The outlook for peripheral neuropathy varies, depending on the underlying cause and which nerves have been damaged. Some cases may improve with time if the underlying cause is treated, whereas in some people the damage may be permanent or may get gradually worse with time.
Over time, those fibers may undergo degeneration and die, which means the neuropathy is worse because of the loss of more nerve fibers. This may cause increased numbness, but it usually causes the pain to get better. In this scenario, less pain means greater degeneration.
Left untreated, nerve damage may worsen over time. It can sometimes start in the nerves farthest from the brain and spinal cord -- like those in the feet and hands. Then it may move up into the legs and arms.
But sometimes, nerve damage can be permanent, even if the cause is treated. Long-term (chronic) pain can be a major problem for some people. Numbness in the feet can lead to skin sores that do not heal. In rare cases, numbness in the feet may lead to amputation.
When to see a doctor. If you experience weakness, tingling, numbness or a total loss of feeling in a limb, see your health care provider to determine the cause. It's important to treat peripheral nerve injuries early.
As a specialist in peripheral nerve surgery, Dr. Seruya wants his patients to know that after a period of 12-18 months nerve damage can become permanent.
To achieve full recovery, the nerve must undergo three main processes: Wallerian degeneration (the clearing process of the distal stump), axonal regeneration, and end-organ reinnervation.
It's difficult or impossible to move part of your body.
If motor nerves are affected, then muscle weakness or even paralysis may occur, says Dr. Smith. These same symptoms could also indicate that there's an underlying issue that needs urgent attention, so it's best to head to the ER.
Nerve damage can usually be diagnosed based on a neurological examination and can be correlated by MRI scan findings. The MRI scan images are obtained with a magnetic field and radio waves. No harmful ionizing radiation is used.
He cautions patients against assuming that nerve damage will simply heal itself. Reality is that a damaged nerve that could have been repaired with surgery, if left untreated for over 12 months, the damage can become permanent.
The symptoms depend on the type of nerve fibers affected and the type and severity of damage. Symptoms may develop over days, weeks, or years. In some cases, symptoms improve on their own and may not require advanced care.
Stage Four: Complete Numbness/ Loss of Sensation
If a patient does not seek treatment for their neuropathy, they will begin to lose all feeling, and their risk of recurrent wounds and subsequent amputation will increase.
The most severe type of nerve injury is an avulsion (A), where the nerve roots are torn away from the spinal cord. Less severe injuries involve a stretching (B) of the nerve fibers or a rupture (C), where the nerve is torn into two pieces.
In many instances, nerve damage cannot be cured entirely. But there are various treatments that can reduce your symptoms. Because nerve damage is often progressive, it is important to consult with a doctor when you first notice symptoms. That way you can reduce the likelihood of permanent damage.
Nerve conduction studies, including an Electromyogram (EMG) may be performed on individuals suffering with nerve pain symptoms. These studies use electrical impulses to determine the level of damage. A final diagnosis will be made by your physician through the help of one or all of these tests.
Your surgeon can remove the damaged section and reconnect healthy nerve ends (nerve repair) or implant a piece of nerve from another part of your body (nerve graft). These procedures can help your nerves regrow.
Electromyogram. An electromyogram evaluates how the nerves and muscles work together by measuring electrical impulses along nerves, nerve roots, and muscles. To perform this test, the doctor inserts a tiny needle—an electrode that conducts an electrical current—through the skin and into the muscle.
Injury to a nerve can stop signals to and from the brain. This can cause muscles to stop working properly and result in loss of feeling. In many cases, nerve injuries can be treated to improve outcomes. However, nerves are very complex structures and do not recover as well as ligaments, tendons, and bones.
Most of the time, the pins and needles feeling is a good sign. It's a short-term phase that means nerves are coming back to life.
Axonotmesis is a more severe grade of nerve injury than neurapraxia, and neurotmesis is the most severe grade of peripheral nerve injury.
Nerve pain often feels like a shooting, stabbing or burning sensation. Sometimes it can feel as sharp and sudden as an electric shock. You may be very sensitive to touch or cold. You may also experience pain as a result of touch that would not normally be painful, such as something lightly brushing your skin.
If your nerve is bruised or traumatized but is not cut, it should recover over 6-12 weeks. A nerve that is cut will grow at 1mm per day, after about a 4 week period of 'rest' following your injury.
Unfortunately, chronic nerve pain rarely goes away completely. However, a combination of multidisciplinary treatments, such as physical therapy, regular exercise, medication, and pain management treatment can hopefully provide significant relief.