Occasionally, I have patients who come in because they have self-diagnosed themselves with neuropathy.  These people have talked to a friend or been searching online for answers and this is what their conclusion is.  Sometimes, they are correct.  Sometimes they are not.  It can be confusing.

Neuropathy” or a more complete diagnosis “Idiopathic Peripheral Neuropathy” is a problem within nerves outside the brain and spinal cord.  The typical history is that a person will start to notice a “numbness” or “tingling” in the toes which, over time, slowly spreads and intensifies until it is unbearable.  It may involve the entire foot or lower leg.  As the problem progresses, it will start to feel like a “burning” or “pins and needles” pain.  They will go see their physician and typically are prescribed Neurontin (Gabapentin) or Lyrica (Pregabalin).  Sometimes, this gives relief, but as the problem worsens, they need higher and higher doses until either they are in such a fog with short-term memory loss or in such pain that they need to find another answer.

The difficulty with nerve pains is that some can be measured and some cannot.  In other words, if there is a shooting nerve pain coming from a herniated disc, the diagnosis may come from nerve tests or MRI.  However, in the case of a neuropathy, all tests are negative and MRI shows nothing.  Hence, the symptoms are the disease.

As I mentioned a moment ago, usually a neuropathy will begin in the distal extremities (toes or ends of fingers) and spread inward involving larger body parts.  So, from the fingers to the hand, to the forearm, etc.  Whereas, a nerve problem that begins as a pressure on the nerves at the spine, like a herniated disc, will start as pain or tingling in the spinal area and spread out into the extremities.  This history helps a chiropractor or other physician know what treatment is going to be most effective.

Neuropathy… or is it?
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