The terms "polyneuropathy," "peripheral neuropathy," and "neuropathy" are frequently used interchangeably, but are distinct. Polyneuropathy is a specific term that refers to a generalized, relatively homogeneous process affecting many peripheral nerves, with the distal nerves usually affected most prominently. Peripheral neuropathy is a less precise term that is frequently used synonymously with polyneuropathy, but can also refer to any disorder of the peripheral nervous system including radiculopathies and mono-neuropathies. Neuropathy, which again is frequently used synonymously with peripheral neuropathy and/or polyneuropathy, can refer even more generally to disorders of the central and peripheral nervous system - uptodate.com/contents/overview-of-polyneuropathy
"The treatment goal related to polyneuropathy is to control the symptoms a person experiences, something that at times involves treating the underlying cause if it is known - such as diabetes."
Polyneuropathy is the most common form of a group of disorders referred to as, 'peripheral neuropathy,' and is caused by damage to a person's peripheral nerves. Peripheral nerves are defined as nerves that are beyond a person's brain and spinal cord. Peripheral nerves travel from a person's spinal cord to their skin, muscles, glands, and internal organs.
With polyneuropathy, a number of nerves throughout a person's body malfunction at the same time. While there are various causes of polyneuropathy, the symptoms people experience remain fairly constant and may include the following:
Some people with neuropathies might experience issues with muscles involving breathing, swallowing, or movement of their eyes. The medical professionals involved in treating people with polyneuropathy may include a multidisciplinary team including neurologists, physical medicine specialists, neurosurgeons, physical and occupational therapists, speech therapists, neuro-psychologists, nutritionists, respiratory therapists, and others who work to ensure a person achieves their best potential outcome.
Neuropathies of all forms commonly belong to three different categories - acquired, hereditary and, 'idiopathic,' meaning there is no understood cause. One of the more common forms of an acquired neuropathy is, 'diabetic neuropathy,' which is the result of badly controlled blood sugar levels in those who experience diabetes. While less common, diabetes may also cause, 'mono-neuropathy,' which is many times characterized by weakness of a person's eye, or of their thigh muscles. Other causes of acquired neuropathies include:
Hereditary neuropathies are not as commonly experienced by people. Those who do experience a hereditary neuropathy have a specific gene that might be passed along from a parent to a child. The most common of these is, 'Charcot-Marie-Tooth disease,' which may take various forms and is characterized by a slowly progressive degeneration of the muscles in a person's hand and forearm, lower leg, foot, and a mild loss of sensation in their fingers, limbs, and toes.
'Idiopathic,' meaning, 'of unknown cause,' is the classification for around one-third of people who are diagnosed with neuropathies. Commonly, idiopathic neuropathies happen in people who are over the age of sixty and tend to progress slowly, or stay unchanged after the initial onset.
A fairly serious yet rare form of acquired polyneuropathy is, 'Guillain-Barre syndrome (GBS).' GBS is a disease that presents suddenly when a person's immune system attacks their peripheral nerves. The early symptoms of GBS include tingling, weakness and a loss of sensation in the person's legs that eventually spreads to their arms. In people with critical instances of the syndrome, issues with breathing, blood pressure and heart rhythm might happen. Despite the severity of the syndrome, recovery rates are good when people receive early treatment.
People with GBS benefit from closely collaborating with a neurology team and working with rehabilitation and physical medicine. The coordinated treatments provide people with multiple benefits, to include the potential for one treatment location and advanced medical care.
The treatment goal related to polyneuropathy is to control the symptoms a person experiences, something that at times involves treating the underlying cause if it is known - such as diabetes. When the underlying cause is corrected, neuropathies might improve on their own. The treatment provided also depends upon the severity of the symptoms the person is experiencing. Controlling the pain may be an important part of a person's neuropathy treatment plan. The most aggressive therapy is commonly reserved for symptoms that greatly interfere with a person's daily functioning. Therapies to control pain caused by polyneuropathy might include the following.
Antidepressants: Specific antidepressants have been found to help with relieving pain caused by neuropathy. They do so by interfering with chemical processes in a person's brain involved in the pain response.
Anti-Seizure Medications: Anti-seizure medications were originally developed with the goal of treating epilepsy, yet are sometimes used to relieve nerve pain. The side effects of these medications may include dizziness and drowsiness.
Pain Medications: Over-the-counter pain medications might be enough to treat milder symptoms. For more severe pain, prescribed painkillers might be administered. Some painkillers may lead to dependence and other side effects unfortunately, so they are usually prescribed when other types of treatments fail.
Corticosteroids: Corticosteroids are anti-inflammatory medications that may relieve severe pain associated with inflammation and nerve irritation. Corticosteroids might be administered orally or injected directly into the area of a person's body where they are experiencing symptoms. Corticosteroids may greatly reduce or eliminate pain for extended periods.
Transcutaneous Electrical Nerve Stimulation (TENS): TENS is a medication-free therapy that involves the application of tiny electrical impulses along specific nerve pathways. The electrical impulses are delivered via electrodes that are placed on a person's skin. While TENS does not work for everyone or for all types of pain, it might be prescribed in combination with other types of treatments -largely to provide a person with relief from acute forms of nerve pain.
When more aggressive treatment is required for progressive types of neuropathy that is causing serious physical dysfunction there are some other options. These options include the following:
Immunosuppressant Medications: Immunosuppressant medications include ones that contain antibodies which curb the autoimmune processes leading to nerve damage.
Removing Malfunctioning Antibodies: Removing malfunctioning antibodies from a person's blood through, 'plasmapherisis,' a process that clears antibodies from the plasma portion of their blood before being replaced in their body is an option.
Certain lifestyle choices and wellness techniques might help people with polyneuropathy to manage their disorder. Some of these choices and techniques are mentioned below.
Exercise has been shown to assist with reducing the pain associated with neuropathy.
Smoking decreases a person's circulation and may worsen the effects of the neuropathy they experience.
Avoid prolonged pressure on nerves by not crossing your legs or leaning on your arms or elbows for extended periods of time.
Avoiding tight socks and shoes and checking your feet often for developing issues such as excessive calluses or blisters is a good practice. Foot massages may also help by stimulating circulation.
May ease symptoms of neuropathy in some people. While alternative therapies have not been studies as extensively as medication treatments for neuropathies, the majority are fairly safe to pursue. Alternative therapies for neuropathy include:
Acupuncture should be performed by a practitioner who is certified. The alternative therapy may take a number of sessions before a person's symptoms begin to improve.
Alpha lipoic acid is a naturally occurring type of fatty acid found in every cell in a person's body. It converts blood sugar into energy to fuel a person's body functions. Alpha lipoic acid is also an antioxidant, something that might work to protect cells from damage from free radicals. Because it may affect blood sugar levels, people should consult with their doctor before using this as an over-the-counter supplement.
Capsaicin is a naturally occurring substance that is found in hot peppers. It can moderately improve the symptoms of neuropathy. The product is available in a cream and people have to gradually develop a tolerance for the heat that is created on contact prior to enjoying relief from neuropathy pain.
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