Peripheral neuropathy occurs when a nerve or nerves to the legs (or arms) are damaged by injury or disease, such as diabetes or Guillain-Barre syndrome, causing increasing numbness, weakness, burning pain, paralysis and/or impaired sensation, depending on the nerves involved and the degree of damage. Treatment options for neuropathy include lifestyle changes and disease management.
Being a non-smoker is important because smoking causes blood vessels to constrict, decreasing the nutrients the nerves receive from the blood, causing further damage. A regular program of exercise, such as walking, is especially important because exercise maintains muscle strength and increases circulation to the legs. If you have paralysis, you should have passive exercises to move your leg through a range of motion. Obesity can add pressure on nerves, increasing nerve damage, so losing weight and establishing healthy eating habits can reduce the symptoms of neuropathy. Alcohol should be avoided because it is particularly damaging to the nervous system, both directly and because of associated vitamin deficiencies. Chronic pain often does not respond well to conventional pain medications, but pain control, which may include anti-epileptic drugs, tricyclic antidepressants and local anesthetics, is very important to allow you to carry out lifestyle changes.
If your neuropathy is related to a particular disease, you must manage it effectively to reduce symptoms and prevent worsening. For example, if you have diabetes, you must maintain your blood glucose level within normal range through diet and the use of medications such as insulin because fluctuating glucose levels increase nerve damage. If you have an autoimmune disorder, such as HIV/AIDS, you may need drugs, such as steroids or cyclosporine (chemotherapy), to suppress your immune system. With some diseases, such as Guillain-Barre, you may have your blood cleansed of factors causing damage to your nerves through plasmapheresis, in which blood is removed, filtered and returned to your body.
Some neuropathy directly relates to pressure on the nerves. Whether caused by trauma (slipped or fractured disk), osteoporosis (weakening of bone) or tumours, pressure over time can cause severe and permanent nerve damage, so treatment to relieve pressure is critical. In some cases, you may need surgical repair of a slipped disc or decompression of a nerve to relieve the pressure. If pressure is caused by a tumour affecting the spine, you may need surgery to remove the tumour or radiation therapy to decrease its size. If you have nerve compression originating lower in your leg, such as from a knee or ankle injury, sometimes braces or orthopaedic supports can reduce nerve pressure and relieve symptoms.