Neuropathy brings pain, weakness or both
DEAR DR. DONOHUE: I’m a person with peripheral neuropathy. I have tolerated this condition for two years, but now it’s getting worse. I have a hard time walking without pain. If you can provide any advice and information, I would appreciate it. — M.K.
ANSWER: The literal meaning of “neuropathy” is “nerve illness.” The “periphery” of peripheral neuropathy indicates the nerves are not in the brain or spinal cord; they’re nerves, mostly in the legs or arms, that bring messages from the brain to muscles that make the muscles move. A disturbance of these motor nerves leads to muscle weakness. Or they’re nerves from the skin and sensory organs that tell the brain how the body feels. A defect in these sensory nerves leads to pain or numbness. Or they’re nerves that are both motor and sensory.
Leg pain — burning, shocking, stabbing or aching – is a common neuropathy sign. One or more of the sensory nerves to your leg is on the blink. If a motor nerve is involved, it makes it difficult for a person to lift his foot off the ground when taking a step – foot drop.
The ideal treatment for neuropathy is finding its cause and addressing that matter. Diabetes, deficiency of vitamin B-12, hereditary conditions and a misguided attack on nerves by the immune system are some of the causes of neuropathy. Quite frequently, a cause cannot be found, and the neuropathy is then called “idiopathic.”
A pretty large menu of treatments exists for the pain of sensory neuropathy. Many of these medicines were originally designed for other purposes, but they have been found to have pain-easing properties in addition to their primary function. The seizure-control medicines Lyrica and Neurontin can deaden neuropathic pain, as can antidepressants like amitriptyline and Effexor. Lidocaine is a pain-numbing agent that comes in a patch applied directly to the skin. Capsaicin (cream, lotion and gel), also applied to the skin, eases pain. Alpha lipoic acid is helpful for the neuropathic pain of diabetes.
One of the smartest moves you can make is to contact The Neuropathy Association at 888-PN-FACTS or on the Internet at www.neuropathy.org. The association will keep you current on any changes or breakthroughs in treatment.
DEAR DR. DONOHUE: I was diagnosed and hospitalized for cellulitis of my leg. I am now home but getting IV antibiotics at a clinic. My leg is swollen, aches and is red. I asked how I got it and what it is, but the explanation wasn’t satisfactory. Please tell me how I contracted this. — V.C.
ANSWER: Cellulitis is an infection of skin cells, hence CELLulitis, and the tissues beneath the skin. The staph and strep bacteria are the germs most often involved. They’re all over the place. They enter the skin cells through a break in the skin, and the break can be so minute that it goes unnoticed. Athlete’s foot is another way that these germs enter the skin of the legs.
The infection spreads rapidly. The skin turns red and feels hot. The leg (or arm or wherever) swells and is very painful.
Antibiotics are the cure. While you are home, keep your leg elevated to reduce the swelling. Time, along with the antibiotics, eventually will rid you of symptoms. If the lymph vessels of the legs have been damaged, you might have to put up with swelling for a longer time. Lymph vessels drain lymph, the fluid part of blood that seeps out of the circulation to bathe all the body’s tissues.
DEAR DR. DONOHUE: Every morning for the past 30 years, I have taken two Excedrin. I started doing this because I used to wake up with a headache, and I got into the habit of doing so. I do not drink coffee or pop. I am 57 and healthy. I am concerned about taking this medicine for so long. Is this something I should stop? I told my doctor, and he said I probably should stop and wean myself off. I wonder what your thoughts are. — E.H.
ANSWER: Yes, stop. People should not take medicines they don’t need. Excedrin is a combination of aspirin and acetaminophen (Tylenol) along with a small amount of caffeine. All medicines, even those as safe as Excedrin, can have side effects. Do as your doctor suggested.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.