The human brain alone has about 86 billion nerve cells, by the most recent estimates. These cells work together in a complex relationship between the different nervous systems of the body, including our main processing center (the central nervous system) and the nerves relegating orders, processing stimuli, and carrying out involuntary actions (the peripheral nervous system).
Over the course of an average person’s lifetime, the body will grow and lose countless nerve cells in the brain and elsewhere. Some of them through the natural consequences of aging. Some of them through trauma or disease. The more significant the damage, the harder it is for the nervous system to compensate – and the more noticeable the effects.
While damage to the central nervous system can be catastrophic, our peripheral nervous system is just as important. Pinched nerves, blood clots, infections, and toxins are just some of the ways our peripheral nervous system can take damage, causing sensory loss, paralysis, and significant, long-lasting pain.
Depending on how and where the damage occurred, recovery and treatment can range from conservative and straightforward to impossible. Protecting the nervous system is important – not just by staying away from obvious physical hazards but through healthier lifestyle choices, regular medical checkups, and preventative measures. These can help reduce the risk of peripheral neuropathy and other nerve conditions.
What Is Peripheral Neuropathy?
Peripheral neuropathy is nerve damage in the peripheral nervous system. Some of the most common types include nerve pain following a viral infection or because of complications from diseases like diabetes, as well as physical trauma and conditions (radiculopathy, damaged nerve roots, chronic nerve pain after surgery, etc.).
Peripheral neuropathy encompasses a very long list of symptoms and causes because it describes virtually any nerve damage in your peripheral nervous system – which, again, is every neuron outside of your brain and spinal cord. This includes the hundreds of nerve roots connected to your spine.
While it is worth mentioning that the majority of cases can be attributed to common illnesses, there are many uncommon and rare causes of nerve damage. Sometimes, it can take a lot of time and patience for a neurologist to identify and diagnose a patient with peripheral neuropathy.
Types of Peripheral Neuropathy
Because there are hundreds of examples of peripheral neuropathy, it’s often more helpful to describe it in general terms. Overall, the condition is recognized through examples of nerve disruption. This is like a nick or cut in your power system, causing fluctuations or outages. Or damage to the fiberglass cables that make up the Internet, severely disrupting the connection in one part of the globe. Nerve disruptions can take on the form of:
- A loss of signals, meaning the brain doesn’t receive the information it should.
- False signals, indicating the brain is receiving signals without a cause.
- Erroneous signals representing the type of signal is correct, but there are still inaccuracies (such as hyperalgesia).
Peripheral neuropathy can affect a single nerve, or an entire limb, or a plexus of nerves. Depending on the severity and location of the neuropathy, a doctor may use different terms to describe the damage, such as mononeuropathy (single nerve), polyneuropathy (multiple nerves), and multiple mononeuropathies (more than one nerve, but still limited).
What Does Peripheral Neuropathy Look Like?
Depending on what portion of the nervous system is affected, one may experience different symptoms. In general, the most commonly affected nerves include:
- Autonomic nerves, which are responsible for everything you don’t think about but need to do to survive, including breathing, your heartbeat, digestion, and more.
- Motor nerves, which are responsible for voluntary movement, including talking, walking, and grabbing. Examples of motor nerve neuropathy include weakness in one leg, inability to hold or grasp objects, or partial paralysis.
- Sensory nerves, which translate outside stimuli into information for the brain to process. These can be found throughout the body, surrounding vital organs, and all over the skin, reporting on anything from the temperature of the wind to the pebble in your shoe.
Damage to each of these systems will result in different symptoms.
For example, motor neuron damage may result in trouble walking, not out of pain, but because one leg just isn’t responding right (in addition to pain, in many cases).
Autonomic nerve damage may include loss of bladder control and arrhythmia (irregular heartbeat), but also the sudden onset of excessive sweating, erectile dysfunction, blood pressure problems, and gastric anomalies.
Sensory nerve damage can cause chronic pain, which is pain lasting more than three months. At this point, most of the damage causing the pain originally should have healed – which means that your pain may be caused by your nerves miscommunicating with the brain.
How Doctors Identify Peripheral Neuropathy
There are countless tests to identify and narrow down potential forms of neuropathy in the peripheral nervous system.
These include imaging tests such as MRIs to check for pinched nerves or swelling, as well as white blood cell counts to test for infection, heart rate monitors and long-term EKGs to test heart function, reflex tests, sweat tests, bladder function tests, ultrasound, and more.
For chronic pain, a doctor may refer you to a pain clinic or an in-depth look at your condition. Pain clinics specialize in treating complex cases of ongoing or long-term pain through the expertise and cooperation of multiple doctors from different specialties.
Not all neuropathy causes pain. But whenever pain is being caused by nerve damage, the pain is also called neuropathic pain. This is in contrast to nociceptive pain, which is caused by noxious (i.e. negative) stimuli: touching a hot stove, getting a paper cut, or taking a bad fall.
Treating Peripheral Neuropathy
Treatments depend on the type and cause of the nerve damage. A pinched or compressed nerve caused by tissue swelling might be managed conservatively through over-the-counter anti-inflammatories and cold compresses. This includes most cases of sciatica and nerve pain originating in the back. Depending on your diagnosis, your doctor may recommend a peripheral nerve stimulator (PNS) procedure. A PNS is a small device that is surgically implanted which delivers electrical impulses stimulating the peripheral nerve changing how the brain perceives pain to the affected nerves.
Malfunctions in your autonomic nervous system may result from an inherited illness or exposure to toxins, with different treatments including medication, dietary changes, bladder training, compression clothes, and more.
Over 20 million people are struggling with peripheral neuropathy in the United States. If any of the symptoms mentioned seem familiar, or if you have been struggling with unidentified pain for months, you must seek medical attention. The sooner the damage is identified, the better your chances of recovery.