What is a polyneuropathy?
Let’s start off by breaking down this word.
Poly = “many”
Neuropathy = “nerve injury”
Therefore, a polyneuropathy means an injury to many nerves.
A polyneuropathy is a length dependent, slowly progressive disorder of nerves in the peripheral nervous system.
When we hear people speak of a peripheral polyneuropathy they are often referring to numbness or tingling in their feet and legs associated with their diabetes. It is sometimes referred to as a “diabetic neuropathy” in these situations.
In the classic sense of a polyneuropathy, all of the nerves responsible for moving and feeling are susceptible to this disease, but in most situations the longest nerves in our bodies (the ones that go into our feet) are the first to go. For the majority of people, that is the extent of the progression, but for others the sensations may worsen and new symptoms may develop into their legs or even their hands.
Why does this happen?
There are many, many different reasons for people to develop symptoms of a polyneuropathy.
For some people the condition is passed down from a parent or family member (inherited), but for the majority of people it is secondary to something else that is going on (acquired).
Because the majority of our patients have the acquired type, we will stick to that as an example.
Underlying conditions such as diabetes, thyroid disorders, B12 deficiencies, or kidney failure can cause a polyneuropathy.
Exposure to toxins or chemicals can also cause symptoms of a polyneuropathy. Examples of this are heavy alcohol or drug use, or exposure to very toxic chemicals (i.e. chemotherapy).
Aging also plays a part in the process. As we age, we slowly lose nerve and muscle cells. This occurs naturally, but for some people this process may happen at a more rapid rate. Without any underlying conditions, this classifies a polyneuropathy as “idiopathic”. This basically means that it happens for no good reason at all.
Symptoms of a polyneuropathy:
As mentioned before, typically people first noticed symptoms in their feet or toes. As the process progresses, these symptoms may refer up into their legs or even into their hands.
Symptoms may vary between person to person, but here is a list of common ones we hear from patients:
- Tingling or pins & needles
- Burning or hot sensations
- Chronically cold feet
- The sensation of having socks bunched up under your toes or the feeling of walking on pebbles
- Inability to know where your feet are while walking
- Poor balance
To properly diagnose a polyneuropathy a physician will get a detailed medical history from you. This includes information about other medical problems, lifestyle factors and the symptoms you are experiencing. The next step would be a detailed physical examination followed by tests that look at the function of the nerves and/or muscles themselves. This is done by having nerve conduction studies (NCS) and/or electromyography (EMG). Both the NCS and EMG help to quantify the degree of injury to the nerves and/or muscles. The physician may also order blood work or in some cases genetic testing.
Treatment & Management
Treatment varies between people and depends on the cause of the symptoms. Finding out the cause can be helpful to stop the progression or reverse the process all together for some individuals. For example, if the cause of the polyneuropathy is a Vitamin B12 deficiency, then supplementing with B12 may help to reverse the symptoms. For someone who has undiagnosed type 2 diabetes, then treating the diabetes and controlling blood glucose levels may help to prevent progression of symptoms.
Making overall healthy lifestyle choices such as eating a well-balanced diet, exercising and avoiding factors that can contribute to nerve damage (i.e. smoking or heavy drinking) can not only manage your symptoms, but may also prevent them from happening all together.
In some situations, there may no way to stop or reverse the process. Instead, there are options to help manage the symptoms of the polyneuropathy. This could include various oral medications, topical creams, exercise or other treatments like acupuncture.
*It is important to talk to your doctor about your symptoms first before you start supplementing with vitamins or start trying different medications. Although the symptoms may be similar for a lot of people, it is important to understand that a polyneuropathy can be caused by many different things. Proper diagnosis is essential for correct treatment*