Nerve Degeneration: The Different Stages of Neuropathy
Published October 26, 2020
Neuropathy, often called peripheral neuropathy, is the damage of one or more nerves in the peripheral nervous system (PNS). The peripheral nervous system is the network of nerves outside of the brain and the spinal cord, or the central nervous system (CNS). These two systems relay signals back and forth that moderate movement and sensations.
When nerve cells, called neurons, become damaged, this results in neuropathy. When this happens, it can become challenging to control the affected body parts. This results in tingling, numbness, weakness, and pain in those parts. Neuropathies largely affect the extremities like hands and feet but can affect other parts of the body too.
The most common causes of neuropathy are:
- Diabetes (more than half of diabetes patients develop neuropathy)
- Autoimmune diseases
Symptoms of neuropathy differ between the type of affected nerves. These nerves fall under three categories, namely:
Motor nerves control your muscle movements and actions.
Sensory nerves relay information from your skin and muscles to the CNS.
Autonomic nerves regulate involuntary physiologic processes like digestion, blood pressure, and digestion.
The common symptoms of motor neuropathy in the affected area are:
The common symptoms of sensory neuropathy in the affected area are:
- Reduced ability to feel pain or extreme temperatures
Tingling feeling (“pins and needles”)
- Burning sensations
- Problems with positional awareness
The common symptoms of autonomic neuropathy differ according to the affected area.
Heart and lungs symptoms
- Abnormal heart rate
- High blood pressure
- Shortness of breath with
- physical activity
- Stomach and intestine symptoms
- Nausea after eating
- Problems controlling bowel movements
- Swollen abdomen
- Vomiting of undigested food
There can be a combination of neuropathies that can affect you at the same time.
Progression of Neuropathy
The progression of this condition can vary depending on the underlying cause. There are severe cases like Guillain-Barré syndrome, wherein the immune system attacks parts of the PNS. In these cases, symptoms appear suddenly, progress rapidly, and recover slowly.
In more chronic forms, symptoms appear gradually and progress slowly. Some people experience periods where their symptoms subside then relapse. Other people experience “plateaus,” wherein their symptoms stagnate for months, even years. Chronic cases usually worsen over time, but generally are not life-threatening.
One of the chronic and most common neuropathies is peripheral neuropathy. Peripheral neuropathy often goes through five stages.
The First Stage: Sporadic Pain and Numbness
The first stage is when subtle symptoms start showing here and there. Usually, you’ll feel these in your hands and feet.
Many patients at this stage will brush off their foot pain since it’s very manageable or occasional.
The leading cause of neuropathy at this stage is excessive sugar consumption. If you start to notice symptoms at this stage, you’ll want to make some dietary changes. Specifically, you’ll want to stop eating carbs, junk food, sweets, and other hyperglycemic foods.
The Second Stage: Pain becomes More Frequent
There’s only a fine line between the first and second stages, but the primary sign is that the pain becomes more severe and more frequent. Similar to the first stage, the symptoms come and go intermittently.
Whereas the symptoms in the first stage were negligible, they become much less so in this stage. The pain starts mounting, to a point where you have to start being concerned. At this phase, you’ll hopefully have scheduled an appointment with your physician to address these problems. It’s not uncommon for your diagnosis to be related to blood sugar issues. This stage is also the one where patients start taking medications to treat symptoms.
The Third Stage: Pain Reaches Its Peak
Contrary to the first two stages, the symptoms are constant and continuous during the third stage. The pain in this stage is almost unbearable. Here, it gets to the point where you might make some lifestyle changes to work around it. This stage is when patients may be taking a cocktail of medication to relieve the pain.
The numbness at this stage starts to pose a danger, too. It can get so severe that you lose some feeling in the affected areas, putting you at risk of getting burns and cuts unknowingly. These injuries can lead to more severe infections, such as sepsis and gangrene. In severe cases, these infections may lead to amputation or even death.
