Download 05/ 2012 Healthy Cells Magazine

05/ 2012 Healthy Cells Magazine
Yibing Li, MD
Numbness, tingling and pain in the hands and feet?
----Checkup Neuropathy
Today, an estimated 15-20 millions of people in the United States suffer from pain,
numbness, tingling and weakness from neuropathy. While several types of neuropathy
exist, all have nerve pain that severely interfere with their sleep, inhibit mobility and
quality of life. It is increasing being recognized as a major cause of painful burning
sensation in the feet and hands.
What is Neuropathy?
Neuropathy means “disease of nerves”, which results from nerve damage and
disconnection between brain and spinal cord to the body. The symptoms usually start in
the feet. The numbness made it difficult to walk and maintain balance, “Sometimes it
feels like I am walking on rocks”.
How is Neuropathy Classified?
Most of the neuropathy can be classified into the three categories:
1. Mononeuropathy: means disease of a single nerve, such as carpal tunnel
syndrome, cubital tunnel syndrome.
2. Multiple mononeuropathy: two or more nerves in different areas affected
3. Polyneuropathy: generalized involvement of peripheral nerve system in the body.
What are Common Symptoms?
Since the nerves of your peripheral nervous system send information back and forth from
your brain and spinal cord to the rest parts of the body, the nerve damages can cause:
-
Numbness and tingling in the feet and/or hands, which may spread upward to
your legs and arms (sensory nerve involvements)
Burning, sharp or electric-like pain
Extreme sensitive to touch, even light touch
Loss balance, lack of coordination, falls
Muscle weakness if motor nerve involved (motor nerves control your muscle
movements)
Bowel or bladder problems if autonomic nerve affected. (autonomic nerves
control blood pressure, heart rate, digestion and bowel/bladder functions)
What Causes Neuropathy?
Sometimes it is difficult to find the exact cause of the neuropathy, but there are a
numbers of risk factors that can interfere the nervous system dysfunction, resulting in the
nerve diseases, such as:
-
Alcoholism
Autoimmune diseases, including lupus, rheumatoid arthritis and Guillain-Barre
disease.
Diabetes
Exposure to poisons, such as heavy metals, certain medications that used to treat
cancers (chemotherapy)
Infections. Certain viral and bacterial infections can cause neuropathy such as
HIV, hepatitis, EB viral infection, lyme disease, etc.
Inherited diseases. Examples are Charcot-Marie-Tooth disease.
Traumas such as motor vehicle accident, sport injuries, falls can damage to the
nerves.
Tumors, either benign or malignant growths can cause pressure to the nerves.
Vitamin deficiencies, especially Vit. B, Vit. E and niacin. They are crucial to
nerve health.
Other diseases, such as kidney disease, liver diseases, thyroid dysfunctions are
very common causes of peripheral neuropathy.
How is Neuropathy Diagnosed?
Neuropathy is not usually a single disease, diagnose may be not easy. The standard
diagnostic process begins with a detailed medical history with complete physical exam,
especially neurological exam by licensed physicians. The gold diagnostic test is nerve
conduction study/EMG and small fiber nerve testing, which can be performed by doctors
who are specialized in nerve and muscles disease such as physiatrists (physical medicine
& rehab doctors) and neurologists. Other common tests include certain blood test and
urine test. Sometimes nerve biopsy is required.
Can Back Pain and Neck Pain Cause Nerve Pain in Extremities?
Yes. Nerve pain in the extremities can result from one or more pinched or nerve roots
from spine (neck and back). Examples are:


Chronic pain that radiates from back down the legs/feet (sciatica or lumbar
radiculopathy.)
Chronic pain that radiates from neck down the arms. (cervical radiculopathy.)
Consult your pain or spine specialist for checkup. Sometimes MRI will be ordered.
Treatments may include physical therapy, epidural injections, etc.
How to Treat Neuropathy?
Even though neuropathy is very difficult to treat, but nowadays more and more treatment
options are available. They range from traditional medications to alternative therapies
that stimulate the nerve system regenerate. The goal is to find out the conditions causing
the neuropathy. If the underlying etiology is corrected, the neuropathy will improve on its
own. The treatment should be individualized.
For example, if the patient’s numbness and tingling in the feet is due to diabetic
neuropathy, the key prevention and treatment of the neuropathy is to manage diabetes.
The common used medications such as Neurontin, Lyrica, Cymbalta, are helpful with
relieving the painful symptoms. Physical therapy with modalities may help the muscle
weakness, balance deficits from the neuropathy. Lifestyle changes including exercises,
quit smoking, eat healthy meals is important as well. People with neuropathy may benefit
from alternative medicine such as acupuncture, alpha-lipoic acid, biofeedback, etc.
But research studies showed the most effective treatments for all kind of painful
neuropathy are a multi-disciplinary medical team care, which has received level I
scientific evidence in medical history.
How to Prevent Neuropathy?
The best way to prevent neuropathy is to carefully manage any medical condition that put
you at risk. Make healthy lifestyle choices and avoid anything that can cause nerve
damage as much as possible. Seek medical care right way if you develop any usual
numbness, tingling, weakness or pain in the hands or feet. Early diagnosis and treatment
warrant the best chance for controlling your symptoms and prevent further damage to
your nervous system.
Dr. Yibing Li, the medical director of Center for Pain Management & Rehab (CPMR),
leads a multi-disciplinary pain management team in Peoria and Pekin. Dr. Li is
specialized in nerve/muscle diseases and interventional pain management. She is triple
board- certified in Pain Medicine, Physical Medicine & Rehabilitation and spf NCS
Electrodiagnosis. For more information, call 309-689-8888 or visit www.cpmrmed.com,