DEAR DR. GOTT: Please tell me about non-diabetic neuropathy of the feet. What causes it? Is there any cure?
DEAR READER: The word neuropathy signifies nerve damage. People commonly associate it with diabetes; however, a number of other possible causes for the disorder include alcoholism, hypothyroidism, Charcot-Marie-Tooth syndrome, celiac disease, deficiency of pantothenic acid (vitamin B5), kidney and/or liver disorders, Guillain-Barre syndrome, varicella-zoster infection (shingles), hepatitis C, HIV/AIDS, exposure to toxins, traumatic injury and more.
Neuropathy can affect our nerves, muscles, joints and organs. When it occurs in the legs, it can cause a feeling of numbness in the feet, gait abnormalities, burning, aching, tingling and trouble walking.
Our nervous systems involve the brain and spinal cord. All nerves in other parts of the body are referred to as our peripheral nervous system. Peripheral neuropathy (PN) typically begins in the longest nerves — the toes. It can affect nerves that control muscles, blood pressure, bladder function, heart rate and more. PN can ultimately lead to numbness of the feet or hands, a burning sensation, muscle weakness, lack of coordination and a great deal more.
Diagnosis should begin in your physician’s office and might include examination and history as well as a check of your muscle strength, the ability to detect specific sensations and reflexes. Your physician may also choose to order laboratory testing to determine whether your thyroid is functioning properly, if you have any vitamin deficiencies or malfunction of your liver and kidneys. A nerve-conduction study can measure the speed with which your nerves carry electrical signals. A CT or MRI might be ordered to determine whether you suffer from a herniated disc or other abnormalities. Finally, a nerve biopsy can be ordered. This test can reveal abnormalities; however, it will not always be clear what has damaged the nerves to cause the neuropathy.
Treatment consists of treating any underlying diseases and over-the-counter pain relievers for mild cases. As symptoms exacerbate, heavier prescription drugs might follow. When those fail to offer relief from pain, drugs such as codeine might be ordered. Some medications, such as lidocaine patches, antidepressants and anti-seizure drugs, have shown promise when prescribed for nerve pain.
On the home front, I recommend you stop smoking if you currently do so, exercise regularly if your physician approves, massage your feet to improve circulation, and avoid activity such as crossing your legs when sitting, a habit that can worsen the nerve damage.
Readers who are interested in learning more about this and other debilitating pain issues can order my Health Report “Managing Chronic Pain” by sending a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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