Numbness, tingling and pain in the hands and feet? Dr Yibing Li explains in this article from the 05/2012 issue of Healthy Cells Magazine.

Today, an estimated 15-20 millions of people in the United States suffer from pain, numbness, tingling and weakness from neuropathy. While several types of neuropathy exist, all have nerve pain that severely interfere with their sleep, inhibit mobility and quality of life. It is increasing being recognized as a major cause of painful burning sensation in the feet and hands.

What is Neuropathy?

Neuropathy means disease of nerves, which results from nerve damage and disconnection between brain and spinal cord to the body. The symptoms usually start in the feet. The numbness made it difficult to walk and maintain balance, Sometimes it feels like I am walking on rocks.

How is Neuropathy Classified?

Most of the neuropathy can be classified into the three categories:

  1. Mononeuropathy: means disease of a single nerve, such as carpal tunnel syndrome, cubital tunnel syndrome.
  2. Multiple mononeuropathy: two or more nerves in different areas affected.
  3. Polyneuropathy: generalized involvement of peripheral nerve system in the body.

What are Common Symptoms?

Since the nerves of your peripheral nervous system send information back and forth from your brain and spinal cord to the rest parts of the body, the nerve damages can cause:

  • Numbness and Tingling in the Feet and/or Hands which may spread upward to your legs and arms (sensory nerve involvements)
  • Burning, Sharp or Electric-like Pain
  • Extreme Sensitivity to Touch even light touch
  • Loss of Balance lack of coordination, falls
  • Muscle Weakness if Motor Nerve Involved (motor nerves control your muscle movements)
  • Bowel or Bladder Problems if autonomic nerve affected. (autonomic nerves control blood pressure, heart rate, digestion and bowel/bladder functions)

What Causes Neuropathy?

Sometimes it is difficult to find the exact cause of the neuropathy, but there are a numbers of risk factors that can interfere the nervous system dysfunction, resulting in the nerve diseases, such as:

  • Alcoholism
  • Autoimmune Diseases including Lupus, Rheumatoid Arthritis and Guillain-Barre Disease.
  • Diabetes
  • Exposure to Poisons such as heavy metals, certain medications that used to treat cancers (chemotherapy)
  • Infections Certain viral and bacterial infections can cause Neuropathy such as HIV, Hepatitis, EB Viral Infection, Lyme Disease, etc.
  • Inherited Diseases Examples are Charcot-Marie-Tooth Disease.
  • Traumas such as motor vehicle accident, sport injuries, falls can damage to the nerves.
  • Tumors either benign or malignant growths can cause pressure to the nerves.
  • Vitamin Deficiencies especially Vit. B, Vit. E and niacin. They are crucial to nerve health.
  • Other Diseases such as Kidney Disease, Liver Diseases, Thyroid Dysfunctions are very common causes of Peripheral Neuropathy.

How is Neuropathy Diagnosed?

Neuropathy is not usually a single disease, diagnose may be not easy. The standard diagnostic process begins with a detailed medical history with complete physical exam, especially neurological exam by licensed physicians. The gold diagnostic test is nerve conduction study/EMG and small fiber nerve testing, which can be performed by doctors who are specialized in nerve and muscles disease such as physiatrists (physical medicine & rehab doctors) and neurologists. Other common tests include certain blood test and urine test. Sometimes nerve biopsy is required.

Can Back Pain and Neck Pain Cause Nerve Pain in Extremities?

Yes. Nerve pain in the extremities can result from one or more pinched or nerve roots from spine (neck and back). Examples are:

  • Sciatica or Lumbar RadiculopathyChronic pain that radiates from back down the legs/feet.
  • Cervical RadiculopathyChronic pain that radiates from neck down the arms.

Consult your pain or spine specialist for checkup. Sometimes MRI will be ordered. Treatments may include physical therapy, epidural injections, etc.

How to Treat Neuropathy?

Even though neuropathy is very difficult to treat, but nowadays more and more treatment options are available. They range from traditional medications to alternative therapies that stimulate the nerve system regenerate. The goal is to find out the conditions causing the neuropathy. If the underlying etiology is corrected, the neuropathy will improve on its own. The treatment should be individualized.

For example, if the patient�s numbness and tingling in the feet is due to diabetic neuropathy, the key prevention and treatment of the neuropathy is to manage diabetes.

The common used medications such as Neurontin, Lyrica, Cymbalta, are helpful with relieving the painful symptoms. Physical therapy with modalities may help the muscle weakness, balance deficits from the neuropathy. Lifestyle changes including exercises, quit smoking, eat healthy meals is important as well. People with neuropathy may benefit from alternative medicine such as acupuncture, alpha-lipoic acid, biofeedback, etc.

But research studies showed the most effective treatments for all kind of painful neuropathy are a multi-disciplinary medical team care, which has received level I scientific evidence in medical history.

How to Prevent Neuropathy?

The best way to prevent neuropathy is to carefully manage any medical condition that put you at risk. Make healthy lifestyle choices and avoid anything that can cause nerve damage as much as possible. Seek medical care right way if you develop any usual numbness, tingling, weakness or pain in the hands or feet. Early diagnosis and treatment warrant the best chance for controlling your symptoms and prevent further damage to your nervous system.

Dr. Yibing Li, the medical director of Center for Pain Management & Rehab (CPMR), leads a multi-disciplinary pain management team in Peoria and Pekin. Dr. Li is specialized in nerve/muscle diseases and interventional pain management. She is triple board- certified in Pain Medicine, Physical Medicine & Rehabilitation and spf NCS Electrodiagnosis. For more information, call 309-689-8888 or visit

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