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NEUROLOGY & NEUROSURGERY SERVICES

Diagnosis & Treatment

Neuropathy

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How Is Neuropathy Diagnosed?

Diagnosis

It is important to diagnose and treat early signs and symptoms of neuropathy. If the condition is left untreated, neuropathic pain and weakness may become permanent. Nerve damage may progress and symptoms may become more severe without proper treatment.

The experienced neurologists at NewYork-Presbyterian can perform comprehensive evaluations to assess the cause of your neuropathy symptoms. Tests may include:

  • Physical exam: Your physician will take your vitals, discuss your medical history, and ask general health questions to aid in diagnosis.
  • Neurological exam: This may include a sensory and motor function evaluation, with reflex testing and a pinprick test to assess the sensory nerve response in the feet and ankles.
  • Blood tests: Your physician will run bloodwork to check your immune health and detect any toxins, vitamin deficiencies, or underlying conditions that could trigger symptoms of neuropathy, such as hypothyroidism, Lyme disease, or hepatitis.
  • Imaging: Your physician may order magnetic resonance imaging (MRI) to view images of your peripheral nerves and check for nerve damage, trauma, inflammation, tumors, and other indicators of abnormalities.
  • Genetic testing: Hereditary or gene testing panels may be recommended by your physician if you are experiencing neuropathy symptoms but do not have a clear diagnosis.
  • Electrodiagnostic assessments: Diagnostics may include an electromyography (EMG) (which measures the electrical activity in muscles), nerve conduction studies (which measure how well signals travel through nerves), and a Q-Sweat test (which measures the ability of autonomic nerves to induce sweating).
  • Skin biopsy: A biopsy measures the number of pain-sensitive and temperature-sensitive or autonomic nerve fibers (which connect the central nervous system to the vital organs) for expert interpretation by a neurologist.

How Is Neuropathy Treated?

Treatment

To treat neuropathy, doctors at NewYork-Presbyterian first address any underlying conditions that may be causing symptoms. Treatment of the underlying condition may resolve ’symptoms and allow damaged nerves to heal. Other medical treatments may also be recommended by your physician, including drugs to alleviate pain and muscle weakness (some of which also have antidepressant or anticonvulsant properties). Topical pain relievers may also help some patients.

If neuropathy is caused by pressure on a nerve, surgeons can sometimes perform a procedure to alleviate the pressure. NewYork-Presbyterian neurosurgeons are highly skilled at performing this kind of procedure.

Recommended treatments for neuropathy may include:

  • Dietary changes, such as reducing the amount of sugar, gluten, and refined carbohydrates and maintaining a low-fat, plant-based diet, can help reduce symptoms.
  • Regular exercise can help control blood sugar and boost blood circulation. Studies have found exercise may preserve nerve health and protect peripheral nerve function. Talk to your physician before beginning any new exercise routine.
  • Medications including amitriptyline, duloxetine, pregabalin, and gabapentin may be prescribed to treat neuropathy pain. These medications are also used to treat other conditions, such as epilepsy, depression, and anxiety, and may cause side effects if taken in high dosages. Other medications including topical pain-relieving creams, anticonvulsant medications, and antidepressants may also be prescribed.
  • Plasma exchange is a procedure in which a doctor inserts a needle to remove blood that contains inflammation-causing cells and then replaces it with healthy plasma. This may be used for nerve damage in extremities including the arms and legs.
  • Nerve stimulation, or neurostimulation, also called TENS (transcutaneous electrical nerve stimulation), may be recommended by your physician for pain reduction. This uses small electrical pulses that target your nerve fibers to help with pain management.
  • Surgical options for neuropathy-related conditions such as carpal tunnel syndrome, ulnar nerve compression, and tarsal tunnel syndrome may be recommended. Your neurosurgeon may suggest peripheral nerve surgery for nerve entrapment that does not respond well to nonsurgical treatments.

Rehabilitation

Rehabilitation may also be used to treat neuropathy and may include physical and occupational therapy. These therapies can help patients regain or maintain their ability to perform daily activities.

Rehabilitation experts at NewYork-Presbyterian work with patients to:

  • Develop an individualized program to maintain or improve function
  • Recommend devices (such as canes, walkers, wheelchairs, braces, and leg splints) to improve leg movement and foot function and equip the home to ensure patient safety and mobility, and recommend neck and back supportive devices as needed
  • Discuss ways to modify activities, conserve energy, and simplify work
  • Suggest regular activity to strengthen feet and legs, such as recumbent biking, using knee flexion machines, or doing strength-training exercise routines focused on these areas

Research

NewYork-Presbyterian researchers are conducting studies to better understand the causes of neuropathy and develop more effective therapies. The Columbia Neuropathy Research Center is committed to basic science and clinical research focusing on peripheral and autonomic neuropathies of all types. At NewYork-Presbyterian/Weill Cornell Medical Center, the Diabetic Neuropathy Research Center focuses on developing new treatments for diabetic neuropathy.

Current research focus includes:

  • Common pain issues
  • Tumors and cancers in the peripheral nerves
  • Autoimmune and inflammatory neuropathies
  • Neuropathy with nutrition anomalies

FAQs

FAQs

Symptoms range according to the type of neuropathy and may include a pins-and-needles sensation or numbness, or a tingling, burning, stinging, or stabbing feeling in affected areas. Neuropathy may also cause muscle weakness and instability, as well as hypersensitivity to temperature and pain.

To treat neuropathy, it is best to receive an early diagnosis and expert care from a neurologist, with routine checkups to manage the condition. After performing a comprehensive health evaluation, your physician will provide an individualized treatment plan.

Although neuropathy cannot be reversed and there is no cure, it’s important to see a doctor if you are experiencing symptoms, so you can begin a customized neuropathy treatment plan. Monitoring your blood sugar and managing diabetes as well as any other underlying health conditions can help improve your neuropathy symptoms and long-term health.

Symptoms of neuropathy range from mild to severe but are rarely life-threatening. You may be at risk of serious health complications if nerve damage is left untreated or if neuropathy is a result of a chronic or critical illness. It is important to see your doctor for regular checkups if you have neuropathy.

Certain diseases, health conditions, trauma, injuries, toxicity, and medication use may trigger symptoms of neuropathy. There are many causes of neuropathy, ranging from genetically inherited conditions to autoimmune diseases that may trigger the condition.

Symptoms of neuropathy may develop from an acute condition, such as trauma or injury, or over time from underlying conditions like diabetes. You may notice symptoms developing over days or it may take months or years for symptoms to progress. There are many different types of neuropathy, and each one has associated symptoms. Your doctor can help you to understand your individual health status and prognosis.

Get Care

Trust NewYork-Presbyterian for Neuropathy Treatment

NewYork-Presbyterian provides comprehensive treatment and management of neuropathy and associated health conditions including diabetic neuropathy. We offer diagnostic testing and a full range of neuropathy services. Our expert neurologists will consider your unique health needs and treat your symptoms of neuropathy to protect and preserve the health of your peripheral nerves. Contact us to make an appointment today.