Neuropathy

Neuropathy is any disorder in which the body's nerves do not work properly due to damage. The nerve damage may be to a single nerve or a group of nerves. Nerve damage can cause pain or loss of feeling in the feet, legs, hands and arms.

Neuropathy symptoms depend on which nerve or group of nerves are damaged. Early signs of nerve damage include tingling or burning in your arms and legs, particularly in your toes and feet.

There are many types of neuropathy (also known as peripheral neuropathy), including diabetic neuropathy, carpal tunnel syndrome and Guillain-Barré syndrome. Polyneuropathy is when multiple nerves and limbs are affected.

Pain associated with nerve damage is referred to as neuropathic pain or neuralgia.

The most common cause of neuropathy is diabetes; however, many neuropathies have no known cause.

When Should I Get Help for Neuropathy?

The following health conditions may cause neuropathy:

• An autoimmune disorder (such as rheumatoid arthritis or lupus)
• Repetitive-stress injury
• Kidney disease
• HIV
• Liver infection
• Vitamin B₁₂ deficiency
• Metabolic disease
• Poor blood circulation in the legs
• Lead poisoning
• An underactive thyroid

Nerve damage can mask important warning signs in your body, such as chest pain (angina) or signs of low blood sugar. Call your primary care doctor if you have early signs of nerve damage, particularly if you have any of the above health conditions.

Neuropathy Care at Rush

If your primary care doctor recommends further evaluation, Rush has many specialists who can help you get to the root of your distress. These experts include neuromuscular physicians who specialize in treating neuropathy, neurologists, pain medicine physicians, and physical medicine and rehabilitation specialists (physiatrists).

Which specialist you see depends on what's causing your neuropathy. Your primary care doctor can recommend the right specialist for you.

Neuropathy diagnosis

To tailor a plan to your needs, your physician will conduct a comprehensive exam. Your exam may include one or more tests, including the following:

• Nerve conduction study and electromyography (EMG). This test looks for damage in the junctions where muscles meet nerves and measures your nerve function and health.
• Skin biopsy. This minimally invasive test takes a small sample of skin for testing. It can be performed by a pain medicine physician.
• Blood tests. Various blood work may help pinpoint the causes of neuropathy. Pain medicine physicians perform these tests routinely.

Neuropathy treatment at Rush

Depending on the type of nerve damage, a variety of treatment options are used, often in combination. Your doctors will work with you to identify a plan that meets your specific needs.

The goal is to target the symptoms and the underlying cause of the neuropathy through some of the following:

• Medications that help with nerve-related pain
• Immune system modulation, including plasmapheresis (a procedure that removes excess antibodies from the blood)
• Bracing, as needed for foot drop, head drop, carpal tunnel syndrome or ulnar neuropathy
• Occupational therapy or physical therapy
• Surgical options. For neuralgia (nerve pain) accompanying neuropathy or carpal tunnel syndrome that is not relieved by the medical options above, surgery may be your best option. For instance, pain originating from the damaged nerves can be treated with the use of nerve stimulators. Many procedures to relieve neuralgia can be performed using small incisions and on an outpatient basis. Your surgeon will discuss your options with you.
• Spinal cord stimulation. This involves blocking the transmission of pain signals from the spine to the brain. Interventional pain management specialists perform this procedure, which typically can be performed with no surgical incision. It is used to treat severe diabetic peripheral neuropathy.

Rush Excellence in Neuropathy Care

• Experienced providers: Neurological and neuromuscular physicians at Rush have expertise in diagnosing and treating neuropathy. This focus can help you find the right treatment plan to improve your quality of life.
• Coordinated care: Depending on the cause of your neuropathy, we may call upon other Rush specialists to provide care for you, such as experts in multiple sclerosis or diabetes, or neurosurgeons. Our team will work closely with these providers to make sure you get the right care at the right time.
• Expertise in complex regional pain syndrome: Complex regional pain syndrome (CRPS or RSD) is a type of neuropathy. Pain medicine physicians at Rush University Medical Center were part of a team of international experts who formulated the diagnostic criteria and validation. We are one of the national leaders in advanced treatment protocols for CRPS and are a referral center for patients both locally and nationally.