Neuropathy: Common Symptoms and Diagnosis

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Neuropathy, the dysfunction or damage to one or more nerves, affects between 25% and 30% of Americans in their lifetime. While it can affect people of all ages, those over 65 are most at risk, with 8% stating they experience some degree of the condition. Peripheral neuropathy comes in many forms, causing people to confuse their symptoms with other conditions or completely ignore the signs.

Here, Dr. Hanid Audish of Encompass defines the most common symptoms of peripheral neuropathy and describe the medical diagnosis process to aid those who’ve otherwise been self-diagnosing the condition.

The Common Signs and Symptoms of Peripheral Neuropathy

Generally speaking, the typical symptoms of neuropathy are as follows:

  • Loss of coordination
  • Tingling (i.e., pins and needles) or numbness, mainly around the hands and feet
  • Stabbing, throbbing, sharp, or burning pain
  • Sensation chains (e.g., extreme touch sensitivity or inability to feel pain or pressure)
  • Muscle twitches, spasms, or cramps
  • Paralysis in certain body parts
  • Abnormal heart rate or low blood pressure, potentially causing fainting, dizziness when standing up, and lightheadedness
  • Excessive or insufficient sweating
  • Urination problems
  • Bloating, vomiting, nausea, diarrhea, or constipation
  • Sexual function issues
  • Unintentional weight loss
  • No sense of feeling in your feet or hands
  • Muscle weakness

However, symptoms vary depending on the type of nerve that’s damaged:

  • Sensory nerves send information like temperature, pain, and touches.
  • Motor nerves deal with the movement of muscles that can be consciously controlled, like those used for walking, talking, etc.
  • Autonomic nerves control organs used in subconscious processes like breathing, digesting food, etc.

Neuropathies tend to affect all three nerve types to certain extents. There is often one primarily affected kind and two mildly damaged.

Medical professionals state there are length-dependent and non-length-dependent forms. In cases of the former, the further nerve endings (i.e., in the feet) are where the symptoms begin or are the worst. Over time, the sensation can spread to other bodily regions. In the latter, symptoms are either patchy or begin around the torso.

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Receiving a Neuropathy Diagnosis

Due to the long list of symptoms, those experiencing a few tend to self-diagnose with peripheral neuropathy or chalk the signs up to “general pain.” Neither help in the long run.

Ideally, people suffering from any combination of the above symptoms should seek a professional medical diagnosis. Doctors typically take these steps to confirm or deny neuropathy:

  1. Medical history and physical exam — The doctor reviews the patient’s medical history and symptoms, asking questions about:
    1. Medications
    2. Exposure to toxic substances
    3. Trauma history
    4. Work
    5. Social habits
    6. Family history of nervous system disease
    7. Alcohol and drug use
    8. Diet
  2. Neurologic exam — Here, the doctor assesses reflex, balance, muscle strength, coordination, and ability to feel sensations.
  3. Imaging and blood work — Doctors order blood work to check mineral, vitamin, and electrolyte imbalances, thyroid issues, antibodies, and more. Imaging tests like MRIs indicate nerve compression and tumors.
  4. Electrodiagnostic assessment (EDX) — Patients could be sent to nerve specialists to determine the location and degree of damage. EDX includes a nerve conduction study (NCS) and needle electromyography (EMG).

Those who notice the common symptoms of neuropathy should seek help from their healthcare provider as soon as possible to mitigate the risk of permanent nerve damage.