Can Neuropathy Be Reversed? See the Best Treatments for Nerve Pain

From msn.com/en-us 

Your nervous system is a key force behind so many important bodily functions. But when your peripheral nerves-those found outside of the brain and spinal cord-are damaged, it can cause pain and numbness and make it difficult to perform everyday tasks. If you've suffered nerve damage, you may be wondering if neuropathy can be reversed. We asked top experts to explain what causes the condition, when it can be stalled or even reversed and how to treat it. 

What is peripheral neuropathy?

The peripheral nerves are located in the arms and legs, explains Jamie Fertal, DO, supportive care medicine physician at City of Hope Orange County. When these nerves become impaired, they are unable to operate properly. This damage to the nervous system is referred to as peripheral neuropathy, she explains. 

Peripheral neuropathy can be caused by compression of a nerve (like carpal tunnel syndrome), physical injury to a nerve such as during surgery, inflammation, infections, viruses, autoimmune diseases, vitamin deficiencies and cancer treatments like chemotherapy. 

The most common type of peripheral neuropathy is caused by diabetes. Diabetic neuropathy occurs when high blood sugar levels damage small blood vessels and nerves, says Alexandra Adler, MD, pain management physician with Lowell General Hospital Pain Management Centre.

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Symptoms of peripheral neuropathy 

Peripheral neuropathy can cause nerve pain, tingling, numbness, burning, itching, muscle weakness or loss of muscle mass (atrophy). It can manifest as a pins and needles sensation, trouble walking or typing, sensitivity to touch and sporadic limb pain. The onset of these symptoms tend to be gradual, says Dr. Fertal, so it's important to see your doctor as soon as you notice any concerning symptoms. 

Can neuropathy be reversed?

The answer to whether peripheral neuropathy can be reversed isn't quite straightforward. In some cases, it can be reversed or at least stopped from progressing, says Dr. Adler. The key? Early intervention. 

"For example, diagnosing diabetes and then treating it is very important in reducing the risk and severity of neuropathy symptoms," she says. "This can be life-saving for people with diabetes. With peripheral neuropathy, sometimes people have such severe numbness in their feet that they cannot feel an injured area and can end up with serious infections because of this. And healing may be slow or insufficient." 

Peripheral neuropathy treatment options

Even in instances where neuropathy can't be fully reversed, finding and treating the underlying cause can mitigate symptoms, our experts agree. There are also ways to manage existing neuropathy.  

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Prescription medications

According to the National Institute of Neurological Disorders and Stroke, common prescription medications used to treat peripheral neuropathy include duloxetine hydrochloride, nortriptyline, gabapentin and pregabalin. 

Topical patches and creams

Lidocaine patches or a topical cream called capsaicin, which can be helpful for small, painful areas, block nerve conduction and can be used as a treatment for peripheral neuropathy. 

TENS machine

You can also ask your doctor about transcutaneous electrical nerve stimulation (TENS), a non-invasive pain relief intervention that involves attaching electrodes to the skin at the site of pain or near damaged nerves and then administering a gentle electrical current. 

Physical therapy 

Finding ways to stay active is highly recommended, Dr. Adler says. This may involve working with a physical therapist or trainer. If walking is painful, super low-impact activities like swimming or pilates may be better tolerated, she offers. 

Supportive shoes

"Some patients with neuropathy in their feet find certain types of shoes that have textures to be comforting," she adds. "The most important thing is wearing protective shoes that fit properly, as shoes that rub or press on joints can lead to skin breakdown and infection, especially if the person does not have a good sensation in their feet and does not notice." 

https://www.msn.com/en-us/health/other/can-neuropathy-be-reversed-see-the-best-treatments-for-nerve-pain/ar-AA1ujt1F?ocid=BingNewsVerp

What can cause nerve pain in the foot?

From medicalnewstoday.com

Nerve pain may result from a pinched nerve or a chronic condition, such as diabetes

Any foot pain can have a significant impact on daily life, and untreated nerve pain may keep a person from enjoying or accomplishing their regular activities.

Below, learn what nerve pain in the foot feels like, what can cause it, and what treatments are available.

Symptoms

Image credit: katleho Seisa/Getty Images

Regardless of the cause of the pain, someone with nerve pain in one or both feet may experience:

• a burning, aching, or tingling sensation
• the sensation of an electric shock in the foot or feet
• pain that gets worse during the night or specific activities
• muscle weakness in the area

Also, the same issue that causes nerve pain may alternately cause numbness.

Causes

The following health issues can lead to nerve pain in one or both feet.

Baxter’s neuropathy

Baxter’s neuropathy is a form of nerve entrapment. It results from the compression of the inferior calcaneal nerve, which sits just under the base of the foot’s arch.

