
Sharp, burning pain
Muscle weakness
Loss of coordination
Sensitivity to touch
Digestive issues
Dizziness or lightheadedness

When sensory nerves are severely affected, you may feel as if you’re wearing a glove. These symptoms are initially felt in the extremities and radiate to the limbs and core over time. Similarly, extended motor nerve damage could lead to paralysis, while autonomic nerve issues might cause heat intolerance, excessive sweating, low blood pressure, and bladder control problems.

If left unaddressed, neuropathy can lead to disability, complications, and a significant decline in quality of life.

Types Of Neuropathy

Neuropathy is not a single disorder but a collection of conditions affecting various parts of the nervous system. Understanding its types helps in addressing specific symptoms and impacts on life.

Peripheral neuropathy: This is the most common type, affecting motor, sensory, and autonomic nerves. Often arising from diabetes, injuries, or infections, it leads to chronic pain and sensory changes, impacting mobility and quality of life.
Autonomic neuropathy: This type of neuropathy involves damage to the autonomic nerves, which control heart rate, blood pressure, and digestion, among other involuntary functions. This condition often originates from systemic diseases, infections, or injuries to the brain or spinal cord, and it can significantly alter body function or lead to disability.
Focal neuropathy: This is damage to specific nerves, often causing sudden weakness or pain in a localized area. This type can result from physical compression or injury, and it primarily affects the region involved.
Proximal neuropathy: Proximal neuropathy impacts nerves in the thighs, hips, or buttocks, leading to pain and muscle weakness. Although rare, this condition can be disabling, limiting movement and independence. It is more commonly seen in older adults and is associated with type 2 diabetes^[3].
Cranial neuropathy: Cranial neuropathy affects the cranial nerves that manage sensory and motor functions in the head and neck. This condition can arise from infections or vascular issues and may severely impact vision, hearing, and facial movement. A specific type of cranial neuropathy, trigeminal neuropathy^[4], involves the trigeminal nerve, which controls sensation in the face and causes severe pain.

Symptoms Associated With Neuropathy

The symptoms of neuropathy can vary in type, location, and intensity. All of them stem from the fact that disrupted nerve pathways impair communication between the brain, spinal cord, and other body parts.

Depending on whether motor, sensory, or autonomic nerves are affected, you may experience symptoms like the inability to feel or control parts of the body, usually the extremities. Autonomic nerve disruption, on the other hand, can lead to problems with involuntary functions such as digestion.

In any case, if left unaddressed, the symptoms of neuropathy can worsen alongside the progression of nerve damage. Over time, they can impact all aspects of life and lead to disability. Here are some common symptoms that may warrant a medical consultation:

Radiating Nerve Pain

Radiating nerve pain from compression or damage may cause tingling, weakness, or numbness in the limbs.

Chronic Leg Pain

Chronic leg pain may result from nerve, circulation, or joint issues, often affecting comfort and mobility.

Muscle Weakness

Muscle weakness may stem from nerve, muscle, or joint issues, making movement and activity more difficult.

Loss Of Sensation In The Upper Body

Loss of sensation in the upper body may signal nerve damage, affecting coordination and daily function.

Difficulty With Fine Motor Skills

Difficulty with fine motor skills may result from nerve, muscle, or joint issues, affecting daily tasks.

Localized Pain

Localized pain in one area may result from injury, inflammation, or nerve issues, impacting movement.

Tingling And Numbness

Restricted range of motion may result from stiffness, inflammation, or damage, making movement difficult.

Muscle Spasms

Muscle spasms are sudden contractions from nerve issues, dehydration, or fatigue, causing pain and stiffness.

Common Causes Of Neuropathy

Neuropathic pain can affect anyone, at any stage of life and, in up to 30% of cases^[5], it has no known cause. Often, this condition arises from a combination of risk factors rather than a single cause. These factors can accelerate nerve damage or make individuals more susceptible to conditions that lead to neuropathy.

A few significant risk factors include:

Age: Older adults are more prone to developing neuropathy.
Alcohol and tobacco use: These substances are known to damage the protective sheath of the nerves, called myelin. They also increase the risk of nutritional deficiencies and lead to vascular problems, which can further aggravate nerve damage.
Family history: Genetic predisposition can influence nerve health.
Prolonged exposure to toxins: Certain chemicals can have neurotoxic effects, leading to nerve damage over time.
Repetitive movements: Overuse of certain body parts can cause nerve compression and speed up deterioration.
Sedentary lifestyle: Lack of movement can impair circulation, restricting the supply of oxygen and nutrients to nerve fibers, and causing their death.

