The physical cause of neuropathic pain is damaged peripheral nerves and as one medical expert notes, may also be due to the attempt of damaged nerves to fire across damaged sections of the peripheral nerve. See: References #1 to #3
Somatization disorder is a long-term (chronic) condition in which a person has physical symptoms that involve more than one part of the body, but no physical cause can be found.
This concept cost me my military career in the 1970’s and 80’s. It sets up the neuropathy patient while they seek help for the horror of neuropathic pain. It is important to understand that the pain and other symptoms of patients with this disorder are real and are not created or faked on purpose (malingering). It is time to stop calling patient’s crazy and ignoring this pain or the other symptoms of a neuropathy.
In 2015 we finally have a growing understanding of neuropathic pain yet with limited medication options, sometimes treatment fails the patient. In the last two decades medicine has come a long way in increasing clinical training of doctors in the diagnosis and treatment of the neuropathies and for this many patients are very grateful. On the other hand, neuropathy patients have many resources today that were not available to them just a few years ago, so the patients have little excuse in teaching themselves so that they are informed advocates who have learned ways to help the doctor and themselves with this chronic condition.
Doctors now know to test for large fiber damage and if they find no recordable damage, that this does not rule out neuropathy, only damage. These tests measure damage and do not diagnose or rule out neuropathy.
The patient can have symptoms and neuropathic pain for years before damage will show in these tests.
Doctors now know that testing for small fiber neuropathy must be done using a (skin biopsy) for this is the only test to show small fiber damage..
After I was diagnosed with an immune mediated neuropathy, doctor after doctor, asked, ‘Why did they not do the spinal tap?”, but today doctors know that this can be, along with other tests and information a helpful test in confirming an immune mediated neuropathy.
Severity of pain
Dr. Norman Latov, MD, PhD of Cornell University notes that while for some patients neuropathic pain is a nuisance, but for millions of other patients, they are in fact living with constant torture at one level or another with untreated conditions that do many times lead to severe disabilities at a greater cost to society.
Neuropathic pain can involve a wide variety of strange sensations, such as violent sudden electric shocks, stabbing, shooting, burning, tingling, pins and needles, severe muscle cramps, bone pain, sense of strange numbness, cement legs, heavy legs, strange feelings of socks on the feet or gloves on the hands, severe skin pain due to touch, no feeling on touch, digestive problems, urinary problems, problems with lack of sweating, and the list goes on, in addition to other known symptoms of neuropathy?
While only a well trained doctor can determine the cause of your symptoms, you may have peripheral neuropathy and you are experiencing neuropathic pain from damaged nerves sending inappropriate but real signals to the brain.
Like many types of neurological pain, neuropathic pain does remit and relapse making it sometimes difficult to understand both for the doctor and the patient.
Unfortunately, doctors and patients note that these neuropathic symptoms are often worse at night. Experts theorize that this may be due to the brains relaxed state and the fact the brain is not ‘busy’ processing other data. This is why pain is sometimes perceived to be worse at night, as the brain is not as busy working on other information.
Did you know that research has shown that patients with ‘tightly wrapped” neurons in the brain will experience more intense pain than other patients! Ref: #4
While not completely understood, often how a patient experiences neuropathic pain and symptoms is related to their genetic makeup, physical and emotional resources or inappropriate exercise or physical activity in which damaged nerves are forced to work.
Did you know that the wrong type of exercise (click to see article) will force damaged nerves to work and increase the pain!
How should a neuropathy patient exercise? Consider ordering a copy of the brand new DVD from Matt Hansen the expert as his perspective on exercise for neuropathy is perfect and understands what we can and cannot do. Yet Matt makes it possible for us to exercise WITHOUT the increase in neuropathic pain, keeping muscles as strong and flexible as possible. To see article on (click on link) Exercise for Neuropathy DVD: When ordering enter the special code NSN 10 and Matt will give 10% of your purchase price back to support the work of the NSN!
We are making progress in Medicine when it comes to understanding neuropathic pain!
In decades past, some doctors did not understand the strange manifestations of neuropathic pain and would dismiss the patient.
