Peripheral neuropathy is defined as an altered function in the extremities that may involve a diminished or absent sensation in response to touch, pain, or temperature, an absence of sweating, foot deformities, and altered gait and weight-bearing. It’s a general term for a series of disorders that result from damage to the body’s peripheral nervous system. It occurs when these nerves malfunction because they’re damaged or destroyed due to injuries, systemic illnesses, infections and inherited disorders.
Peripheral neuropathy refers to the many conditions that involve damage to the peripheral nervous system, the vast communication network that sends signals between the central nervous system (the brain and spinal cord) and all other parts of the body. Peripheral nerves send many types of sensory information to the central nervous system (CNS). They also carry signals from the CNS to the rest of the body.
Types of peripheral neuropathy
More than 100 different types of peripheral neuropathy exist. Each type has unique symptoms and specific treatment options. Peripheral neuropathies are further classified by the type of nerve damage involved. Mononeuropathy occurs when only one nerve is damaged. Polyneuropathies, which are more common, occurs when multiple nerves are damaged. Most commonly they are classified according to the numbers and types of nerves involve
According to the number of nerves
Mono neuropathy e.g.: carpal tunnel syndrome
Polyneuropathy e.g.: Guillen barre syndrome
According to the types of nerve involve
Sensory neuropathy
Motor neuropathy
Autonomic neuropathy
Symptoms of peripheral neuropathy
Symptoms usually start with numbness, prickling, or tingling in the toes or fingers. It may spread up to the feet or hands and cause burning, freezing, throbbing, and/or shooting pain that is often worse at night. The pain can be either constant or periodic, but usually, the pain is felt equally on both sides of the body in both hands or on both feet. Some types of peripheral neuropathy develop suddenly, while others progress more slowly over many years. Symptoms may vary according to the type of peripheral neuropathy.
Symptoms of sensory neuropathy can include:
Pins and needles in the affected body part
Numbness and less able to feel pain or changes in temperature, particularly in your feet
A burning or sharp pain, usually in the feet
Feeling the pain from something that should not be painful at all, such as a very light touch
Loss of balance or coordination caused by less able to tell the position of the feet or hands
Symptoms of motor neuropathy can include:
Twitching and muscle cramps
Muscle weakness or paralysis affecting one or more muscles
Thinning (wasting) of muscles
Difficulty lifting the front part of your foot and toes, particularly noticeable when walking (foot drop)
Symptoms of autonomic neuropathy can include:
Constipation or diarrhea, particularly at night
Feeling sick, bloating, and belching
Low blood pressure, which can make you feel faint or dizzy when you stand up
Rapid heartbeat (tachycardia)
Excessive sweating or a lack of sweating
Problems with sexual function, such as erectile dysfunction in men
Difficulty emptying your bladder of urine
Loss of bowel control
Depending on the specific nerve affected,
Symptoms of mononeuropathy can include:
Altered sensation or weakness in the fingers
Double vision or other problems with focusing your eyes, sometimes with eye pain
Weakness of one side of your face (Bell's palsy)
Foot or shin pain, weakness, or altered sensation
Causes for peripheral neuropathy
Most instances of neuropathy are either acquired, meaning the neuropathy or the inevitability of getting it isn’t present from the beginning of life, or genetic. Acquired neuropathies are either symptomatic (the result of another disorder or condition; see below) or idiopathic (meaning it has no known cause).
Symptomatic acquired peripheral neuropathy
Physical trauma Diabetes
Chemo-induced neuropathy
Inflammatory infections
Auto-immune diseases
Protein abnormalities
Exposure to toxic chemicals (toxic neuropathy)
Poor nutrition
Kidney failure
Chronic alcoholism
Certain medications – especially those used to treat cancer and HIV/AIDS.
Genetically-caused polyneuropathies are rare.
The causes of peripheral neuropathy in some people remain unknown – this is called idiopathic neuropathy.
Physiotherapy aims and treatments
Treatment methods may vary according to the patient and types of disease, the following are the common physiotherapy treatment protocols used in peripheral neuropathies.
Pain reduction
Regain muscle strength
Prevent soft tissue contracture
Improve patient’s posture
Increase patient’s mobility
Increase balance and coordination
Increase fitness and energy levels
Complications
Peripheral neuropathy can sometimes cause other medical problems, such as foot ulcers, heart rhythm changes, and blood circulation problems.
These complications vary depending on the underlying cause of peripheral neuropathy.
References
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet
https://www.foundationforpn.org/what-is-peripheral-neuropathy/symptoms/
https://www.nhs.uk/conditions/peripheral-neuropathy/
Sovika Selvakumar
