Most people have heard of carpal tunnel syndrome, the affliction of the wrist and hand often associated with long hours at a computer keyboard. But most people don’t know that carpal tunnel is actually a type of focal neuropathy, a condition affecting nearly eight percent of the general population, which also has a link to diabetes.
Neuropathy, in general terms, means nerve damage. Neuropathy can be focal (one nerve - such as carpal tunnel or a pinched nerve in the neck or back), or generalized, affecting multiple nerves at once. Neuropathies can be genetic in origin or acquired and develop over time.
Divisha Raheja, MD, a neuromuscular specialist, with St. Luke’s Neurology Associates, explains that the most common cause of neuropathy in the United States is diabetes, affecting close to 50 percent of patients with this condition, although long-standing history of smoking, drug and alcohol use, certain medications, toxic exposure to heavy metals and infections such as hepatitis C and HIV can also be associated with neuropathies.
Neuropathy symptoms can include anything from weakness, muscle cramps and muscle loss to pain, numbness, a tingling or burning sensation in toes and may gradually involve the feet, lower legs and hands. It could also cause lightheadedness, constipation, diarrhea, bloating or abnormal sweating.
“Most neuropathies are very slowly progressive, however some can progress rapidly and may require aggressive treatment,” explains Dr. Raheja. “That’s why it’s important to seek treatment early to figure out the best course of action and identify the cause; the best way to avoid progression is early treatment.”
Dr. Raheja is a board-certified neurologist and fellowship-trained in neuromuscular medicine. She completed her internship at York Hospital, a neurology residency at Drexel University College of Medicine and fellowship at Penn State Hershey Medical Center. She then worked at Penn State Hershey Medical Center to focus on caring for patients with neuromuscular disorders, such as muscle diseases, muscular dystrophies and neuropathies.
Since it is difficult to reverse the neuropathy process, the goal is to identify and target the high-risk patients with lifestyle modification before they develop irreversible neuropathy. Studies have shown that lifestyle modification with diet control, regular exercise and weight loss can improve the nerve fiber density and encourage nerve regeneration.
“More and more we are seeing increased incidence of neuropathy in patients who have borderline glucose/prediabetes/ high triglycerides and obesity and the recommendation for these patients is to educate them regarding lifestyle modification, regular exercise, avoiding carbohydrates and following a lean protein diet, so they can head off both diabetes and the neuropathy that can accompany it,” says Dr. Raheja. “My goal is to make sure my patients understand their symptoms, educate them about the disease process and risk factors associated with disease progression and work with them to provide the best care.”