I spoke with Dr. Amanda Van Straten, Neurologist at Northeastern Vermont Regional Hospital to answer a question from a reader: What can you tell me about peripheral neuropathy?

Peripheral neuropathy refers to damage to the nerves in the arms, legs or both said Dr. Van Straten. People with peripheral neuropathy often experience burning and/or tingling in these areas, as well as muscle weakness and poor balance.

Although there are many causes for and many reasons why someone experiences it, Dr. Van Straten said the leading cause of peripheral neuropathy in the country is diabetes.

About 60 – 70 percent of people with diabetes have some form of nerve damage that cause symptoms, including tingling or burning feet, pain down one arm or leg and numbness and weakness, according to the National Institute of Neurological Disorders and Stroke (NINDS).

Alcohol use is the second leading cause of peripheral neuropathy. Other causes can include vascular and blood problems, autoimmune diseases, hormonal imbalances, kidney and liver disorders, nutritional or vitamin imbalances, exposure to toxins, certain cancers, chemotherapy drugs and infections, according to the NINDS. Although it’s rare, there are cases of genetic peripheral neuropathy as well.

Once nerve damage happens it can’t be reversed, Dr. Van Straten said, so preventing and/or managing your diabetes and not overindulging in alcohol are important. According to the American Diabetes Association, once neuropathy is detected, the focus is on keeping the feet and legs healthy and on managing pain.

“Once neuropathy occurs we can’t fix the nerve damage, we can only treat the symptoms,” Dr. Van Straten said. “Figuring out why you have the symptoms will help better determine what treatment options are available.”

Treatment options can include prescription and non-prescription medications, herbal remedies, injections, and acupuncture, among others, she said.

There are various medications that can be used to help treat peripheral neuropathy, but Dr. Van Straten noted that medications don’t always work the same for everybody. She also said medications often used for pain caused by nerve damage work differently than “traditional” pain medications in that they need to be taken every day to suppress the pain and it usually takes several weeks to months before the medications take effect. Sometimes, you may need to try a few different medications before you find one that works right for you.

Dr. Van Straten said tests may also be done to help determine the cause of peripheral neuropathy as well as appropriate treatment options. If a patient tells her that their feet are cold and hot, Dr. Van Straten said she usually conducts an exam and does bloodwork, and can also do a nerve conduction study, which measures nerve and muscle function.

Treatment depends on the cause of the peripheral neuropathy, Dr. Van Straten said, and because of this you should check with your primary care provider for treatment options.

We want to hear from you! Are there health topics or issues that you’d like to read about in an upcoming Vital Signs? Email us your suggestions at vitalsigns@nvrh.org, or mail them to NVRH, c/o Katie Bocchino, P.O. Box 905, St. Johnsbury, VT, 05819.

This is the latest installment of Vital Signs, a periodic column by Katie Bocchino, Director of Healthcare Integration at Northeastern Vermont Regional Hospital. Bocchino will provide community health commentary on a range of subjects including health policy, healthy living and current events through the lens of Vermont. After beginning her career in journalism working for two Maryland newspapers, Bocchino transitioned to working in healthcare about six years ago. She holds a Master of Science in Healthcare Administration from Champlain College.


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