Diabetic NeuropathyPeripheral neuropathy is the term for damage to the nerves of the peripheral nervous system (any nerve outside of the brain and spinal cord). Neuropathy may be caused either by diseases of the nerve or from the side-effects of systemic illness. Systemic illnesses such as diabetes, even “pre-diabetes,” and thyroid disorders can lead to neuropathy symptoms. Other causes such as chemotherapy, arthritis, vitamin deficiencies, heavy metal toxicity, drug-induced, leprosy, and alcoholism can lead to neuropathy.
Common Neuropathy SymptomsTypically the hands and/or feet are affected with symptoms of painful burning, tingling, numbness, cramping and/or weakness. Sometimes this distribution of symptoms is referred to as the “stocking & glove” pattern. At Florida Plastic Surgery Group, a common description from our patients with neuropathy is: “I awaken at night with a burning, cramping pain in my foot that I cannot shake or wring out.” Can neuropathy be treated surgically? If your neuropathy is classified as a “compressive neuropathy,” then you may be a candidate for surgical treatment. One of the main types of neuropathy, or “compressive neuropathy,” is due to focal pressure on a nerve. Nerves pass through fixed openings all over our body that allow for a certain space for the nerve to pass through. When a nerve is swollen – as occurs due to the metabolic effects of high blood sugar in diabetes, pre-diabetes, or thyroid disorders – it can become compressed at these fixed openings. A compressed nerve is not only tender at the site of compression but can lead to overall pain and numbness in the affected extremity. By surgically decompressing or relieving pressure on the intact nerve, pain may be decreased and sensation can return. In the legs, returning protective sensation is critical as it may prevent ulcer formation and ultimately prevent amputation. During peripheral nerve decompression surgery, the nerve is not cut. Common examples of this condition are carpal tunnel syndrome in the upper extremity or tarsal tunnel syndrome in the lower extremity. What are non-surgical treatments for neuropathy? If you suffer from neuropathy, you must see your primary care physician first to determine if the underlying medical condition can be treated to relieve your neuropathy symptoms. If medical management does not alleviate your neuropathy or you are not a surgical candidate, a pain management specialist may offer alternatives to help with your pain.
The ProcessAm I candidate for neuropathy surgery? The first step in our comprehensive treatment of peripheral neuropathy is to establish a diagnosis and work with your primary care physician, endocrinologist, neurologist to ensure that any underlying medical disease is adequately being treated. We will perform a comprehensive neurosensory examination of the affected limb to determine if you suffer from a “compressive neuropathy” that can be surgically treated. I have a compression neuropathy, what is the next step? Prior to the initial consultation:
- Complete our peripheral neuropathy questionnaire
- Obtain your records from prior treating physicians outlining previous treatment or diagnostic studies pertinent to your peripheral neuropathy
- One of our surgeons will review your history with you, perform a physical examination, and answer all your questions and concerns
- Our surgeon will identify if a focal compression site is present and surgically treatable to relieve your neuropathy symptoms