Peripheral neuropathy is a type of pain caused by damage to the peripheral nerves. These nerves carry messages to and from the body to the brain and spinal cord. When damage or injury occurs, the brain gets the wrong signals, leading to weakness, numbness, burning and pain in the affected nerve or group of nerves.

The Neuropathy Association estimates about 20 million Americans have some degree of peripheral neuropathy. It can happen at any age, but is most common in older people. Symptoms most commonly occur in the hands and feet. In some cases, the pain can be severe and debilitating. Some people can't tolerate the touch of clothing (like a sock). Walking can be difficult or painful. Pain can also interfere with the ability to perform daily activities or get a good night's sleep.

About 30 percent of cases of peripheral neuropathy are caused by diabetes. The condition can also be caused by trauma, surgical scars, kidney disease, imbalance in hormone production, infection, tumor or nutritional deficiency. In about one-third of patients the cause can't be found.

Treating Peripheral Neuropathy

Treatment or control of underlying conditions may help reduce symptoms of peripheral neuropathy. Some patients can also benefit from prescribed exercises and physical therapy. Stopping smoking is also important because smoking narrows the blood vessels. This reduces blood flow and passage of nutrients to damaged nerves and limits their ability to heal.

Shai Rozen, M.D., a Plastic Surgeon with UT Southwestern Medical School, Dallas, is using another treatment for some patients with painful peripheral neuropathy, called nerve decompression. He explains that sometimes scar tissue builds around a nerve. The scar contracts as it hardens, putting pressure on the affected nerve. Releasing the scar tissue can sometimes alleviate the symptoms.

Rozen says it can be difficult to determine which nerves are affected by the peripheral neuropathy. To locate the correct nerve, he injects an anesthetic agent into the probable nerve and watches the patient's reaction. If the symptoms improve, then the correct nerve has been identified. Then he follows the path of the nerve, looking for signs of scar tissue or any other type of structure that may be pressing on the nerve. Once the constricted area has been identified, a small cut is made into the tissue to open up the space and free the nerve. That relieves the pressure and, hopefully, greatly reduces or eliminates the symptoms.

Surgical decompression is commonly used for carpal tunnel syndrome. Some physicians are even using it to relieve symptoms for some patients with headaches. More recently, a few surgeons are using the technique to treat patients with painful peripheral neuropathy from diabetes.

For information on the clinical trial studying nerve decompression for patients with diabetic peripheral neuropathy, visit http://clinicaltrials.gov. Then type the trial identification number in the search box: NCT00703209.

For general information on peripheral nerve pain:

American Chronic Pain Association

American Pain Foundation

The National Institute of Neurological Disorders and Stroke

The Neuropathy Association

For specific information on diabetic neuropathy:

American Diabetes Association