Risk factors include:

• plantar fasciitis — inflammation of the plantar fascia, the part of the feet that connects the heel bone to the toes
• obesity
• bone spurs
• flat feet, or fallen arches

Morton’s neuroma

Morton’s neuroma involves thickened tissues compressing nerves between the toes.

A person may experience pain on the bottom of the foot that worsens when walking, particularly in tight high heels. The pain may fade during rest or after removing the shoes.

The pain may be burning, stabbing, or tingling, or it may feel like an electric shock. It may extend to the back of the foot or leg, causing cramping. Some people also experience numbness between their toes.

Common causes of Morton’s neuroma include:

• wearing narrow shoes
• wearing high heels
• inflammation of the joints
• thickening of foot ligaments
• injury to the front of the feet, such as from high-impact sports or jogging
• lipomas — lumps beneath the skin that contain an overgrowth of fat cells

Tarsal tunnel syndrome

Tarsal tunnel syndrome causes pain in the feet and legs due to compression of the posterior tibial nerve, which runs down the back of the lower leg, or the plantar nerves in the feet.

Researchers currently do not know how common this condition is, as doctors often underdiagnose it. However, it appears to be more common in females.

Symptoms of tarsal tunnel syndrome include:

• sharp, shooting pain in the inner ankle and along the foot
• numbness on the underside of the foot
• pain when flexing and moving the foot
• a tingling or burning sensation

The symptoms may worsen at night, while walking or standing, or after physical activity. The pain often lessens after resting.

Tarsal tunnel syndrome may result from:

• wearing poorly fitting shoes
• injuring the feet or legs
• developing postsurgical scarring
• having varicose veins
• having a ganglion cyst
• having lipomas

Peripheral neuropathy

Peripheral neuropathy is an umbrella term for numbness, tingling, and burning sensations in the toes, feet, fingers, hands, or a combination of these areas. The symptoms may worsen at night.

Also, peripheral neuropathy can cause nonspecific symptoms that make it difficult to move the feet and do basic activities.

Researchers do not fully understand why certain people develop peripheral neuropathy while others do not.

However, they have identified conditions that increase the chances of developing peripheral neuropathy. These health issues include:

• infections
• a deficiency of a nutrient, such as B12
• alcohol use disorder
• diabetes
• certain hereditary conditions, such as Charcot-Marie-Tooth disease, which causes a loss of muscle tissue
• Guillian-Barré syndrome, a condition that causes rapid muscle weakness

Diabetic neuropathy

Both type 1 and type 2 diabetes can cause nerve pain in the toes and feet. Diabetic neuropathy affects more than 90% of people with diabetes.

Typically, the nerve pain first affects the toes and surrounding areas, and it may then slowly spread to the rest of the feet and up the legs.

Symptoms of diabetic neuropathy include:

• tingling, burning, sharp, or shooting pain in the toes or feet
• the sensation of an electric shock in these areas
• pain that usually worsens at night, causing sleep disturbances
• pain when touching the skin

Researchers remain unsure of the exact causes. Some theories point to changes in the blood vessels, the metabolism, the immune system, or the body’s sodium and calcium channels.

Several factors increase the chances of people with diabetes developing neuropathy:

• advancing age
• having diabetes for a longer period
• consuming alcohol
• using tobacco products

Sciatica

Sciatica happens when something damages or compresses the sciatic nerve, the longest and widest nerve in the body. It extends from the lower back, through the buttocks, and down the legs, ending just beneath the knee.

The most common cause of sciatica is a herniated, or bulging, disk in the spine.

While sciatica tends to affect the back, hips, and upper legs first, the pain can spread down the legs into the feet and toes.

Symptoms of sciatica include:

• back pain on one side
• pain or a burning sensation in the buttocks
• leg weakness
• pain in the leg and foot

Treatment

The following approaches can help relieve nerve pain in the feet.

Home care strategies

A person may benefit from:

• using hot or cold packs
• resting
• taking over-the-counter pain relief medication, such as ibuprofen (Advil)
• massaging the feet
• wearing a splint for support

Also, try to avoid sitting or standing for long periods.

Some people find that wearing wide, soft-soled, laced shoes with low heels helps relieve pressure on the feet and nerves.

However, for some people with nerve pain, a firm sole may be more beneficial than a soft sole.

Medical treatments

The best approach depends on the cause of the nerve pain.

To treat peripheral or diabetic neuropathy, doctors may prescribe:

• medication for pain relief
• antidepressants
• anticonvulsants

In some situations, a doctor may recommend deep tissue massages and corticosteroid injections to help manage symptoms, especially if the cause is sciatica.

If sciatica results from a hernia, abscess, or tumour, a doctor often refers the person for surgery.

Doctors may also recommend physical therapy, as stretching and strengthening the legs and feet can help manage symptoms, including pain.

