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For many older adults, neuropathy (nerve damage) has traditionally been considered a diabetes complication. Treatment or prevention has focused on controlling blood sugar levels. Now we now that the incidence of neuropathy is associated with other chronic diseases. Cardiovascular risks for developing neuropathy include blood lipid levels, hypertension, obesity and smoking (New England Journal of Medicine, 2005).
Neuropathy can actually affect three types of nerves: motor, sensory and autonomic. Motor nerves are voluntary nerves that carry signals to muscles to move. Sensory nerves carry messages to the brain about shapes, temperatures or pain so a person can react. Autonomic nerves are involuntary nerves that we do not consciously control - heart, breathing, sweating, and bladder.
Research continues to be conducted to try to find out exactly what happens in the body that results in nerve damage to certain areas. At this time, what we do know is there are different kinds of neuropathy.
Distal symmetric polyneuropathy affects both sides of the body. While it usually affects legs and feet, it can also affect the hands. Individuals with this type of neuropathy usually have numbness and prickling sensations or they may feel pain in the toes and feet and have what they describe as overly sensitive skin.
Arthropathy neuropathy is also called Charcot's Joint. This most often occurs in the foot because a joint breaks down due to nerve problems. If the foot becomes unstable, it may be difficult to walk.
Cranial neuropathy affects the nerves that connect the brain to sight, hearing and taste. Most often it affects the nerves that control eye muscles and can result in double vision.
Autonomic neuropathy affects the involuntary muscles that control bladder, intestinal tract and other organs. People affected with this type of neuropathy may have diarrhea, constipation, reoccurring urinary tract infections or problems with digestion.
Compression mononeuropathy results because of a single nerve being damaged. This can occur due to compression on the nerve or due to restriction of blood flow to the nerve. Carpal tunnel syndrome is the most common form of this nerve damage.
Older adults need to discuss any symptoms of nerve damage with their doctor. Be aware of the following symptoms: muscle weakness, muscle cramps, numbness, tingling or unusual muscle sensation, fainting or loss of bladder control. A doctor can then conduct a screening that will measure muscle strength, sensation and autonomic nerve function. After this screening, you may be referred to a more definitive examination using electric shock to stimulate nerves and determine the reaction.
If neuropathy has occurred, it is important to avoid additional nerve damage. Treatment includes maintaining an ideal weight, having a regular exercise program, not smoking and avoiding injury to extremities. Individuals with diabetes are encouraged to maintain the recommended blood glucose level. Individuals with heart disease need to keep their blood pressure and cholesterol at recommended levels.
References: "Neuropathy and Nerve Damage," American Diabetes Association, www.diabetes.org; New England Journal of Medicine, Jan. 27, 2004.
For more information, contact your local
Colorado State University Extension office.
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