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Some people with HIV/AIDS describe peripheral neuropathy as a burning sensation. Others say that it's like a thousand hot needles poking the feet and hands. This is peripheral neuropathy. Whatever you call it and however you describe it, peripheral neuropathy can be an uncomfortable, very annoying, and sometimes a crippling condition. What causes peripheral neuropathy and what can be done about it?
What is Peripheral Neuropathy?
Peripheral neuropathy (PN) is a condition of the peripheral nervous system. The peripheral nervous system includes all the nerves outside of the brain and spinal cord. Nerves that send sensations from the hands and feet are two examples of peripheral nerves.PN is a result of damage to the peripheral nerves. Sometimes it's due to a problem with the nerves ability to send impulses across the nerve endings. Other times, there is a defect in the myelin sheath, the insulating covering of the nerve. This nerve damage affects the nerve's ability to send pain and sensation impulses from the feet and hands to the brain. As a result, numbness, tingling and pain in the feet and hands develops. The severity can range from a mild nuisance to symptoms so severe that a person is unable to walk.
What Causes Nerve Damage and PN?
There are several causes of nerve damage that results in PN. Anything that can cause damage to the peripheral nerves can cause PN. Some examples include:- medical conditions such as diabetes
- viruses such as CMV
- opportunistic infections
- as a side effect of some medications including those that treat HIV
- nerve damage caused by HIV itself
What HIV medications Should I Be Concerned About?
Some but not all HIV drugs can cause PN. In addition there are some medications used to treat associated conditions that can also cause peripheral neuropathy. Medications known to cause PN are:- Hivid (ddC)
- Videx and Videx EC (ddI)
- Zerit (d4t)
- Dapsone (used to decrease the risk of PCP)
- Isoniazid (INH) (used to treat TB)
- Flagyl (a commonly used antibiotic)
If acted upon quickly, stopping the med in question will usually resolve the PN. On occasion, lingering symptoms of PN will persist after stopping the meds.
How is Peripheral Neuropathy Treated?
PN can be treated with and without medicines, depending on the severity and the cause. Generally speaking, the more severe the symptoms, the more likely the PN will have to be treated with other medicines.Non-medicinal Methods of Treatment
- wear loose shoes
- don't walk long distances
- don't stand for long periods of time
- magnets worn in the socks have proven beneficial in PN caused by diabetes
Medicinal Treatment
- Neurontin: An anti-convulsant
- Amitriptyline or Nortriptyline: Anti-depressants that increase peripheral nerve impulses
- Ibuprofen: for mild symptoms
- Vitamin B Complex
Peripheral neuropathy is at the very least an annoying inconvenience and to many it's a debilitating, painful disease that interferes with a person's ability to walk, work and function.
If you have burning, numbness or pain in the feet or hands, notify your doctor right away.
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