How many of us have ever had the sensation of pins and needles poking under your skin? Have you ever sat in the same position for so long that maybe your leg or foot went numb? You may have experienced neuropathy. "Neuropathy?" you say. Yes, this is the term used when there is some kind of short or long-term damage or injury to a nerve. There are many causes of neuropathy and depending on the cause and extent of injury, the damage may or may not be reversible. In this article, we will review some of the different types of neuropathy, some causes of neuropathy, and various recommended treatments.

Nerve injury can be classified into three main categories using the Seddon system. This classification system is based on the type of damage done to the nerve and its ability to heal.

• Neuropraxia is the mildest form of nerve damage. The wrapping around the nerve (myelin) is damaged by some type of compression or direct hit trauma. Usually vibratory sensation and fine point touch is lost when this happens. Neuropraxia is usually healed anywhere from days to months as long as the myelin around the nerve heals.
• Axontmesis is a disruption to the fibers in the nerve (axons) and the wrapping around the nerve (myelin). A special term has been given when the axons are damaged but not severed - Wallerian degeneration. Axontmesis can be caused by stoppage of blood flow (ischemia), toxins, or prolonged compression. Recovery is possible with axontmesis, but chances of healing decreases if the injury to the nerve is far from the organ that the nerve supplies.
• Neurotmesis is the worst type of nerve injury. Not only are the wrapping (myelin) and axons disrupted, the supporting tissue is injured as well. You would see neurotmesis in gunshot wounds, lacerations, puncture wounds, and open fractures. The nerve is usually severed in neurotmesis and the chances for healing are basically little to none.

A healthy lifestyle can lessen the chances of developing neuropathy. Vitamin B-12 deficiency has been linked to myelin decay. Vitamin B-12 can be found in many sources such as seaweed, soy, dairy products, and eggs. If you are diabetic, glucose is key to controlling the symptoms of neuropathy. Studies have shown that excess sugar in the blood produces an alcohol, which destroys the nerves. Prevention of neuropathy is one reason why nutritional guidelines have been established for diabetics. Surgical procedures can be a cause of neuropathy. Avoidance of nerves is a top priority during surgery; however, sometimes they cannot be avoided. Usually the nerve injury is temporary and subsides with active range of motion and healing of the surgical site.

Depending on your specific cause of neuropathy, there are many treatments available.

• One treatment would be to protect the already damaged nerve from further damage by wearing protective gear that the doctor may give you.
• Medications such as gabapentin or preglabin can be prescribed by your doctor to help alleviate the symptoms of neuropathy.
• Cryoderm, available on footDrHorsley.com, has been proven to be effective in the treatment of neurological pain.
• Your doctor may choose to have you use capsaicin. Capsaicin is a topical agent that helps reduce the pain and tingling associated with neuropathy.
• Surgical treatment, external neurolysis, also exists for certain types of neuropathy depending on the location of the nerve.

If you or someone you know has existing neuropathy, please know there is help and options available. Visit FootDrHorsley.com to schedule your appointment with a podiatrist to review your specific treatment plan and other possible remedies available.