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Numbness, Tingling, and Pain - Oh My!

Wednesday, December 14, 2022 11:20 AM

3 Common Misconceptions About Neuropathy

By Karyn Odway

An estimated 20 million Americans – mostly older than age 50 – suffer with neuropathy, a condition of the peripheral nerves that run throughout your body transmitting signals to and from the brain and spinal cord. These nerves help you feel and move, and when these nerves are not functioning properly, a person might experience sensations of numbness, tingling, and pain. Muscle weakness also could result, impacting how a person moves.  

Foot pain, Asian woman feeling pain in her foot at home, female suffering from feet ache use hand massage relax muscle from soles in home interior, Healthcare problems and podiatry medical concept“There are hundreds of reasons why someone would develop problems with the peripheral nerves, so a thoughtful approach to the problem is needed to treat what can be a life-altering condition,” says NorthShore Neurological Institute Neurologist Octavia Kincaid, MD, who specializes in the detection and treatment of peripheral neuropathy. “If a person has symptoms of neuropathy, the first thing we need to address is whether their symptoms are the result of the peripheral nerves or some other part of the nervous system.”

Here, she shares common misconceptions about the condition:

Misconception #1: Peripheral neuropathy is a simple medical diagnosis.

“Being diagnosed with peripheral neuropathy means your physician knows which part of the nervous system is causing the symptoms, but not why or what to do about it,” Dr. Kincaid explains.  “Patients who are told they have neuropathy should ask for details about the diagnosis to answer these questions.”

Numbness, tingling, pins-and-needles sensation, and pain are all symptoms of neuropathy, which is the dysfunction of one or more nerves. Some of the more common causes include diabetes, chemotherapy, nutritional deficiencies, and excessive alcohol consumption.   

“We need to find the anatomical source of the sensations or pain to determine if it’s a nerve root disorder or a pinched nerve,” Dr. Kincaid explains. Diagnostic testing involves blood work, including but not limited to checking for diabetes and vitamin B12 levels, as well as imaging to look for possible nerve damage in the spine.

“We are looking for other medical problems that might lead to neuropathy like diabetes or that could explain why they have symptoms that mimic neuropathy like spinal stenosis,” Dr. Kincaid explains.

She cautions that a third to as many as half of all patients experiencing symptoms of neuropathy will never know the cause, which would be classified as idiopathic. “If we’re not sure of the cause, we manage the symptoms.”

Misconception #2: Numbness, tingling, pain, and weakness must be peripheral neuropathy.

Dr. Kincaid says many otherconditions present as the typical symptoms of peripheral neuropathy.

Numbness, tingling, pain, or weakness symptoms could come from spinal cord compression or spinal stenosis, which is caused by a pinched nerve.  Sudden onset of numbness or other sensory symptoms may need to be evaluated for possible stroke.

“Spine disease – like stenosis in the lumbar region or cervical spine issues – can mimic neuropathy, especially in the elderly,” she notes. “Conditions that involve the spine are commonly misdiagnosed as peripheral neuropathy.”

Misconception #3: Symptoms of peripheral neuropathy are always permanent.

“Generally, nerve damage or dysfunction may be reversible,” Dr. Kincaid says. “But only a person’s own body can heal it. Once we figure out what’s triggering the pain, tingling, or numbness and properly treat it, you’ll increase the chances of the nerve healing.”

  • For diabetic neuropathy, studies have found the antioxidant alpha lipoic acid in high-dose supplement form (600 mg daily) could result in a decrease in neuropathic pain, but no other symptoms such as numbness and tingling.
  • For patients with alcohol substance use disorder, it might take years before nerves are restored once excess drinking stops. Alcohol is a neurotoxin, so too much of it will damage nerves. As the saying goes, “the dose makes the poison.”
  • For vitamin B12 deficiency neuropathy, once a patient’s B12 levels are regulated by taking B12 supplements, the damage could be reversible.
  • For chemotherapy-induced neuropathy, once chemotherapy treatments for cancer subside, the pins-and-needles feeling often goes away, but not always.  
  • For chronic pain, there are six categories of treatment that can be considered: Physical therapy, occupational therapy, pain psychology, medications, nerve blocks/injections, and neurostimulation. If pain associated with neuropathy is not well controlled with these therapies, you may consider reaching out to pain specialists, such as those at the Northshore Integrated Pain Center.

“If it’s a reversible problem, we can set the stage for the nerve to heal by treating the underlying condition, so don’t ignore nerve issues,” Dr. Kincaid concludes. “Even if the problem cannot be reversed, effective treatments exist to improve function and reduce the pain that often comes with neuropathy.” 

 

Octavia Kincaid, MD, is a neurologist at the NorthShore Neurological Institute, specializing in the diagnosis and treatment of peripheral neuropathy. You may schedule an appointment online or call (847) 570-2570 847.570.2570.