Peripheral neuropathy is a common condition found in the population because of its variety of causes. This condition having a large number of causes few of which are diabetes mellitus, chronic liver disease, chronic kidney disease, metabolic disorders, Charcot Marie tooth disease, autoimmune disorders, drug-induced, radiation, etc. .
Is Peripheral Neuropathy A Serious Condition?
In the epidemiological data of India, the incidence of peripheral neuropathy has been determined between 5 to 2400 among the population of 10,000 in various different studies done on multiple communities . A number so high is very much threatening and poses a serious problem for the doctors as well as the health system. It becomes problematic for the economy of the country because it leads to a high disability rate and also gives emphasis on the fact that causes are increasing multiple times which is leading to such a large number of cases.
The non-healing nature of the neurones after the damage incurred to them makes it even more serious to deal with because they cannot be replaced. It makes the disability permanent and also proves to be debilitating for the patient’s quality of life. With the loss of trophic factors released by the nerves, it becomes difficult for the muscles to adapt and they undergo atrophy and wasting. Trophic nonhealing ulcers develop soon after the loss of cutaneous nerve sensations and can even progress to a stage where the amputation of the limb is needed to save the patient .
Can Peripheral Neuropathy Be Reversed?
Peripheral neuropathy is the damage incurred to the nerves which can be sensory or motor in nature. The mechanism of damage in the majority of the cases is demyelination of the nerves and loss of Schwann cells covering the myelin sheath. Sometimes axonal damage via Wallerian degeneration can also occur as the mechanism for neuropathy.
The reversal of the peripheral neuropathy depends upon the cause and extent of the condition. Few causes are known which only temporarily causes malfunctioning of peripheral nerves presenting as peripheral neuropathy and can be cured once the aggravating and precipitating factor is removed. In initial stages when the earliest symptoms have just started to appear there may be a reversal of neuropathy because only a few cells are damaged and can be compensated by other nerve cells.
Absolute reversal of peripheral neuropathy is usually not seen because the neurones are the non-proliferating type of cells and the damaged cells cannot be replaced by new ones. Once the symptoms have increased towards severity, it is impossible to reverse the condition. No medical treatment or drug has been discovered which could effectively cure the neuronal damage and initiate its reversal. Only supportive treatment can be given to reduce the symptoms and improve the quality of life.
With the advent of new technological advances in the medical field, it has been now possible to limit the damage by the nerve grafting techniques to replace the damaged nerves. A transcutaneous electrical nerve stimulation system can be established at the peripheral site of nerve damage which can provide continuous impulses when required to compensate for the loss of nerve stimulation. (1) (3)
Peripheral neuropathy’s widespread causes and its irreversible nature makes it a serious condition that should not be taken lightly and immediate treatment should be taken for limiting the disease. It is also responsible for causing severe disabilities like amputation of the limb, bony deformities, development of contractures, muscular wasting, etc. which increases the work hours lost to the disability and affects the productivity of patients. The patient can become dependent and the quality of life is affected severely.
Reversal of the already occurred damage cannot be done but its limitation to the extent can be done with rigorous control of the causative factors and use of supportive treatment for it. Although various research projects are being pursued no treatment has been found supporting the reversal of peripheral neuropathy. The prevention remains the key for its minimization.
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