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Get the facts about neuropathy

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About 2-7% of people in the United States have neuropathy, which makes it one of the most common neurologic problems, right after headache. It increases in people who are over the age of 50 or 60, so the older we get, the more likely we are to have this medical condition.

Definition of neuropathy

When most people say “neuropathy,” they mean polyneuropathy or the neuropathy that affects people starting in their feet. People can also have neuropathy in their hands.

Signs and symptoms of neuropathy

People often describe numbness and tingling.

Pain is also a big symptom and it’s something that bothers people more than the other symptoms. It can be an electric pain, a burning pain or a sharp pain, and it’s usually located in a “stocking glove” pattern because it’s like stockings going up your leg and gloves on your hands.

Neuropathy can also cause weakness but that’s usually a much later symptom. 

When to see a doctor

If you have symptoms such as these that concern you, you should talk about them with your primary care physician (PCP). Many people experience numbness and tingling from time to time, but I’m talking about numbness and tingling that stay with you.

Treatment for neuropathy

The healthcare community cannot make nerves get better or repair, yet, but hopefully if we can address the underlying problem we can prevent nerves from getting worse.

We do that by finding out what caused the neuropathy and treating the cause.

Causes

Diabetes causes 50% of all neuropathies. If you have diabetes—or even pre-diabetes—by all means, get it under control through diet and exercise.

Alcohol is the No. 2 cause of neuropathy. Quitting alcohol is the best thing you can do for yourself.

6 medications for pain

Currently, there are six really good medications for neuropathy pain. Five of these are off patent, or generic, which make them very affordable; they are amitriptyline, nortriptyline, duloxetine, venalafaxine and gabapentin. The brand medication is pregabalin.

I would recommend that you try the generic medications before the brand one because there really isn’t any evidence that one works better than the other. It’s a matter of finding the one that works for you and even trying different combinations of these medications.

Making a difference

The things that will really make the most difference in your quality of life with neuropathy are making your pain manageable—and controlling what you can control, like diabetes and alcohol consumption.

Next steps

Brian_Christopher_Callaghan_MDBrian C. Callaghan, M.D., is an Assistant Professor of Neurology at the University of Michigan. He completed his medical degree and neurology residency at University of Pennsylvania Hospital and a fellowship in neuromuscular disease at U-M. He also completed a master’s degree in clinical research at the U-M School of Public Health. His clinical and research interests focus on peripheral neuropathy.

 

Neurosciences logoThe University of Michigan’s multidisciplinary neuroscience team is made up of more than 70 nationally recognized neurologists, neuroanesthesiologists and neurosurgeons. Leading the way in brain, spine and nervous system care for close to 100 years; patients have access to services that can be found at only a handful of places; as well as innovative treatments with the latest research. Neurology and Neurosurgery at the University of Michigan Health System have been recognized by U.S. News & World Report numerous times for excellence in patient care.