Neuro Praxis Düsseldorf

Paresthesia and pain

Parasitic sensations and pain such as tingling, burning, stinging are typical symptoms of nerve diseases such as polyneuropathy. These complaints are also referred to as paresthesias (“next to, past” perception). This also includes the "ant running" that is often perceived on the soles of the feet or walking "as if on cotton wool". The disturbing sensations can, however, also be perceived as itching, a feeling of electricity, a furry feeling or a feeling of swelling.

Often the feet and especially the toes are particularly affected. In principle, the sensory disturbances can occur in the feet and hands. In addition, tingling, burning or stinging can also affect the body, face, scalp and also the oral cavity.

Paradoxical sensations

It is not uncommon for a polyneuropathy, which can lead to sensory disturbances and numbness, to change the temperature perception of the feet and hands. For example, toes or fingers can feel particularly cold in warm ambient temperatures and warm skin temperatures.

In everyday life, for example, it can be difficult to correctly assess the water temperature when showering or bathing due to polyneuropathy. When it is cold, the opposite effect can be observed, so that a sensation of heat or painful burning sensation is perceived. These paradoxical, false impressions or discomforts arise from the disease of a special group of nerve fibers, the "small fibers", i.e. small-caliber nerve fibers with little or no medulla. These fibers not only convey sensitive impressions but also regulate skin blood flow, skin moisture and metabolic processes. It is not uncommon for small fiber polyneuropathy to lead to severe dryness and even reddening of the skin on the lower legs, feet and hands, comparable to sunburn or skin irritation.

Symptoms of polyneuropathy

Not infrequently, the pain and abnormal sensations of small fiber neuropathy, but also the accompanying complaints such as digestive problems, sleep disorders and feelings of exhaustion, resemble the description of fibromyalgia. At the ANS-Clinic, specialized examination methods are used to look for small fiber neuropathy. If interdisciplinary diagnostics are necessary for this, this will be coordinated by us. The main goal of diagnostics is to find a treatable cause.

In principle, polyneuropathy can affect all nerves in the body. Parasitic sensations, pain and numbness indicate a disease of the sensitive nerves supplying the skin. As part of the examinations, attention is also paid to whether other parts of the nervous system are diseased. Therefore, attention is paid to possible muscle weakness, disorders of balance and coordination, poor circulation and bladder or digestive disorders.

For example, it is relevant whether there are gait disorders, trips and falls. Important observations in this context can be the tips of your feet getting caught on doorsteps or your feet not rolling over while walking. If the hip and thigh muscles are primarily affected, straightening up from a crouch or climbing stairs will be tedious. If the shoulder girdle, arm or hand muscles are affected, it can be difficult to carry bags but also to open bottles or glasses.

Wide range of causes

Parasitic sensations and pain caused by diseases of the sensitive nerve fibers are typically annoying when you want to relax, in the evening or when you are sitting quietly. Occasionally there may be an urge to move the legs, which makes it impossible to sit still. Those affected typically describe "restless legs". The night's rest can also be very disturbed by the urge to move the legs. When looking for relief from their symptoms, many sufferers find that foot baths, massages, transcutaneous electrical nerve stimulation (TENS) or acupuncture provide short-term relief.

For the diagnosis of a polyneuropathy of the so-called small fibers, that is, a disease of the slow-conducting, myelin-poor nerve fibers, suitable examination methods are now available. We use these examinations in the ANS Clinic in the Neuro Praxis Düsseldorf for the diagnosis.

The functions of the vegetative (internal) organs are also recorded through a careful all-round look as part of the polyneuropathy. Depending on the cause of the polyneuropathy, these can be affected to varying degrees. It is therefore not unlikely that a treatable cause will be found. Occasionally, tingling or pins and needles on the feet and hands are associated with the use of medication or the lack of certain vitamins. The aforementioned abnormal sensations can also be caused by diseases in the field of rheumatology, gastroenterology or cardiology. Parasitic sensations and pain can occur early in the course of a chronic disease such as diabetes mellitus or liver or kidney disease.

Always taking rare causes into account

Other possible causes associated with abnormal sensations include chronic inflammatory nerve diseases, for example in the context of infections or autoimmune diseases, toxic nerve damage, thyroid diseases, but also the lack of certain vitamins or trace elements. The search for the cause also includes preventive examinations and, in individual cases, imaging examinations of the chest and abdomen.

Some causes can be treated well. Thanks to many years of experience in the field of polyneuropathy, in particular with the involvement of the autonomic (autonomic) nervous system, we include a wide range of causes in the diagnosis. We also work closely with colleagues in other medical specialties. In the clarification and treatment of rare diseases, the now extensive network of our cooperation with specialist doctors helps us.

The spectrum of drug treatment options is also wide. Pain relief, sleep improvement and also an improvement in mood can be achieved. However, medication is not always necessary for treatment. The non-drug treatment methods that we use for treatment are just as diverse. In the treatment of polyneuropathy involving small fibers, in our experience, the combination of medicinal and non-medicinal treatment methods has proven itself.