At this stage, you’ll need immediate medical intervention. You might be able to see positive changes if you change your diet immediately and extremely. Some medical procedures, like transcutaneous electrical nerve stimulation, may be needed to relieve some symptoms. If you have diabetes, you will need to be especially wary of these symptoms, as diabetes patients are more susceptible to infections.
The Fourth Stage: Numbness Overcomes the Areas
At this stage, the majority of the pain will subside, which gives most patients relief. However, the underlying truth is that their condition just took a nosedive. In this fourth stage, the pain makes way for the numbness in the affected areas.
At this point in neuropathy, much of the damage has been done and is irreversible. If you have diabetes, neuropathy should be accompanied by other complications.
The condition may now affect your walking and your balance, increasing the instances of falling. You’ll need immediate medical attention with drastic changes in your diet. You may also require aggressive restorative operations. The treatment may restore the affected areas close to new, but it will likely not be the same as before.
The Fifth Stage: Complete Loss of Feeling
At the fifth stage, you may not feel like you have feet at all. The nerves in your feet are close to dead, making you incapable of walking without assistance. In many cases, you will need a wheelchair to move around.
It’s at this stage that the risk of amputation and other related complications are at their highest. Physicians will have to pull all the stops and treatments to save what nerves are left. Following this stage, you’ll likely feel the effects of neuropathy for the rest of your life. We highly recommend that you get yourself checked and treated as soon as you see signs.
Prevention of Neuropathy
Before you ever feel the symptoms of this debilitating condition, you can take measures to prevent it. Here are some tips:
- Manage your diabetes. Make sure that your blood sugar levels are within the ranges recommended by your doctor.
- Maintain a healthy lifestyle. This consists of eating a balanced diet, exercising regularly, and refraining from alcohol. These practices will keep your organs functioning well and supply your body parts with the right nutrients.
- Stop smoking. If you are a regular smoker, you will want to stop this habit entirely. Smoking constricts blood vessels that supply nutrients to the nerves. With limited nutrition, neuropathy can worsen more rapidly.
- Review your medications. You’ll want to go over your medications with your doctor to ensure that they do not aggravate your symptoms. Many drugs cause and aggravate peripheral neuropathy.
- Address vitamin deficiencies. B vitamins are essential vitamins in keeping your nervous system healthy. A deficiency in B vitamins can lead to neuropathy.
- Avoid factors that lead to nerve damage and trauma. Repetitive motions and actions can damage the nerves in your hands and feet and lead to repetitive strain injuries (RSIs).
The first step in treating neuropathy is to treat the underlying cause. Treatment is generally aimed at slowing down or stopping the degeneration of blood cells.
Aside from medication to treat underlying causes, you’ll also want to address the symptoms and pain.
- Pain relievers: Over-the-counter pain medications, like nonsteroidal anti-inflammatory drugs (NSAIDs), can relieve mild symptoms. For more severe symptoms, your doctor might prescribe painkillers. Many of these painkillers contain opioids, making them prone to abuse, and are only prescribed when other medications fail.
- Anti-seizure drugs: Some of the same medications used to treat epilepsy are used to treat nerve pain. The American Drug Association (ADAs) recommends starting with pregabalin or gabapentin.
- Antidepressants: Specific antidepressants can address nerve pain. Tricyclic antidepressants may be effective against milder and moderate nerve pain.
Sometimes, a cocktail of these three may be used, but it would be best to consult with your doctors first.
There are treatments meant to treat symptoms and signs of peripheral neuropathy.
- Transcutaneous electrical nerve stimulation (TENs): This treatment uses low currents of electricity to provide pain relief.
- Physical therapy: Many of the symptoms of neuropathy, like muscle atrophy, can be treated through physical therapy. Physical therapy can strengthen your muscles and promote movement in affected areas.
Surgery. Some cases of neuropathy are caused by excessive pressure on nerves. You may need surgery to relieve a lot of that pressure.
About The Author
Terrence Tan Ting is an industrial engineer by profession but a full time writer by passion. He loves to write about a wide range of topics from many different industries thanks to his undying curiosity.