Peripheral Neuropathy - Not just a problem of diabetes!

You've probably heard that one of the many possible complications of diabetes (type 1 or 2) is nerve damage, the medical term being "peripheral neuropathy" when it affects the limbs or “periphery”. Through the years of high and/or fluctuating blood sugar levels, the nerves become de-myelinated, often starting in the feet, which often initially brings on the sensation of "something being stuck to the bottom of my foot" or "feeling like I'm wearing a tight sock, but I'm not". This can slowly worsen to include a loss of fine touch protective sensation and sensations of tingling, numbness, shooting pains, and burning pains.

Podiatrists have several standardised tests that can be carried out to determine if someone has peripheral neuropathy and to what degree.

It is quite eye opening to find out, however, that diabetes is not the only cause of peripheral neuropathy. Not by a long shot....other causes include traumatic injury, vitamin B12 deficiency, infection, exposure to toxins such as medications, chemotherapy and alcohol (yes, alcohol!), and a big one.....idiopathic, which means the cause is unknown. As a

matter of fact, my 55-year-young best friend in the USA has peripheral neuropathy (but NOT diabetes) and is taking Lyrica to alleviate the burning in her feet. No one knows why she has neuropathy.

Another surprisingly large cohort of sufferers is simply those with too many birthdays. I have countless elderly patients who complain of odd sensations such as tingling toes, or toes that are irritated by the slightest touch of a sock or a sheet. Oddly, studies have shown that taller folks are more susceptible and I know a few examples of this.

Aside from taking Lyrica (which comes with its own side effect of making you very sleepy), some tricks podiatrists may use involve a trial and error arsenal of trying to "distract" the nerves in the toes or balls of the feet with various coverings -- for example, spray on band aid has been very useful for some of my patients with "overly sensitive" toes...another method is adhering a piece of very thin, stick-on dressing such as opsite waterproof film dressing (think of Glad Wrap thinness) to the irritated area.

For severe cases, more invasive and controversial treatments include the electrical current treatment and spinal cord stimulation carried out by neurosurgeons.

Peripheral neuropathy remains a vexing problem that often evades a simple solution. When the cause is known,

management of the underlying condition (e.g. control of blood sugar levels) is the key to reducing symptoms and avoiding further damage.

By Gentry Winters