Understanding these risk factors is crucial, as they provide context for the causes of neuropathy below.

Diabetes

A 2019 study^[6] suggests that over half of adults with diabetes also live with neuropathy. It typically manifests as peripheral neuropathy but can also involve autonomic, focal, or proximal neuropathies.

Nerve damage occurs because elevated blood sugar levels can lead to a buildup of sorbitol, which can harm nerve fibers and disrupt normal neural function. Regular monitoring and managing blood sugar levels are crucial to prevent or reduce the severity of neuropathic symptoms in diabetic patients.

Trauma Or Injury

Trauma or injury can cause neuropathy when physical damage disrupts nerve structure or signal transmission. This can occur due to sudden impacts, compression, or severing of nerves.

Common examples include car accidents, falls affecting the spine or limbs, and fractures that pinch or compress nerves. These injuries can lead to immediate and long-term neuropathic pain, muscle weakness, or sensory disturbances.

Viral And Bacterial Infections

Certain viral or bacterial infections can lead to neuropathy by directly attacking nerve tissues or by causing ongoing inflammation, which can cause nerve degeneration. Examples include:

Herpes zoster or shingles, which causes postherpetic neuralgia
Bacteria such as those responsible for Lyme disease
Guillain-Barre syndrome
HIV/AIDS: globally, 30-60% with HIV^[7] are also diagnosed with neuropathy

Autoimmune Diseases

In autoimmune diseases, the immune system mistakenly attacks the body’s own healthy tissues, which may include nerve fibers. Conditions such as lupus, rheumatoid arthritis, and Sjögren’s syndrome can lead to chronic inflammation. Over time, this systemic inflammation damages the myelin sheath and impairs signal transmission.

This can result in symptoms like numbness, tingling, or muscle weakness, depending on which nerves are affected. For this type of neuropathic symptom, treatments often focus on managing the autoimmune response.

How Is Neuropathy Diagnosed?

Early diagnosis is crucial as it helps prevent further nerve damage and manage symptoms more effectively through targeted treatments. However, diagnosing neuropathy requires a comprehensive approach due to its many potential causes. Common diagnostic tools include:

Physical Exam

A thorough physical exam is often the first step in diagnosing neuropathy. This includes evaluating sensory and motor functions, reflexes, and muscle strength.

A physician may also carry out a comprehensive review of your medical history to identify patterns or risk factors such as previous illnesses, family history, or lifestyle factors that may increase the risk of neuropathy, such as poor general health, smoking, or drinking alcohol.

Nerve Conduction Studies

Nerve conduction studies are essential in diagnosing neuropathy. They assess the speed and strength of electrical signals traveling along the nerves. These studies are performed by placing electrodes on the skin over nerves and muscles. Then, the physician will provide some stimuli to measure changes in the electrical activity.

This helps identify which nerves are affected and the extent of the damage, providing insight into the specific type of neuropathy.

Blood Tests

Blood tests are conducted to uncover underlying conditions that may contribute to neuropathy, such as diabetes, rheumatoid arthritis, vitamin deficiencies, or kidney dysfunction.

By analyzing blood samples, healthcare providers can detect imbalances or conditions that might lead to or aggravate nerve damage.

Complications Of Untreated Neuropathy

Peripheral neuropathy (PN) can have serious complications, especially when linked to chronic or inflammatory conditions like diabetes. As neuropathy progresses, nerve damage often worsens, increasing the risk of debilitating health issues.

Chronic neuropathic symptoms, including pain and activity limitation, also impact mental health. Studies^[11] show high rates of depression (65.6%) and anxiety (73.7%) among people with untreated neuropathy. Additionally, around 70% of people^[12] with nerve damage also experience poor sleep quality. These complications can lead to fatigue, isolation, dysfunction, and declining mental health, creating a cycle that affects all aspects of life.

Managing this condition in a proactive way is critical to prevent this cascade of complications and reduce the risk of permanent damage.

Chronic Pain And Disability

Untreated neuropathy can lead to chronic pain and mobility limitations, especially as nerve damage is allowed to progress further. Persistent pain can severely impact a person’s ability to perform daily activities, reducing quality of life and potentially leading to disability.

Infections And Injuries

Neuropathy often reduces sensation in the extremities, increasing the risk of unnoticed injuries or infections, especially in areas that are not always visible. Simply put, if you can’t feel your toes, you may not notice a cut or scrape, which can become infected and lead to ulcers.

