Neuropathy

Neuropathy means damage to a nerve.  When the nerves are damaged in the arms, forearms, hands, thighs, legs or feet, it is called a peripheral neuropathy.  Peripheral Neuropathy can be caused by infections, toxins, autoimmune disease, alcoholism, vascular and metabolic diseases.  Kidney disorders can lead to excessive toxins, which can damage nerves.  Liver conditions can cause chemical imbalances, which also damage nerves.  Vitamin deficiencies, particularly niacin, Vitamins B1, B6, B12 and E can cause neuropathies.  Vascular damage can decrease blood flow and oxygen supply to the nerves, quickly causing neuropathy.  Connective tissue disorders can cause edema or swelling which puts physical pressure on the nerves and the inflammation can spread to the nerves.  Chronic inflammation can lead to destruction of connective tissue causing the nerves to be more vulnerable to compression.  Medicinal drugs are toxins and can have a direct effect on the nerves.  Cancers and benign tumors can place physical pressure on the nerves as can repetitive stress on certain parts of the body such as the wrists can cause Carpal Tunnel Syndrome which is a type of focal neuropathy since it is localized to one area.

Common symptoms associated with neuropathy:

• Tingling
• Numbness
• Pain
• Weakness

Dr. Schwartz is one of the few chiropractors in the country board certified in Electrodiagnosis.  He performs electromyography (EMG) and nerve conduction studies which are detailed specialized tests for neuropathy.

Autonomic neuropathy (autonomic nerve dysfunction)  is another type of neuropathy.  Instead of the peripheral nerves being effected, the autonomic nerves are damaged.  These are the nerves that supply your organs, such as the heart, kidneys, liver and stomach.  Autonomic neuropathy can become life threatening and may require emergency medical care in cases when breathing becomes impaired or when the heart begins beating irregularly. The autonomic nervous system controls involuntary function; these are such things as digestion, control of hormones, control of blood pressure, etc.  Common symptoms of autonomic nerve damage can include:

• an inability to sweat normally (which may lead to heat intolerance)
• a loss of bladder control (which may cause infection or incontinence)
• an inability to control muscles that expand or contract blood vessels to maintain safe blood pressure levels.  A loss of control over blood pressure can cause dizziness, lightheadedness, or even fainting when a person moves suddenly from a seated to a standing position (a condition known as postural or orthostatic hypotension). 
• Gastrointestinal symptoms frequently accompany autonomic neuropathy. Nerves controlling intestinal muscle contractions often malfunction, leading to diarrhea, constipation, or incontinence. Many people also have problems eating or swallowing if certain autonomic nerves are affected.

Dr. Schwartz also performs a specialized test that involves Heart Rate Variability and Sympathetic Skin Response.  This test can help diagnose autonomic neuropathy.  Diabetics should be tested once per year for autonomic Neuropathy and if they have the above symptoms in their extremities should have the EMG and Nerve Conduction Studies.