Peripheral Neuropathy | What is the Main Cause of Peripheral Neuropathy

What is Peripheral Neuropathy

Peripheral neuropathy is a condition where the nerves located outside of the brain and spinal cord (peripheral nerves) become damaged. This will lead to symptoms like numbness, tingling, pain, weakness, and sometimes muscle cramps, usually affecting the hands and feet. This happens due to impaired communication between the central nervous system and the rest of the body; it can be caused by various factors, including diabetes, vitamin deficiencies, certain medications, or injuries.

Causes of Peripheral Neuropathy

Diabetes is the main cause of peripheral neuropathy in the UK and the US. High blood sugar levels damage nerves in the extremities. This type of nerve damage is called diabetic polyneuropathy. Other causes include

• Infections: Shingles, Lyme disease, hepatitis B and C, and HIV can all cause neuropathy 
• Autoimmune diseases: Rheumatoid arthritis, lupus, and Sjögren’s syndrome can cause nerve damage 
• Kidney and liver disease: Toxins from these conditions can damage nerves 
• Cancer: Some cancers, like lymphoma and multiple myeloma, can cause neuropathy 
• Genetic conditions: Charcot-Marie-Tooth disease is a genetic condition that causes nerve damage 

Other causes 

• Physical nerve damage from injury or surgery: Trauma to nerves from falls, motor vehicle accidents, or sports injuries can cause Peripheral neuropathy. Also, prolonged pressure on nerves from poorly fitting casts, braces, or crutches could trigger it.
• An underactive thyroid gland can cause it. This means that untreated hypothyroidism can damage the peripheral nerves, leading to symptoms like numbness, tingling, and pain in the hands and feet due to impaired nerve function.
• Exposure to toxins like arsenic, lead, or mercury
• Medications: These medications include some cancer drugs, HIV/AIDS drugs, and antidepressants. Also on this list are Vitamin B6 (pyridoxine) in high doses and disulfiram, used to treat alcohol use disorder.
• Alcoholism
• Malnutrition: Malnutrition can directly contribute to peripheral neuropathy as a lack of essential vitamins and nutrients, particularly B vitamins like B12, can damage nerves and lead to the development of this condition; essentially, a poor diet or inadequate nutrient intake can result in nerve damage causing peripheral neuropathy symptoms like numbness, tingling, and pain in the hands and feet
• Repetitive motion: Repetitive motion can be a significant cause of peripheral neuropathy, particularly when it leads to nerve compression or entrapment, as seen in conditions like carpal tunnel syndrome. This is where repeated hand movements can pinch the median nerve in the wrist; essentially, continuous repetitive motions can put sustained pressure on a nerve, causing damage over time. Common examples of these repetitive tasks are jobs involving repetitive typing, assembly line work, and playing certain instruments for extended periods, which can all contribute to nerve damage from repetitive motions.
• Family history of neuropathy: A family history of neuropathy can significantly increase the likelihood of developing peripheral neuropathy, as it suggests a genetic predisposition to the condition, meaning the person may have inherited genes that make them more susceptible to nerve damage, often associated with disorders like Charcot-Marie-Tooth disease (CMT) which is the most common hereditary neuropathy

Stages of Peripheral Neuropathy

Peripheral neuropathy progresses through stages, typically described as

• Stage 1 (Early):
  • Mild tingling, prickling sensations in hands and feet. 
  • Symptoms may be intermittent and not bothersome enough to seek medical attention. 
• Stage 2 (Moderate):
  • Pain becomes more noticeable and consistent, difficult to ignore. 
  • May experience burning or aching sensations. 
• Stage 3 (Severe):
  • Intense pain that significantly impacts daily activities. 
  • Difficulty walking due to reduced sensation in feet. 
  • Muscle weakness may develop. 
• Stage 4 (Advanced):
  • Complete numbness and loss of sensation in hands and feet. 
  • Increased risk of injuries and infections due to lack of pain perception