For instance, foot ulcers are a common complication of diabetic neuropathy, which, if left untreated, can become severely infected and may require intervention. According to clinical trials^[13], ulcers stemming from neuropathic symptoms account for 50-75% of nontraumatic limb amputations.

Muscle Atrophy And Weakness

Unmanaged neuropathy can cause significant muscle weakness and atrophy due to disrupted nerve signals to muscles. Over time, the reduced use of muscles served by damaged nerves can lead to a decrease in mass and strength. In turn, this causes a decline in a person’s mobility and physical capabilities.

Loss Of Autonomic Function

Neuropathy can also affect autonomic nerves, leading to a loss of autonomic—or involuntary—functions, which are necessary for daily life.

This can include issues such as an abnormal heart rate, sudden drop in blood pressure, gastrointestinal problems, loss of bowel and bladder control, and impaired sweating. Losing these functions can significantly affect overall health and quality of life. However, they can be prevented or managed with timely treatment and intervention.

We provide evidence-based treatments for neuropathy.

At Compass Pain and Wellness, we recognize that neuropathy affects each individual in a unique way. So, each patient can only benefit from a personalized approach to treatment.

Our multidisciplinary team focuses on treating the whole person rather than just symptoms, crafting comprehensive care plans that address your specific needs, wants, and challenges.

By focusing on evidence-based, comprehensive care, we empower you to select the most beneficial therapies for your health. We are dedicated to guiding you toward achieving your personal health goals.

Medication Therapy

Medication therapy uses tailored prescriptions to reduce chronic pain and improve daily function and comfort.

Acupuncture

Acupuncture stimulates targeted points on the body to reduce pain, support healing, and restore energy balance.

Peripheral Nerve Stimulation

Peripheral nerve stimulation sends mild electrical signals to disrupt chronic pain from damaged peripheral nerves.

Epidural Steroid Injection

Epidural steroid injections reduce spinal inflammation to ease pain radiating from nerve compression or irritation.

Mindfulness and Meditation

Mindfulness and meditation help manage chronic pain by reducing stress and promoting emotional resilience.

Nerve Block

Nerve blocks interrupt pain signals from specific nerves to reduce chronic or procedure-related discomfort.

Physical Therapy

Physical therapy improves strength, flexibility, and mobility while addressing pain from injury or chronic conditions.

Spinal Cord Stimulation

Spinal cord stimulation delivers electrical pulses to block nerve pain and reduce discomfort in the back or limbs.

Injuries Associated With Neuropathy

At Compass Pain and Wellness, our multidisciplinary team goes beyond alleviating the symptoms of neuropathy. Our goal is to target the root cause of nerve damage and chronic pain. To do so, we address various injuries from accidents that are commonly associated with neuropathy.

Whiplash

Whiplash occurs from rapid, forceful back-and-forth neck movement, commonly in rear-end car accidents. This sudden strain can pull and tear the soft tissues and nerves in the neck.

Back Injury

Back injuries often involve damage to muscles, ligaments, or discs. They commonly stem from age-related degeneration, lifting improperly, sudden movements, or falls. These injuries can pressure nerves, causing pain, numbness, or weakness in affected areas.

Neck Injury

Neck injuries can result from trauma, strain, or the natural degeneration of the cartilage discs located between vertebrae. These injuries can affect the cervical spine and surrounding nerves, causing pain, stiffness, nerve compression, and reduced head and neck mobility.

Spinal Cord Injury

Spinal cord injuries result from trauma to the spine. When the nerves in the spinal cord are compressed or severed, the communication of nerve signals traveling between the brain and body is interrupted. This can lead to severe disability, sensation loss, and paralysis.

Leg Injury

Leg injuries from sprains, fractures, or muscle tears can irritate or compress peripheral nerves. This can lead to localized pain, numbness, or impaired function, which can affect mobility and daily activities.

Shoulder Injury

Shoulder injuries often involve rotator cuff tears, dislocations, or strains, impacting the surrounding nerves. These injuries can cause pain, limited range of motion, and nerve compression that impair arm and hand function.

Our Providers

Meet our experienced and compassionate team of doctors who specialize in helping you manage your condition. With a patient-centered approach, our doctors work to understand your unique needs and provide compassionate, personalized care. Trust our providers to guide you on your journey to better health and improved well-being.

Dr. Kristi Reed, MD

Dr. Randolph Cribbs, MD

Dr. Carl Balog, MD

References

Reach out to Compass Pain today to schedule your consultation and discover treatment options that can improve your quality of life.

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