Tests & Procedures for Neuropathy

Neuropathy, commonly referred to as peripheral neuropathy or nerve damage, is a term used to describe a range of health issues (and their symptoms) that result in either damage to – or compression of – the nerves outside the spinal cord and brain. There are over 100 identified types of neuropathy affecting over 20 million people a year. The condition is most common among diabetics, alcoholics, drug users, those with a family history of neuropathy, and those who have suffered a traumatic injury.

Your experience with the disease will vary based on the underlying cause, and your symptoms will depend on the type of nerves affected. If left untreated, neuropathy can lead to more serious complications. Getting a proper diagnosis and treatment from a neuropathy specialist near you can go a long way in ensuring your long-term health.

Since neuropathy can have many different causes, thorough testing will be key in determining an accurate diagnosis. We begin with a comprehensive physical examination. Understanding your full medical history is also important. We may ask about a wide range of topics, including alcohol consumption, family history with nerve conditions, and any potential exposure to toxins.

Additional tests are often required to gain more insight into the problem. In such cases, your doctor may order:

• Blood tests: Blood tests can reveal vitamin deficiencies, signs of diabetes such as high glucose levels, and more.
• Imaging tests: We use MRIs, CT scans, and ultrasounds to detect abnormalities in vessels and bones or to visualize things such as pinched nerves or herniated discs.
• Nerve function and conduction tests: We may use electromyography (EMG), which records electrical activity in your muscles, to detect nerve damage; autonomic reflex screens to see how autonomic nerve fibers are working; sensory tests that determine how you perceive temperature and touch; or sweat tests that tell us how your body produces sweat.
• Nerve and skin biopsy: Biopsies allow us to look for abnormalities or a reduction in nerve endings.

Sometimes, we aren’t able to identify a specific cause of neuropathy. This is known as idiopathic neuropathy, and is quite common, occurring in 30 to 40 percent of cases. Even if we aren’t able to identify a cause for your neuropathy, we can still provide relief through treatment.

As neuropathy can have multiple causes, treatment will involve both alleviating symptoms and treating the underlying disease.

Medication and therapy

While surgery is the most effective method of treatment for neuropathy, pain-relieving medication and certain types of therapy can ease symptoms, including:

• Pain relievers: Over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) can help. Severe pain may require prescription medications.
• Anti-seizure medications: Certain medicines used to treat epilepsy can help with nerve pain, including gabapentin and pregabalin.
• Antidepressants: Certain types of antidepressants have been shown to help with discomfort by blocking the signals that transmit pain. These can include tricyclics, SSRIs, and SNRIs.
• Topical medications: These can include capsaicin cream and lidocaine patches.
• Physical therapy: If you have muscle weakness, physical therapy can help improve your movement and strength.

Nerve decompression surgery

At The Institute for Advanced Reconstruction, our surgeons are among a select group of plastic surgeons in the world with the specialized training and precision to perform this complex surgery. Nerve decompression surgery relieves pressure on nerves by surgically removing the constricting tissue or bone, or widening the canal encasing the nerve. In our experience, decompression surgery is successful in relieving the symptoms of neuropathy in up to 90 percent of well-selected patients.

What to expect on the day of your surgery

We perform nerve decompression surgery on an outpatient basis, either at our own Center for Outpatient Surgery or at the hospital. The entire procedure is typically completed in 45 minutes to an hour and uses microsurgical techniques to minimize the size and number of incisions required.

Recovery and outcome

Recovery is gradual and will take about 2 to 3 weeks. During this period, our physicians will continue to monitor for improved muscle tone and function, along with the return of sensation. Your first follow-up visit to our office is usually a week after surgery, at which point we will remove your bandages. Three weeks after your surgery, we will remove your sutures.

Physical and occupational therapy will be very important in the aftermath of your surgery. Therapy helps to keep joints and extremities mobile and enhances your recovery.