Healthy Foot Blog/Understanding Peripheral Neuropathy

Understanding Peripheral Neuropathy

Tuesday, October 17, 2023

Peripheral neuropathy is a malfunction of the peripheral nerves, or the nerves outside the brain and spinal cord (the central nervous system).  The peripheral nerves include all other nerves of the somatic and autonomic nervous systems.  

To understand this more completely, let me break down first the somatic nervous system into its various parts:

  •  Large Fiber Sensory Nerves:  Neuropathy of these sensory nerves include the larger sensory nerve fibers extending from the Central Nervous System.  These large fiber nerves are long myelinated (sheathed) nerves that allow fast conduction of impulses to the brain or spinal cord.  They principally carry non-nociceptive (non-painful) stimuli and dysfunction is usually not associated with pain.   The symptoms include numbness, tingling, weakness and loss of reflexes.
  • Small Fiber Sensory Nerves: Neuropathy of these sensory nerves include smaller nerve fibers furthest from the central nervous system (brain and spinal cord) and usually much smaller and unmyelinated (in most cases).  These nerves carry many different sensation types, but are usually associated with nociceptors (pain receptors).  They, therefore, present with the pains or abnormal sensations called paresthesia (tingling, prickling or even burning).  
  • Motor Nerves: These nerves are also typically large fiber nerves and are usually myelinated. As opposed to sensory nerves flowing back to the central nervous system, these nerves carry signals to the muscles.  Therefore neuropathy will produce weakness, cramping, contractions and fasciculations (bouncing of the muscles).

The autonomic nervous system can also be affected by peripheral  neuropathy.  This is the most commonly "forgotten" presentation of peripheral neuropathy.  Symptoms can affect any of the automatic functions of the body such as: dizziness, lightheadedness, exercise intolerance, sweating abnormalities, dryness of skin, poor blood sugar regulation, difficulty digesting foods, urinary problems, vision abnormalities and sexual dysfunction

In the autonomic nervous system there are also two systems:

  •  Sympathetic Nervous System:  Fight or Flight reactions of the body.  Upregulating the necessary functions to allow you to fight or flee, while downregulating the unnecessary functions like digestion.  
  • Parasympathetic Nervous System: Rest and Digest reactions of the body.  Downregulating many of the systems to allow the body to rest, relax and digest.  

When these systems are out of sync (as with peripheral neuropathy) the body has difficulty doing many of the normal functions and can lead to other problems.

No matter what the presentation of peripheral neuropathy, even severe symptoms, peripheral neuropathy can be treated.  The key is Understanding your peripheral neuropathy (including how it is unique), Managing the symptoms so you can function as normal, Treat the causes of neuropathy to prevent additional nerve damage so that you can Thrive even with peripheral neuropathy.  In other words, we want to change your world by empowering your extraordinary life!

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