At Advanced Care Specialists, our medical team works daily to redefine the patient experience. Our providers want to provide the patients with an experience that never have had before when seeking medical attention. We take time to listen to patients and actually hear what they are telling us. This is exactly why we decided to bring in unique treatment options for patients with peripheral neuropathy. We grew exhausted listening to patients tell us they were
diagnosed with peripheral neuropathy but were subsequently told that there was nothing to do for them. Our medical team wasn’t satisfied with this answer.
We spent time researching and figuring out what was the best approach for peripheral neuropathy patients. When our clinic began announcing that we had treatment options available for peripheral neuropathy patients, we didn’t expect to receive the flood of patients we did. What we quickly realized is that many of these patients hadn’t been given the thorough care they deserve to find an accurate diagnosis or even explain why they have the symptoms they do.
At ACS, we summarize our approach in three words – individualized, comprehensive, and innovative. Our approach to handling peripheral neuropathy patients is exemplified by these three words. Not one neuropathy patient is the same. It is of the utmost importance to take a thorough and extensive history. To determine the severity and type of nerve impairment, our team starts extensive testing in office but may also rely on additional testing such as MRIs and EMGs. Finally, our treatment protocols are innovative providing relief for peripheral neuropathy patients that they have not otherwise found.
The most common symptoms that patients come in with are numbness, tingling, and sometimes burning in their extremities. These complaints may also be accompanied with difficulty with balance and even a heaviness feeling in their legs. However, these symptoms can be caused by a variety of different conditions.
About 50% of the patients that come in for peripheral neuropathy treatment do not have it. Patients either have self-diagnosed incorrectly or were given a diagnosis without a thorough investigation of their symptoms. Because of these overlapping symptoms, it can be difficult to find an accurate diagnosis for patients.
Although patients come in thinking they have peripheral neuropathy, we ensure that our patients leave with the right answers. This is a key step in the process because this determines which treatment options are most appropriate for them. Our medical team collaborates and discusses each case at length to help develop a plan.
Neuropathy is such an umbrella term, meaning that many conditions fall under this category. I will elaborate on the most common conditions that present with symptoms like tingling, burning, and numbness. (The following is not meant to take the place of a proper medical examination and should not be intended as medical advice.)
The most known condition associated with those symptoms is peripheral neuropathy. Most patients have symptoms that involve tingling and numbness in their hands and feet. They often experience burning as well and difficulty with balance, as it continues to progress. Symptoms tend to be worse at night which affects the patient’s quality of sleep. The most common cause of peripheral neuropathy is diabetes but can also be toxin, chemo or drug induced. The best way to determine the presence of peripheral neuropathy is through an EMG.
The next most common condition that patients present with is called neurogenic claudication. This is an intimidating name, but this is caused by stenosis in the lumbar spine. Stenosis is where the spinal canal is narrowed and places pressure on the nerves. The symptoms are isolated to the lower extremities. Also, while they have symptoms such as heaviness, pain and numbness in their legs, it tends to go away with rest or by bending forward. This is one key differentiator in determining diagnosis but this diagnosis is often confirmed via MRI.
Another cause for these overlapping symptoms is called cervical myelopathy. The mechanism is due to compression of the spinal cord, at the level of the neck. Even though this compression is happening high up in the spine, it still can cause symptoms in the feet. We often hear about compression of the spinal cord in cases of severe trauma like a car accident, football injury or falling from a tall height. However, there still can be slight or mild compression of the spinal cord due to disc bulges or advanced degeneration in the neck. The key to this diagnosis is also frequently confirmed by MRI.
Another frequent diagnosis that comes into the clinic is something called a radiculopathy. This is where a patient experiences numbness and tingling, but on only one side of the body and in one extremity. For example, it may be contained to just the right arm or left leg. The most common case of radiculopathy that we treat is called sciatica, which involves the sciatic nerve. The key piece of the patient’s history is that it only happens on one side. This is how it is differentiated from the other diagnoses discussed in this article.
The causes associated with numbness, tingling, burning, difficulty with balance are not limited to this article. It is easy to see the complexity of these cases. Unfortunately, many patients coming into our facility think they have peripheral neuropathy, when in fact they don’t. Our team will help you find the answers you are looking for. Any patient that comes to ACS will be heard and listened to. They will receive a thorough evaluation and lengthy medical history to accurately find out what is the cause of their symptoms. If needed, additional blood work and imaging may be ordered to help shape the clinical picture.
This article is not intended to give medical advice to anyone reading this article. It is important to seek medical care from a knowledgeable medical provider to receive an accurate diagnosis. This is key to ensure that you receive the right type of treatment.
We hope this article was informative in realizing the complexity of neuropathy cases. However, the next article will take a more in depth look into our treatment options. Stay tuned. In the meantime, go to our YouTube channel and hear about the experience of one of our patients from their own perspective and words.
Dr. Emma Minx