Neuropathic pain is nerve pain. It can be caused by injury or disease that damages single nerves or groups of nerves. Sciatic nerve pain that travels down the leg, which is caused by a back injury, is one example. Nerve damage brought on by long-term high blood glucose levels that damages the protective myelin sheath of nerves is called diabetic neuropathy. Diabetic neuropathy starts in the sensory nerves of the hands and feet. This is why it is most often referred to as peripheral diabetic neuropathy. Neuropathy that affects the nerves of the heart, gut, and other systems is called autonomic neuropathy.
Peripheral neuropathy symptoms usually begin with a burning or tingling sensation in the fingers and toes. The pain can become excruciating over a period of time. Sufferers often complain that their feet feel as if they are on fire with pain. The pain leads to the loss of feeling in the hands and feet. As the nerve fibers are damaged by inflammation or destruction of the myelin, their ability to send signals is interrupted and diminished. Feeling in the feet of diabetics is usually the first to go. Sufferers often describe how they can no longer detect what type of surfaces they are walking on. It may be impossible to get a pair of shoes that are comfortable to wear.
Those who suffer from autonomic neuropathy may have delayed digestion that leads to vomiting or bouts of diarrhea and constipation due to the gut not moving the food along appropriately. Those with autonomic nerve damage to the heart muscle may develop an arrhythmia. Gastroparesis is paralysis of the gut due to nerve damage. The gut works by nerve pulses that initiate peristalsis to make the gut move food along the digestive track. Nerve damage interrupts the signals.
Neuropathy treatment may include surgery for trauma-induced nerve damage or gaining tight control of blood glucose levels of diabetics to prevent further nerve destruction. Medications that help with nerve pain include anti-inflammatory medications such as ibuprofen. Certain anti-seizure medications and medications used in the treatment of depression also work in treating nerve pain.
Those suffering with autonomic neuropathy may need a pacemaker if the nerves that control the rhythm of the heart are damaged. Gastroparesis also has an implantable pacemaker-like option to stimulate nerves in the gut to work. Metoclopramide (Reglan) is the only drug of its kind approved in the U.S. for treating gastroparesis, but some patients cannot tolerate the side effects.