Neuropathy Is Not One Condition

Root cause 01

Diabetic Neuropathy

Also called diabetic peripheral neuropathy

Diabetic neuropathy is nerve damage caused by prolonged exposure of peripheral nerves to elevated blood glucose. It affects the longest nerves first, which is why symptoms usually start in the toes and move up the feet over months or years. The damage involves both the sensory fibers themselves and the small vessels that feed them, the vasa nervorum.

Typically indicated: Metabolic Optimization, Class IV Laser Therapy, IV Nerve-Support Infusions

Commonly reported

• —Burning or tingling in the feet that is worse at night
• —Numbness that makes the floor feel padded or far away
• —Sharp, electric pains in the toes or soles
• —Loss of protective sensation on monofilament testing
• —Unsteadiness in the dark or on uneven ground

Root cause 02

Peripheral Neuropathy

Also called idiopathic peripheral neuropathy

Peripheral neuropathy is damage to the nerves carrying signals between the spinal cord and the limbs. When testing does not identify diabetes, compression, chemotherapy or another clear driver, the case is often labeled idiopathic. A correctable nutritional or hormonal deficiency turns up in a meaningful share of those cases once someone runs the labs.

Typically indicated: IV Nerve-Support Infusions, Class IV Laser Therapy, Hormonal Correction

Commonly reported

• —Symmetric numbness that began in both feet at about the same time
• —Pins and needles that has crept up toward the ankles over time
• —Burning that intensifies at rest and interferes with sleep
• —Reduced vibration sense at the great toe on examination
• —Bedsheets or socks that feel painful against the skin

Root cause 03

Compressive Neuropathy

Also called nerve compression and entrapment neuropathy

Compressive neuropathy is nerve dysfunction caused by mechanical pressure on a nerve root or a peripheral nerve rather than by a systemic metabolic process. The pressure may come from a herniated disc, a narrowed spinal canal, or fibrotic tissue that has formed around a nerve after chronic inflammation or injury. Because a specific nerve is affected, the symptoms follow that nerve's territory instead of appearing symmetrically in both feet.

Typically indicated: Mechanical Decompression, Shockwave Therapy, Class IV Laser Therapy

Commonly reported

• —Symptoms in one limb, or clearly worse on one side
• —Pain that radiates from the low back or neck down into the limb
• —Numbness that changes with position, bending, or how far you walk
• —Weakness in a specific muscle group rather than general unsteadiness
• —Night symptoms in the hand that ease with shaking or repositioning

Root cause 04

Metabolic Neuropathy

Also called metabolic and hormonal polyneuropathy

Metabolic neuropathy is nerve damage driven by a systemic metabolic or endocrine disturbance rather than by direct mechanical injury. Thyroid deficiency, low testosterone, estrogen deficiency, insulin resistance and prediabetes all alter the chemical environment peripheral nerves depend on. The resulting symptoms look much like other distal neuropathies, which is why the driver is only found when it is specifically tested for.

Typically indicated: Hormonal Correction, Metabolic Optimization, IV Nerve-Support Infusions

Commonly reported

• —Numbness and tingling in both feet with no diabetes diagnosis
• —Burning sensations alongside fatigue, cold intolerance or weight change
• —Symptoms that developed gradually over years rather than after an injury
• —Reduced sensation on monofilament or vibration testing at the feet
• —Muscle cramping and a general loss of strength in the legs

Root cause 05

Chemotherapy-Induced Neuropathy

Also called chemotherapy-induced peripheral neuropathy (cipn)

Chemotherapy-induced peripheral neuropathy is nerve damage caused by neurotoxic cancer treatment rather than by a metabolic or mechanical process. Platinum agents damage the sensory neurons of the dorsal root ganglion, while taxanes and vinca alkaloids disrupt the microtubule transport that keeps long axons alive. The result is usually a symmetric glove-and-stocking pattern in the hands and feet that tracks with cumulative dose.

Typically indicated: Class IV Laser Therapy, IV Nerve-Support Infusions

Commonly reported

• —Numbness and tingling that appeared in the hands and feet during treatment
• —Cold-triggered pain in the fingers, common after oxaliplatin
• —Difficulty buttoning clothing, writing, or feeling small objects
• —Burning in the soles that is worse at night
• —Loss of balance from reduced position sense in the feet