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From head to toe, nerve damage can affect any part of the body. The condition is surprisingly prevalent—20 million people in the U.S. alone. Half of all people with diabetes have some form of nerve damage, according to the American Diabetes Association, and diabetic neuropathy is just one of more than 100 types.
What Causes Nerve Damage?
The American Academy of Orthopaedic Surgeons portrays the nervous system as a complex collection of electrical cables and wires within the body. When the wires are compressed or broken, the nerves cannot receive or send messages to specific parts of the body.
The result is damage to the central or peripheral nervous system and the areas of the body they service. The central nervous system is the brain and spinal cord. The peripheral nervous system consists of nerves outside the brain and spinal cord.
One of the problems with nerve damage is that it can develop as a result of such a wide range of injuries, diseases, conditions, and even treatments. Below are a few examples, but in many cases the causes of nerve damage are simply idiopathic (unknown).
- Inflammatory bowel disease
- Vitamin B6, B12 deficiencies
- Toxic substances
- Inherited diseases
- Alcohol abuse
- Lyme disease
- Kidney disease
- Trauma (injury)
- Other medications (anticonvulsants, statins, blood pressure drugs)
What Are the Symptoms of Nerve Damage?
Symptoms vary, depending on which nerves have been compromised and the severity of the damage. The symptoms can be as mild as a tingling feeling (think of when your foot temporarily “goes to sleep”) or as severe as total loss of feeling or intense pain. Here’s a more comprehensive list of symptoms.
- Tingling sensation
- Burning sensation
- Sharp or stabbing pain
- Muscle weakness
- Muscle atrophy
- Lack of coordination
- Sensitivity to touch
- Heavy sensation in arms, legs
- Drop in blood pressure
- Excessive sweating
- Dropping things
- Bowel, bladder dysfunction
- Digestive problems
The indirect effects of nerve damage can be just as difficult as the primary symptoms. People with the condition are more likely to fall because of loss of balance or muscle weakness. They are more likely to experience burns because they cannot feel temperature changes and more likely to develop infections because of unnoticed injuries.
How Is Nerve Damage Diagnosed?
Your family doctor or a neurologist will conduct simple tests to assess muscle strength, reflexes, balance, coordination, hearing, vision, and signs of numbness.
More sophisticated tests determine the location and severity of damage, and electromyography (EMG) records electrical activity in muscle tissue. An EMG may detect problems with muscles, nerves, or signals between the two.
Blood tests, including measurements of creatinine levels, might indicate kidney dysfunction.
TIPS FOR PROTECTING YOURSELF
- Be careful with sharp, hot, and cold objects.
- Check your feet regularly for cuts and other wounds.
- Move slowly and use handrails when going up and down stairs.
- See that rooms, stairways, and hallways are well lighted.
- Remove objects that could cause you to trip or fall.
- Don’t walk in bare feet.
- Make sure water isn’t too hot.
- Wear gloves and socks in cold weather.
- Use dishes that won’t break.
- Get up slowly to give your body time to adjust.
Adapted from the Canadian Cancer Society
Make sure your doctor knows if there is a family history of neuropathy or diabetes.
How is Nerve Damage Treated?
The first line of treatment is often to determine the underlying or associated condition, if there is one. Treating diabetes, shingles, or kidney disease, for example, may help manage the effects of nerve damage.
Over-the-counter medicines may help with pain or discomfort, but research does not support their effectiveness. However, ibuprofen and aspirin can help reduce inflammation, which may relieve pressure on irritated nerves.
Anti-seizure drugs such as pregabalin (Lyrica) and gabapentin (Gralise, Neurontin) interrupt pain signals.
For diabetic nerve pain, anti-depressants such as amitriptyline (Tryptanol), desipramine (Norpramin) and imipramine (Antideprin, Deprinol) are considered first line medications. Duloxetine (Cymbalta) is an FDA-approved drug to treat pain associated with diabetic neuropathy.
Other non-invasive or minimally-invasive treatment options are physical therapy, acupuncture, massage, transcutaneous nerve stimulation (TENS), a healthy diet, and regular exercise.
Nerve blocks—not considered a conservative method—are performed by injecting an anesthetic directly into a nerve.
If a nerve and/or its insulation have been severed, surgical treatment involves sewing together the insulation around both ends of the severed nerve so new fibers can grow and the nerve can regain its function.
Recovery time and effectiveness depends on the age of the patient, the type of injury, its location, and the nerve itself. Full recovery can take months or years.
What is the Outlook for People with Nerve Damage?
For some people, symptoms of nerve damage will gradually get better with time. Patience and determination are key factors in recovery. In others, the damage can be permanent.
Knowing the difference in the two prognoses and being realistic about eventual recovery are important. If nerve damage has been mild or moderate, having a short-term recovery goal is motivating. If the damage is severe and total recovery not likely, the patient has to go about lifestyle changes consistent with the reality of permanent nerve damage.
In either case, nerve damage is a serious but treatable condition. Be aware of the symptoms, let your doctor know about them, and then choose which combination of treatments can help you return as close as possible to the activities of normal life.
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