Neuropathy: What’s behind nerve pain, tingling and numbness?

Neuropathies are disorders of the nerves that can cause a wide range of symptoms. But what exactly does the term “neuropathy” mean? What types exist, what causes them, and what treatment options are available? This article provides an overview and explains how neuropathies are diagnosed and treated.

Table of Contents

• What is neuropathy?
• What are the different types of neuropathy?
• What are the causes of neuropathies?
• What are the risk factors for neuropathy?
• What are the typical symptoms of neuropathy?
• How is neuropathy diagnosed?
• What are the treatment options for neuropathies?
• Summary

What is neuropathy?

Neuropathy refers to damage or dysfunction of nerves. The nervous system consists of:

• Central nervous system (CNS): brain and spinal cord

• Peripheral nervous system (PNS): nerves outside the brain and spinal cord that transmit signals to muscles, skin, and organs

When one or more nerves are damaged, symptoms such as pain, tingling, numbness, or muscle weakness can occur. The exact symptoms depend on which nerves are affected (NCI, 2023).

What are the different types of neuropathy?

There are more than 100 different types of neuropathy. They are usually classified according to the number of nerves affected and the type of nerve damage.

By number of affected nerves

• Mononeuropathy: Only a single nerve is affected, for example in carpal tunnel syndrome (compression of the median nerve).

• Polyneuropathy: Several peripheral nerves are damaged at the same time. This is the most common form, often caused by diabetes or long-term alcohol abuse.

By type of affected nerves

Source: NIDDK, 2023

What are the causes of neuropathies?

Neuropathies can be inherited or develop due to various factors:

• Diabetes mellitus – the most common cause (diabetic polyneuropathy)

• Infections/viruses – e.g., Lyme disease, hepatitis C, HIV

• Autoimmune diseases – e.g., rheumatoid arthritis, lupus, celiac disease

• Nerve injuries – from trauma, surgery, or long-term nerve compression

• Alcohol abuse – direct nerve damage and vitamin deficiencies

• Vitamin deficiencies – especially vitamins B1, B6, B12, folic acid (B9), and vitamin 

Source: Cleveland Clinic, 2022

What are the risk factors for neuropathy?

• Diabetes (poorly controlled blood sugar)

• Genetic predisposition

• Age over 40

• Unhealthy lifestyle: alcohol consumption, smoking, lack of physical activity

Source: Mayo Clinic, 2022

What are the typical symptoms of neuropathy?

The symptoms depend strongly on the type of neuropathy.

Overview of symptoms:

Symptoms often develop gradually. Early medical evaluation is important to prevent progression.

Source: CDC,2022; Cleveland Clinic, 2020; Cleveland Clinic, 2022

How is neuropathy diagnosed?

Diagnosis is made through a medical examination and, if necessary, additional tests:

• Neurological examination – reflexes, muscle strength, sensation

• Blood tests – e.g., for vitamin deficiencies, diabetes, infections

  • Self-tests such as a vitamin deficiency test or blood sugar test from Homed-IQ can also be helpful for preventive screening

• Nerve conduction study (NCS) – measures how quickly signals travel along nerves

• Electromyography (EMG) – measures electrical activity in muscles

• Imaging – CT, MRI, or X-ray to rule out other causes

Source: NHS, 2022

What are the treatment options for neuropathies?

Treatment for neuropathy usually focuses on treating the underlying cause and relieving symptoms. This may include:

• Treating the cause: e.g., blood sugar control in diabetes, vitamin supplementation in deficiency

• Medications: pain relievers, antidepressants, anticonvulsants

• Physiotherapy: strengthening and maintaining mobility

• Healthy lifestyle: balanced diet, regular exercise, avoiding alcohol and nicotine

• Invasive procedures: e.g., nerve blocks or implanted pain pumps in severe cases

Anyone who has neuropathy or is experiencing symptoms of neuropathy should speak to their doctor about the best treatment strategy (Mayo Clinic, 2022).

Prevention

While not all neuropathies can be prevented, adopting healthy habits can significantly lower the risk of nerve damage or slow its progression. Key preventive measures include:

• Good blood sugar control in diabetes

• Vitamin-rich diet (especially B vitamins)

• Reduce alcohol consumption, do not smoke

• Regular exercise and a healthy lifestyle

Prognosis

The prognosis depends greatly on the cause:

• With treatable causes (e.g., vitamin deficiency), symptoms may improve within weeks.

• In chronic conditions (e.g., diabetes), neuropathy may progress but can be slowed down with consistent treatment.

• In some cases, symptoms may persist permanently.

Summary

Neuropathies are diverse nerve disorders with many different causes and symptoms. Early diagnosis is crucial to prevent further nerve damage. Through a combination of treating the underlying cause, managing symptoms, and maintaining healthy lifestyle habits, patients can significantly improve their quality of life.