Peripheral neuropathy is nerve damage to the nerves that are outside of the brain and spinal cord.

The brain and spinal cord are considered the central nervous system. This central system sends messages to the rest of the nerves in the body, called the peripheral nervous system. Nerves in your fingers, arms, feet and other areas of the body can detect pain, temperatures, and other sensory inputs and send those signals back to the central nervous system.

Signs and Symptoms of Peripheral Neuropathy

Peripheral neuropathy can cause numbness, pain and weakness, usually in the hands and feet. It can also affect digestion, urination and blood circulation. 

Peripheral neuropathy can feel like stabbing, prickling, burning or tingling. Symptoms can start with numbness, prickling or tingling in the hands or feet. Numbness or tingling can remain in the hands or feet or spread up into your legs and arms. 

Peripheral neuropathy can cause extreme sensitivity to normal activities, like walking barefoot or lying under a blanket. Extreme peripheral neuropathy can cause complete numbness in the feet, which can cause falls and a lack of coordination. Some patients explain peripheral neuropathy as feeling like they are wearing gloves or socks when they are not. 

Causes of Peripheral Neuropathy

Multiple Myeloma

Peripheral neuropathy can be caused by the blood cancer multiple myeloma and its treatments. The protein produced by the myeloma cells can directly damage nerve cells. Sometimes, myeloma can be complicated by a condition called amyloidosis (protein buildups) that can also cause peripheral neuropathy. These high levels of protein can thicken the blood and slow down blood flow, which can also cause peripheral neuropathy. Peripheral nerves that leave the spinal cord can also be damaged from fractured vertebre caused by myeloma. 

Steroid medications such as dexamethasone and prednisone used in myeloma treatment regimens can elevate blood sugar, therefore blood sugar levels should be monitored by the treating team regularly. The proteasome inhibitor bortezomib (Velcade) and the immunomodulatory drug thalidomide (Thalodid) are known to cause peripheral neuropathy. Using the subcutaneous version of Velcade can reduce peripheral neuropathy, but please talk with your doctor if you are expeiriencing these symptoms.

It is important to mangage peripheral neuropathy carefully in myeloma and not allow it to worsen. Your doctor can modify the dose and frequency of your treatment to reduce the development and severity of peripheral neuropathy, preventing long-term damage. 

Diabetes

Diabetes is the most common cause of peripheral neuropathy. Over time, high blood sugar levels can damage the small blood vessels that supply the nerves in your body. This prevents nutrients from reaching the nerves and without nutrients, the nerves can become damaged and disappear.

Other Causes

Other causes of peripheral neuropathy can include autoimmune disorders, infections, genetic disorders, cancer tumors, disease like kidney disease, liver disease and an underactive thyroid. Additional causes can include exposure to poisons, alcoholism (which leads to vitamin deficiencies), or injury to a nerve. Cancer medications, as described above, can also cause peripheral neuropathy. 

Factors that Worsen Peripheral Neuropathy

• Smoking – interferes with peripheral circulation and nerves so consider stopping. Ask the GP or practice nurse for advice and/or local support
• Diabetes – Monitor blood sugar levels carefully. Chronically elevated blood sugar levels can damage the peripheral circulation and nerves
• Alcohol – Chronic alcohol abuse also frequently leads to nutritional deficiencies (including B12, thiamine, and folate) that contribute to the development of peripheral neuropathy
• Infections – Some bacteria and viruses such as shingles can cause peripheral neuropathy

What Makes Peripheral Nueropathy Better?

• Vitamins including B-1, B6 and B-12, Vitamin E and niacin are critical for nerve health
• Exercise helps improve blood circulation and oxygen supply to the nerves
• Eating a well-balanced diet with fresh foods provides sufficient vitamins for nerves
• Avoid highly processed foods
• Drink plenty of water
• Cut out alcohol
• Eliminate smoking
• Gaabapentin is commonly prescribed for peripheral neuropathy

To see what other mulitple myeloma patients have tried to reduce peripheral neuropathy, search our HealthTree Side Effect Solutions.