Neuropathy

Pay attention to that ‘pins and needles’ sensation

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Dr. Kristi Gill, a general neurologist at Payson Regional Medical Center, recently spoke to a group at the Senior Circle about neuropathy.

Just about everyone has experienced that “pins and needles” sensation in their feet and hands. Usually we say our foot/hand has “fallen asleep” because we have rested on it wrong.

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A diagnosis of neuropathy would start with getting a patient’s clinical history — medical problems, lifestyle, symptoms, exposure to toxins, alcohol use, and family history, followed by a physical exam of sensation, reflexes and strength and then special tests aimed at proving that there is neuropathy and trying to find the cause with blood work and additional tests.

If the sensation becomes frequent or constant it is time to talk to your health care provider. There is a chance you have developed neuropathy.

Kristi Gill recently spoke to members of the Senior Circle and others about neuropathy. Gill, a general neurologist, recently joined Payson Regional Medical Center.

Neuropathy is damage or disease of the nerves, she explained. It is not a single disease, but it can be a problem on it’s own or the complication of a number of other diseases.

Surprisingly, she said up to half the people with neuropathy are asymptomatic and the condition is discovered when they are being examined for something unrelated.

Among its many causes: a third of all cases are seen in patients with diabetes, alcohol, age, toxins, heredity, infections, nutrition, hormones, liver and/or kidney disease, autoimmune conditions, or it can be idiopathic — not related to any discoverable condition. Nerve pain and neuropathy can also come from pinched nerves in the neck, back, wrist, elbow, knee, shoulder and groin; it can also be post-stroke; and it can come from shingles.

Gill said there are three nerve types: sensory, which send information to the brain; motor, which send information from the brain; and autonomic, which direct heart rate, blood pressure, sweating, digestion.

Among the neuropathy symptoms associated with the sensory and motor nerves:

• cramps

• twitching

• burning pain

• stabbing pain

• buzzing

• tingling

• sensitivity to touch

• increased pain sensitivity

• fatigue

• weakness

• wasting

• numbness

• balance problems

• problems differentiating hot and cold

Symptoms with the autonomic nerves may include: bowel problems; bladder problems; impotence; heat intolerance/sweating abnormalities; skin, hair, nail changes; cold hands and feet; lightheadedness.

Gill said diagnosis of neuropathy would start with getting the patient’s clinical history — medical problems, lifestyle, symptoms, exposure to toxins, alcohol use, and family history. This would be followed by a physical exam of sensation, reflexes and strength and then special tests aimed at proving that there is neuropathy and trying to find the cause with blood work and additional tests.

The treatment could include fixing or removing the underlying cause, preventing further damage and pain relief.

Among the medications that might be prescribed are antidepressants; Lyrica or Neurotin; analgesics or topicals.

There are some procedures available for focal neuropathies such as decompressive surgeries, injections and Botox.

Gill said there are a variety of alternative treatments offered for the condition: acupuncture; supplements; homeopathic; LED therapy; infrared therapy.

The patient can also take measures: make sure they have good nutrition (food is best as opposed to supplements); if they drink alcohol, the amount should be moderate (about one four-ounce drink for women and two for men); regular good medical care; and safety precautions if needed (a walker, checking feet).

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