Young people with diabetes are developing neuropathy at alarming rates according to a recent study published in Diabetes Care. Researchers from the University of Michigan, Ann Arbor found that diabetic peripheral neuropathy grew in prevalence the longer a young person had diabetes (Type 1 and 2) and was linked to poor glycemic control and modifiable lifestyle habits like smoking and over-consumption of cholesterol.
Unfortunately, diabetic neuropathy isn’t the only type of peripheral neuropathy which affects people young and old. Often localized to the hands and feet, peripheral neuropathy describes any host of conditions involving damage to nerves outside the brain and spinal cord (peripheral nervous system). This type of damage can lead to numbness, burning, tingling, weakness, and pain. Peripheral neuropathy can present in other places on the body too like the arm and legs as well.
Common types of peripheral neuropathy include
Diabetic Neuropathy - Diabetes-induced nerve disorders result when blood glucose levels remain high for extended periods of time and when blood vessels become damaged and can longer properly supply nutrients and oxygen to nerves. Drastic consequences can include vision loss and amputation.
Carpal Tunnel Syndrome - The median nerve which runs from your arm through your wrist and into your hand can incur undue pressure if the carpal tunnel it passes through becomes inflamed and narrows. This can lead to tingling, numbness, and pain in the wrist, hand, and fingers.
Sciatica - When a branch of the long-running sciatic nerve which travels from the lower back down the leg becomes compressed or pinched, numbness, tingling, or pain may occur in the hips, buttocks, and leg.
Peripheral neuropathy results from myriad potential factors including exposure to environmental toxins, injury, heredity (genes), malnutrition, inflammation from infection or autoimmune disease, and even some medicines. Nerve compression can cause temporary or long-term damage and can occur when a muscle or other connective tissue tightens up around a nerve, like the piriformis muscle in the buttocks might around that sciatic nerve or the carpal tunnel might around the median nerve.
Injury to a nerve, on the other hand, will involve direct contact or impact from an external force on the body, leading to nerve compression or damage. For example, if you improperly use crutches for a leg injury without crutch pads to cushion your armpit, you can actually permanently damage the axillary nerve running down your arm. This condition is called axillary nerve dysfunction and can result in shoulder weakness, arm tingling and pain, and limited range of motion.
While some peripheral neuropathy is not wholly preventable, like sciatica which results from degenerative disc disease (or osteoarthritis of the spine), some is and requires patients to be avid about their own health and wellbeing. Take for example the study mentioned above which found that over 20% of youth with type 2 diabetes and 7% with type 1 diabetes experienced diabetic peripheral neuropathy. In addition to smoking and increased cholesterol levels, researchers associated diabetic peripheral neuropathy to risk factors including obesity, increased diastolic blood pressure, and poor glycemic control.
For those lifestyle modifications which can make a huge difference in the health and pain levels of someone with existing peripheral neuropathy, experts suggest that clinicians should work more closely with patients. Clinicians should aim to screen and identify potential neuropathy development, as well as act on known risk factors to mitigate the severity of their patient’s condition or disease.
For preventable injuries, like you see with axillary nerve dysfunction from using crutches, or carpal tunnel syndrome from overusing the wrist in a repeated motion, patients should educate themselves or ask for proper instruction when it comes to using equipment for home or work use. The peripheral nervous system does have some capacity to self-heal and repair, however, with repeated damage, nerves can go unhealed and leave patients with a lifetime of burning sensitivity, numbness, tingling, pain, or worse.
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