Today, that is not the case as medicine has grown in its understanding of neuropathic pain and patients are become better at describing the level of pain or symptoms so that the doctor understands their condition and how to treat them.
Many great doctors now report in books and medical journals, especially Dr. Norman Latov in his book for patients and “The Journal of the Peripheral Nervous System” (Ref #3). Since the decades of the 60’s to the 90’’s, we have made great strides toward understanding and attempts to treat neuropathic pain.
One of the most critical aspect beyond the treatment of neuropathic pain, is the absolute requirement for the patient and physician to establish a partnership in which they work together to find out what may work among the options for each individual patient.
Patient systems are different and each patient must be seen as unique when it comes to discovering what works and what does not work for each patient presenting with neuropathic pain.
Conversely, it is not enough to treat these symptoms of a neuropathy.
Doctors are become better at conducting the testing necessary in attempts to no only look for a cause, but to identify the TYPE of the neuropathy.
If the cause is unknown, the worst possible diagnosis is a diagnosis of ‘Idiopathic’ Neuropathy. (click on link to read article)
For many doctors now tell us, the use of differential diagnosis (subtle differences between neuropathies) may point to a possible cause. (See Refs: 1 & 3) Thus the other important goal is to identify the type of neuropathy as according to Dr. Norman Latov and other experts, this often points to a suggested cause!
To see How Neuropathic Pain is treated.
#1 Norman Latov, MD, PhD, FAAN Peripheral Neuropathy: When the Numbness, Weakness and Pain Won’t Stop, ANN Press, 2007
#2 Mims Cushing, You Can Cope With Peripheral Neuropathy (Ideas from neuropathy patients), with Dr. Norman Latov, DEMOS Publishing, 2009
#3 Textbook of Peripheral Neuropathy, Peter D Donofrio, MD, Editor, Professor of Neuropathy, Chief of Neuromuscular Section, Vanderbilt University Medical Center, Nashville, TN Published by DEMOS Medical, 2012.
#4 “Journal of the Peripheral Nervous System” published by the Peripheral Nerve Society.
I have 2 questions: My Doc and others tell me to continue to try to walk but feet are very painful with arthritis and peripheral neuropathy(not sure what type yet) I do other exercises but miss walking. Should I keep doing it as I can take the pain sometimes but don’t want to make the neuropathy worse.
Also, when I stand up I weave slightly, like a drunk and can’t stand still. Is this due to the neuropathy?
I am sorry, but your doctor is giving you wrong advice. Forcing damaged nerves to work will create more pain and this is not necessary. There are appropriate exercises for neuropathy patients. I will send you an E mail from our website that explains it all and provides a link to a great DVD done by the expert on this issue Dr. Hansen DPT. Yes, the difficulty standing an the weaving are all do to the neuropathy, but it is always good to have a doctor check if anything else is going on… like with the inner ear or other issue. I will in the e mail send you a link to the symptoms of neuropathy.
Hi I have been told by specialists that I have neuropathy in my feet up in my hands, also in my eyes.
It is very painful, I can not drive at night any more my eyes become very blurry. Walking is getting very difficult.
I now have a urinary problem with my flow,could this be from neuropathy.
Any suggestions for any neuropathy problems would be appreciated.
Ray. There is lots of information and help we can send you. It will be easier for me if I do this with an E Mail to you and will do so.
Diagnosed with Peripheral Neuropathy by a Neuroligist about two years ago. I am having problems with my balance, and my ability to get out of a chair and walk is worse, just in last couple months. Need to find a good specialist preferably in Los Angles, but willing to travel if necessary. I have had nerve damage, and suffered from numbness in my feet for a good 35 years, and about four years ago diagnosed with pre-Diabetis,. Would appreciate any recommendations you may have, and Doctor referral. Thanking you in advance.
Gerald: I will send you a personal E mail from firstname.lastname@example.org to recommend a Neuromuscular Neurologist near LA. Will also send you a link for information on a conference for patients to be held in LA in June that will be helpful to you. Look for e mail and if you do not receive one, let me know. With caring regards Col Gene