Surgery may also benefit people with nerve pain caused by issues other than sciatica. For example, if a person has tarsal tunnel syndrome, treatment may involve surgery to release a nerve. This has a success rate of up to 96%.

Diagnosis

First, the doctor takes a history and examines the painful area. They may also request imaging, such as an ultrasound or an MRI.

If they suspect specific conditions, such as peripheral or diabetic neuropathy, the doctor may request participation in a nerve conduction study or blood and other samples for lab tests.

When to contact a doctor

If foot pain threatens to keep a person from taking part in daily activities, they should let a doctor know.

This is especially crucial if an underlying condition, such as diabetes, may be contributing to the pain and other symptoms.

Summary

Nerve pain in the foot tends to result from a compressed nerve or diabetes. A range of health issues may be at play, and they tend to cause similar symptoms.

For this reason, receiving a diagnosis is key. It is especially important to contact a doctor if the pain is worsening or home care techniques cannot ease it.

The doctor will work with the person to develop an effective treatment plan. When necessary, surgery tends to have a high success rate.

https://www.medicalnewstoday.com/articles/nerve-pain-in-foot#diagnosis

When to See Your Doctor About Leg Pain

From womenfitnessmag.com

Every day, your legs take the most brunt from the activities you undertake. However, you should not experience pain due to this. However, if you experience, you should not ignore it because it could be an indicator of  a serious condition. Leg pains may result from three kinds of conditions – these are ailments that result from bone, joints, and muscle, conditions relating to veins and clots, as well as nerve conditions. So, when should you consider seeing a doctor due to leg pain? Here are situations that require you to seek medical attention:

1.  Blood ClotsWhenever blood thickens and clumps together inside a vein, it turns into a clot. When this happens in a vein that is located deep inside the body, it is referred to as deep vein thrombosis. The majority of deep vein clots occur in the lower part of the leg or on the tight. The possibility of these clots occurring is high among people who remain inactive for extended periods of time, for instance during long car rides or flights.

Persons who smoke, are overweight or are on certain medications are predisposed to blood clots. What makes deep vein clots highly risky is the fact that clots can break and get into the bloodstream then travel through the artery to the lungs. If this happens, the clot blocks the flow of blood – causing a serious condition known as pulmonary embolism. Some steps that you can take to prevent deep vein clots are weight loss, support stockings, and medication. If you suspect that you have developed a blood clot, you need to see a doctor as soon as possible.

2.  Peripheral arterial disease of the lower extremities

This is a condition that occurs when arteries that feed the legs get hardened and damaged. When the arteries get blocked or become narrow, the legs do not get sufficient blood. This causes the lower parts of the legs to cramp. As a result, pain is experienced during exercise, walking or climbing stairs. At the onset of this condition, patients can manage with taking rest. However, is the arteries are severely blocked or narrowed; the pain remains persistent and would do not heal as they should.
Persons who are at risk of developing this condition are people who are obese, smokers and persons who have high cholesterol, are diabetic or have high blood pressure. If you develop this condition, you need to see a doctor. There are instances where surgery may be required after hours doctors services but treatment includes medicines to control diabetes, cholesterol, and high blood pressure. In addition to medication, making lifestyle changes such as eating healthier, quitting smoking, managing weight and exercising can help.

3.  Varicose veins
These are common conditions that many are familiar with because they show on the skin surface. The veins have a twisted, purple or dark blue appearance that results from a weak vein and valve walls. Persons who have this condition tend to experience dull aches after standing. Some pain-relieving treatments include the use of support stockings and switching between sitting and standing throughout the day. In addition to these medications, patients should see a doctor to access other kinds of treatment, particularly when the varicose veins are extremely painful.

4.  Narrowed spinal canal and sciatica
There are instances where nerve problems can be a cause of leg problems. One of these problems is the narrowed spinal canal that results from spinal arthritis, and sciatica that developed when there is pressure on nerve roots due to the push by the herniated disc. Some of the common signs of sciatica are numbness, weakness, tingling, fatigue and leg pain that is associated with burning and cramping of the leg when a person stands or sits.

This pain can start from the hip and the back, then extend to the legs later. While taking rest can help with other leg pains, it does not help much with sciatica. Rather, this condition requires a patient to see a doctor who may recommend medications such as pain relievers and anti-inflammatories. Patients are also advised to rest for several days. Stretching exercises and physical therapy as well as cold and help do help with relieving some symptoms. If there are no changes and the pain does not reduce, doctors may recommend surgery or change medication.

5.  Diabetic neuropathy
This is a complication that develops due to diabetes where nerves get damaged by high levels of blood sugar. The condition causes pain on both legs coupled with reduced sensation and numbness on the lower parts of the legs. If you have this condition, it’s important that you see your doctor right away for pain control treatment as well as medications to manage blood sugar levels.

https://www.womenfitnessmag.com/when-to-see-your-doctor-about-leg-pain/