Neuropathic Pain: Peripheral Neuropathies

Abstract

Peripheral neuropathy is pain originating from the nerves in the periphery (arms and legs). These diseases can affect one or more nerves, and can be the result of various etiologies from focal trauma all the way to immune reactions. Diagnosing peripheral neuropathy heavily involves a good history and physical examination. Though, in the event a patient’s history is not sufficient to determine a diagnosis, laboratory workup and diagnostic testing can be beneficial; including, basic bloodwork, nerve conduction studies, electromyography, and even quantitative sensory testing. As determination of any underlying processes is often crucial for diagnosing peripheral neuropathies, their treatment is also a top priority (such as glycemic control in diabetic patients). Various pharmacologic modalities have been found to be beneficial for neuropathies, including anti-neuropathic and topical agents. Meanwhile others, such as opioids, are less efficacious and their risks seldom outweigh possible benefit.