Nerve pain (polyneuropathy)

The term polyneuropathy means that many (Greek poly = many) nerves are affected at the same time and not a single one as in carpal tunnel syndrome, for example. However, this always affects only the "Peripheral Nervous system"  - so all nerves Outside of our spinal cord and brain (= central nervous system, CNS).

What are peripheral nerves?

A peripheral nerve has different tasks. It provides movement (motor), conducts sensation (sensitive)  such as pain, touch, temperature and position (e.g. joint position) into our central nervous system for processing and regulates our autonomic nervous system such as bowel function, heart rate (vegetative). Accordingly, the following symptoms may indicate a polyneuropathy, that is, a disease or damage of the peripheral system, usually first on the feet:

  • Tingling, formication
  • Painful stinging, electrifying
  • Numbness or constant feeling of pain
  • Feeling of walking on cotton wool, gait and step insecurity
  • Muscle cramps
  • Muscle weakness or muscle atrophy
  • Permanent cold feeling of the feet, missing or exaggerated temperature sensation (e.g. when showering)

If the polyneuropathy also affects autonomic nerves, symptoms such as cardiac arrhythmia, disturbances in blood pressure regulation, urinary and fecal incontinence, constipation or impotence may occur.

Causes: What causes polyneuropathy?

A polyneuropathy is a consequence or symptom of other diseases or "neurotoxic substances" that damage the nerve (axon) or its sheath (myelin sheath). Here is a partial ranking of the causes of polyneuropathies by frequency:

  • diabetes mellitus
  • Increased harmful alcohol consumption
  • Medication !!!
  • Inflammatory due to pathogens (e.g. Borrelia, viruses)
  • Vit B12 deficiency
  • Autoimmune or autoimmune diseases
  • For disorders of protein metabolism
  • Paraneoplastic, i.e. accompanying a tumor disease
  • Hereditary
  • Unresolved (approx. 20-30% )

Diagnosis

The diagnosis of polyneuropathy is made by neurological examination and measurement of the nerve conduction velocity of the affected nerves. (NLG and EMG). Thereafter, supplementary blood tests, rarely nerve fluid examinations (CSF) or nerve sampling (nerve biopsy) is required.

Therapy

Treatment is primarily based on the cause. If, in addition, the pain is considerable, it can be effectively combated by certain drugs which are also effective in the treatment of epilepsy or by small amounts of antidepressants. However, one method that only works well for some forms is the so-called "high tone therapy", in which electrodes are attached to the lower and upper leg and stimulated for 30-60 min/day.


Further information:

Self-help group Polyneuropathy Germany
http://www.pnp-shg.de