Ask the Doctor: There Is Hope for Neuropathy
DEAR DR. DONOHUE: I am a 79-year-old woman with peripheral neuropathy.
I have a numb left foot and pain extending the length of my leg and occasionally into the hip.
Early in the mornings, as I begin to move about, my leg seizes up, and the pain is intense.
I use a heating pad, which eventually eases the pain.
I have had diabetes for 30-plus years. It is well-controlled. - J.H.
ANSWER: Simplifying peripheral neuropathy invites egregious errors, but I hope it adds to people’s understanding of this condition.
“Peripheral” here refers to the arms and legs, mainly the legs.
Neuropathy is nerve injury.
Nerves that bring messages from the brain to muscles, instructing them to move, are motor nerves.
Nerves that bring sensations from the body and body surface to the brain are sensory nerves.
And some nerves combine both functions. Neuropathy can affect either kind.
Motor nerve impairment leads to muscle weakness, even to the point where muscles no longer work.
Sensory nerve impairment brings numbness, peculiar sensations or outright pain.
You have predominantly sensory nerve involvement.
The “seizing up” you describe is a muscle cramp, and that sometimes is part of the neuropathy picture.
Diabetes, deficiencies of some of the B vitamins, an autoimmune attack on nerves, excessive intake of alcohol and some inherited conditions lead to neuropathies.
Antidepressants can alleviate neuropathic pain.
Amitriptyline and Cymbalta are two that are often prescribed.
Seizure-control drugs like Lyrica and Tegretol also suppress it.
Capsaicin cream (Zostrix, no prescription needed) applied to the painful area can bring relief.
Lidoderm patches and lidocaine gel, products related to Novocain, offer easing of pain.
If routine pain medicines are ineffective and the pain is severe and disruptive, drugs like oxycodone and tramadol (morphinelike drugs) can be prescribed and should not be feared.
Get in touch with the Neuropathy Association.
It provides you with more-extensive explanations and guides you in treatments.
The phone number is 800.247.6968.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.