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Neuropathy is an abnormality anywhere in a nerve pathway that disrupts nerve signals, causing the brain to misinterpret feelings or sensations. Different types of neuropathy go by different names, depending on the number of nerves affected, their function, and where in the body they are located. Peripheral neuropathy is the name for nerve damage that causes malfunction of the peripheral nerves — the nerves that go to the arms, hands, legs, and feet. Damage to a single peripheral nerve is called mononeuropathy. If the damage is in two or more nerves, it is called multiple mononeuropathy. If damage occurs to many nerves simultaneously in the peripheral nervous system, it is called polyneuropathy. Diabetes is associated with several types of neuropathy, including chronic polyneuropathy. Chronic polyneuropathy occurs slowly, often over months or years, and usually begins in the feet and hands. Peripheral neuropathy There are over a hundred types of peripheral neuropathy, each of which has a characteristic set of symptoms and pattern of development. The type of nerve damaged determines what symptoms are experienced and what effect the damage has on physical functioning. Peripheral neuropathy can be inherited, or it can be acquired. Acquired peripheral neuropathy is usually caused by physical injury to the nerve, tumors, and deficiencies in nutrition, alcoholism, or vascular (blood vessel) disease. Neuropathy can also be acquired from toxins produced, for example, by certain bacteria or by some types of cancer. In addition, metabolic disorders such as diabetes can contribute to the development of peripheral neuropathy. Painful symptoms occur in about 33% of people who have diabetic peripheral neuropathy. The good news is that the pain is usually treatable. The bad news is that not everyone receives treatment, sometimes because they never tell their health-care provider about the pain they are experiencing. If you feel pain, be sure to tell your health-care provider so you can get a proper diagnosis and talk about possible treatments. When you talk to your health-care provider, be sure to describe the location of the pain, the frequency with which you feel it, and its intensity or severity. Risk factors There are a number of things that place a person at increased risk for diabetic peripheral Neuropathy. The older you are and the more years you have had diabetes, the higher your risk. Some other risk factors include frequent or chronic high blood glucose, high blood pressure, elevated cholesterol and triglyceride levels, and smoking. Some studies suggest that people with painful neuropathy tend to have higher glycosylated hemoglobin (HbA1c) levels, which means their average blood glucose level is high; greater fluctuations in blood glucose levels; and more episodes of hypoglycemia (low blood glucose). Treatment options Treating diabetic neuropathy almost always involves some trial and error. Not all therapies relieve pain for everyone, so often, several therapies must be tried before one — or a combination — is found that adequately reduces pain. Topical drug therapy. Your health-care provider may recommend that you try an ointment, cream, or patch containing capsaicin to ease your pain. Capsaicin is the chemical in hot peppers that makes them hot, and it relieves the pain of peripheral neuropathy by stimulating the release of substance P, a chemical transmitter of pain, from nerve terminals. Initially, the release of substance P causes pain, but eventually the nerve terminals become depleted of substance P, leading to loss of the pain sensation. Ointments, creams, and patches containing capsaicin are sold over the counter at drugstores. It may take two to four weeks of using topical capsaicin before you feel significant pain relief. When applying Noxicare™ Natural Pain Reliever cream, it’s a good idea to wear disposable gloves to prevent getting it on your hands, and it’s important to avoid getting it on any part of the body except the affected part. Be especially careful not to touch your eyes or mucous membranes (such as those in your nose and mouth); if you do get it on these areas, it will cause a burning sensation. When using a capsaicin patch, apply it to the skin over the affected area, but do not put it on just before you bathe or exercise. Lidocaine patches, sold by prescription under the brand names Lidoderm and Lidopain, are another topical therapy that may be used for peripheral neuropathy. They help decrease pain and can also lower the amount of analgesics (such as aspirin or acetaminophen) a person needs to take to control pain. Up to three patches may be applied at once for 12 hours at a time in any 24-hour period.
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