Question:

My doctor says I have neuropathy in both my feet. There seems to be nothing that can help this. What can you tell me about my condition?

Answer:

Peripheral neuropathy is a deterioration in the functioning of the nerves that carry messages between the spinal cord and extremities. The condition results from either damage or irritation to the myelin sheaths that surround and protect nerves or damage to the conducting fibers of the nerve. It is not related to a circulation problem.

People who have neuropathies often describe a burning sensation along the involved nerves. In addition, muscle weakness, loss of feeling, loss of ability to distinguish hot and cold, and, occasionally, loss of reflexes may develop.

Numerous problems can cause peripheral neuropathy. A partial list includes injury from trauma, continuing pressure on a nerve, for example from a slipped disc, or inflammation or nerve destruction by disease. The most common diseases that sometimes affect nerves are: diabetes, vitamin deficiency (especially vitamin B-12 deficiency), alcoholism, kidney failure, a condition called Guillain-Barre' syndrome and inherited diseases. Less common causes include drugs, toxins and cancer.

Symptoms of peripheral neuropathy usually begin gradually and progress slowly over many months. The first sign is often a tingling sensation in the toes or the balls of the feet that spreads upward. Pain and numbness may proceed in the same way, and skin can become extremely sensitive so that even the lightest touch can be painful.

A nerve conduction test is an objective way the doctor can determine whether or not a neuropathy exists. The test measures the speed that an impulse moves down a nerve. In addition, this test sometimes provides information about the type of neuropathy causing symptoms.

However, even after extensive studies that include urine tests, blood tests, x-rays, and sometimes a biopsy of the nerve itself, the cause may not be apparent. In fact, for one out of five people with peripheral neuropathy, no cause can be found. Even so, these studies need to be done because some of the causes, such as vitamin deficiencies, can be easily corrected.

There is no proven treatment for peripheral neuropathy, but there are some options available to help relieve your symptoms, or at least make them more tolerable. For example, certain anti-depressants and anti-seizure drugs are effective for relieving symptoms in some people, although the exact mechanism of how these drugs help is not fully understood. With these treatments, it may take several weeks to relieve symptoms.

It is important to keep your feet meticulously clean, wear properly-fitting shoes, and carefully examine your feet each day. If you have lost feeling in your feet, you may cut or injure them without realizing it - a perfect setup for infection or ulcer formation.

For more information, contact the Neuropathy Association, 60 East 42nd Street, Suite 942, New York, NY 10165-0999, (800) 247-6968; e-mail info@neuropathy.org; Web site http://www.neuropathy.org.