Neuropathy: Pain & Tingling & Numbness…Oh My!

What is Neuropathy?

Neuropathy refers to the injury or damage to a nerve that can cause numbness, tingling, weakness, loss of sensation, or pain. This most commonly affects the body’s extremities, such as the hands and feet.  These effects may lead to loss of coordination, impacting a person’s day to day life.

What are the Types?

Peripheral – This is the most common type. It affects the feet and legs first, then the hands and arms.

Autonomic – This form specifically affects the nerves that control internal organs.

Proximal – This causes weakness and pain in the hips, thighs, and buttocks.

Focal – Typically affecting the face or eye, this can result in sudden weakness or pain.

What are the Causes?

There are many causes, from injury to genetics to lifestyle habits. The most common causes are:

1. Diabetes

   • Diabetic neuropathy mostly affects the legs and feet. Caused by prolonged high blood sugar levels, this form causes the nerves to not heal or regenerate the way they should.

2. Injuries/Trauma

   • The recurring strain and pressure on nerves can cause nerve damage. From sitting too long to fractures, neuropathy can be caused by many things. Trauma can lead to nerves being stretched farther than they should, compressed, cut, and more.

3. Infections

   • Some infections attack the nerve directly, such as shingles. Infections may also cause inflammation in the body that can lead to nerve compression.

4. Autoimmune Diseases

   • These conditions occur when the body mistakenly attacks its own tissue, leading to nerve damage. An example of this is Rheumatoid arthritis.

5. Alcoholism

   • Chronic excessive alcohol use can cause alcoholic neuropathy. The toxic effects of alcohol damage the nerves.

6. Medications

   • Some medications have neuropathy listed as a side effect, such as chemotherapy drugs, antibiotics, and antiviral medications.

7. Hereditary Disorders

   • There are some disorders, such as Charcot-Marie-Tooth Disease, that may cause neuropathy. 

8. Vascular Disorders

   • Poor circulation can reduce the blood flow to nerves. The oxygen and nutrient deficiencies may lead to damage of the nerves.

9. Liver Disease & Chronic Kidney Disease

   • The build-up of toxins caused by impaired liver or kidney function can lead to damaged nerves. 

10. Thyroid Disorders

    • Fluid retention may cause compression of nerves.

Ways to Diagnose

The top three ways to diagnose neuropathy is through EMG/NCV testing, blood tests, and physical and neurological examination.

1. The nerve testing, also called EMG/NCV testing, assesses nerve and muscle function. So, how does nerve testing work? To start, EMG stands for electromyography. This portion of the test determines the electrical activity of the muscle by inserting a small needle (similar to the size of an acupuncture needle) into the muscle and recording the electrical activity when the muscle is at rest and when the muscle is active. Next, there is NCV which stands for Nerve Conduction Velocity test. NCV studies measure how fast electrical signals travel through your nerves. To perform this, our DPT places electrodes on the skin above the nerve being tested and further down the nerve pathway then an electrical impulse is applied to the nerve. The electrode that is placed down the nerve pathway is considered the “receiving” electrode, and it measures the speed that the electrical signal passed through the nerve and the strength of the electrical response. (Hands-On Physical Therapy)
2. Blood tests are helpful in identifying if the neuropathy stems from metabolic, autoimmune, or nutritional causes. Examples of this are diabetes, vitamin B12 deficiency, kidney dysfunction, thyroid disease, or autoimmune conditions.
3. Neurological and physical examination relies on the physiological effects to diagnose, such as muscle weakness, reduced reflexes, and loss of sensation. This form of diagnosing neuropathy helps guide the physician to determine if the patient requires further testing and which specific areas need testing.

Ultimately, nerve testing, such as EMG/NCV testing, is the most effective and thorough form of diagnosing neuropathy. This testing defines the exact nerves being impacted and the extent of the injury.

Best Treatments for Neuropathy:

Medications, lifestyle modifications, and physical therapy are the best treatments for neuropathy pain relief and symptom alleviation. Non-surgical treatment for neuropathy pain offers a more holistic way to treat your symptoms.

There are a variety of medications that may be prescribed for your neuropathic pain. While these may help with the pain, they do not treat the root cause of your condition. Medications like gabapentin and pregabalin manage the pain but not to treat the neuropathy itself.

Lifestyle modifications include, but are not limited to: diabetes management, nutritional supplements, reducing alcohol consumption, maintaining a healthy diet, and more. These changes are best complemented with physical therapy.

Can physical therapy help with neuropathy?

The answer is yes! Physical therapy uses neuro-re education to aid the process of treating neuropathy. This is done with Pulse Direct Current Electrical Stimulation (PDCES). PDCES paired with therapeutic exercise can improve neuropathy symptoms efficiently when properly performed. From physical therapy for neuropathy pain relief to physical therapy for improving function, this form of treatment is paired well with the other two treatment styles to get an all around better result.

How Can Catalyst Physical Therapy Help?

Catalyst Physical Therapy provides both EMG/NCV testing and neuropathy treatment. We utilize Pulse Direct Current Direct, dry needling, and more. There are different treatments for physical therapy for neuropathy in hands and physical therapy for foot neuropathy. Catalyst Physical Therapy utilizes the best foot soak for neuropathy. This foot soak uses Pulse Direct Current Electrical Stimulation to increase blood flow, reduce pain, and promote nerve health. Another modality is dry needling for foot neuropathy. Dry needling improves blood circulation, muscle tension, and nerve irritation. Catalyst Physical Therapy specializes in manual therapy.

Our physical therapists will go through a thorough examination with you, learning your medical history and evaluating your current condition. Then, they create a personalized treatment plan made specifically for you! This one-on-one physical therapy can be just what you need

Call our Clearwater, FL physical therapy clinic or Palm Harbor, FL physical therapy clinic at (727)286-8408 to schedule a Free Consultation then see if Catalyst Physical Therapy & Diagnostics is the right fit for you!