Navigating chronic pain and neuropathy: Symptoms, causes and treatments

Trinity Health Hauenstein Neurosciences Center – Grand Rapids is shining a light on a condition that affects millions of Americans but is often misunderstood: painful peripheral neuropathy.
Peripheral neuropathy occurs when nerves outside the brain and spinal cord are damaged. These nerves play a vital role in sending signals between the body and the brain. When they’re not functioning properly, it can lead to a wide range of symptoms — from numbness and tingling to sharp, burning pain.

“Many patients describe it as a pins-and-needles sensation, or a burning pain that starts in the feet and gradually moves upward,” says Melanie Taylor, MD, a neurologist with Trinity Health Medical Group and Medical Director of the Neuromuscular Program. “It can be frustrating, and it often interferes with sleep, mobility and quality of life.”

What causes peripheral neuropathy?
Peripheral neuropathy can result from a variety of underlying conditions. Common causes include:
•    Chronic illness (such as diabetes)
•    Vitamin deficiencies
•    Autoimmune diseases
•    Infections (such as Lyme disease or hepatitis C)
•    Toxin exposure (such as alcohol)
•    Genetic conditions

Diagnosis typically begins with a detailed medical history and physical exam and may include specialized tests such as nerve conduction studies or skin biopsies.
“Identifying the underlying cause is key,” explains Dr. Taylor. “For example, improving blood sugar control or stopping a medication might slow down or even reverse nerve damage.”

Recognizing the symptoms
Painful peripheral neuropathy often begins in the feet or hands and progresses upward, a pattern known as length dependent. Symptoms may include:
•    Burning, stabbing or shooting pain
•    Tingling or “electric shock” sensations
•    Numbness or reduced ability to feel temperature or pain
•    Muscle weakness or cramping
•    Balance issues or difficulty walking

Some individuals also experience digestive issues, lightheadedness or abnormal sweating due to nerve damage affecting involuntary body functions.

Treatment options
While there is no single cure for painful peripheral neuropathy, many approaches can help manage symptoms and improve quality of life.

Treatment typically begins with addressing the underlying cause, such as adjusting medications, treating infections or correcting nutritional deficiencies. Symptom management is tailored to each patient and may include:
•    Medications such as gabapentin, pregabalin (Lyrica) or certain antidepressants to calm overactive nerves
•    Topical treatments such as lidocaine or compounded creams
•    Physical therapy to improve strength and balance
•    Complementary therapies such as acupuncture, massage or mindfulness-based stress reduction
•    Advanced options such as spinal cord stimulation or nerve blocks for severe, treatment-resistant cases

“We take a multidisciplinary approach,” says Dr. Taylor. “That means combining medical treatment with physical therapy, pain psychology and lifestyle support to help patients regain control over their lives.”

When to seek help
If you’re experiencing persistent numbness, tingling or unexplained pain in your hands or feet, don’t ignore it. Early diagnosis and treatment can make a significant difference in managing symptoms and preventing further nerve damage.

To receive care for peripheral neuropathy or other chronic pain conditions, ask your primary care provider for a referral to Trinity Health Hauenstein Neuroscience Center – Grand Rapids Campus.