Peripheral Neuropathy

Dr. Reza Mobarak, Southwest Foot and Ankle Center 

Numbness, tingling, loss of sensations. These may all be signs of neuropathy. This disease affects over 20 million Americans today and is still growing, but is recognized as one of the least recognized issues with patients today. Although there are different types of neuropathies, the major type of neuropathy is diabetic neuropathy, which is a nerve disorder caused by diabetes.

People with diabetes can develop nerve damage throughout the body. Some of these people have no symptoms and others may have symptoms such as pain, tingling, or numbness – loss of feeling – in the hands, arms, feet, and legs. Approximately 60 to 70% of people with diabetes have some form of neuropathy. They can develop nerve issues at any time, but the risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes at least 25 years. Diabetic neuropathies can also appear to be more in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.

Peripheral neuropathy, the most common type of neuropathy, affects pain and loss of feeling to the toes, feet, legs, and arms. There are other types of neuropathies as well such as autonomic neuropathy, proximal neuropathy, and focal neuropathy. These other types of neuropathies affect different parts of the body.

I know one of the major questions are: “What causes neuropathy? or How  do I get it?” Well, it can be caused by many factors. Researchers are studying how prolonged exposure to high blood glucose causes nerve damage. The nerve damage is most likely due to a combination of factors. Metabolic factors may include: high blood glucose, long duration of diabetes, and possibly low levels of insulin. Neurovascular factors can lead to damage to the blood vessels that carry oxygen and nutrients to the nerves. Other factors may include: injury to the nerve, life style factors, such as smoking and alcohol use.

Now how do you know if you have diabetic neuropathy or even just plain neuropathy? First off, we diagnose neuropathy on the basis of symptoms and the physical exam. We may check your blood pressure, heart rate, muscle strength, reflexes, and sensitivity to position changes, vibration, temperature, and light touch. A comprehensive foot examination is also performed a yearly basis to check for peripheral neuropathy. Patients that are diagnosed with peripheral neuropathy need more frequent foot exams. We assess the skin, muscles, bones, circulation, and sensations of the feet. We also assess the protective sensations or feeling in your feet by touching your foot with a nylon monofilament – similar to a bristle on a hairbrush – that is attached to a wand. The patients who cannot sense pressure from a pinprick or the monofilament have loss of protective sensations. In that turn, we administer a test called a NCV (nerve conduction exam). This will help determine the type and extent of nerve damage.

Once we access the neuropathy, many treatments are available. These include prescription medication, vitamins, as well as a treatment that we administer in the office that has given recognition and success to many of our patients. This is performed by our VST MonoDynamice Device. A non-invasive treatment performed in the office 2 – 3 days a week for a total of approximately 30 treatments. This has proven very successful by improving the condition of the damaged nerve by a pulse waveform. We are proud to announce that we have had great success with this device in increasing blood circulation to the area of concern, removing swelling, increasing range of motion, and relaxation of muscle spasms. We also use this device in the reduction of post surgical complications and post surgical stimulation. Our practice is proud to also say that we are one of the few with this device to offer to our patients; subsequently, we have helped many patients with neuropathic issues. With current studies that we have started, pre and post nerve biopsies have showed regeneration of nerve fibers, meaning that VST has increased optimism in our patients.

If neuropathy is an issue or of concern for you, please have it evaluated. It is never too late to do something about it. With proper testing and treatments, your condition can improve. If you have any questions or would like to be evaluated for neuropathy, please call our office for an appointment: 972-316-0902.

Dr. Reza Mobarak heads the Southwest Foot and Ankle Center with offices in Plano and Lewisville and may be reached at 972-316-0902.