Most commonly associated with diabetes other known causes include alcohol abuse, back issues causing nerve impingement or idiopathic, meaning no known reason why the condition persists.
With prolonged damage to the nerve from increase blood sugars, alcoholic degradation of the nerve covering or unknown reasons the nerve begins to fire improperly thereby sending the wrong messages and symptoms to begin to occur.
Special tests such as a nerve conduction velocity test can detect impingement syndromes throughout the lower back and legs causing the symptoms. Once the symptoms begin a punch biopsy known as an epidermal nerve fiber density test can be performed in the office to detect the degree of degradation of the nerve endings.
Treatment depends on the severity of the symptoms and can begin by modifying your diet to lower blood sugars which will decrease the severity of the neuritis as your hgba1c lowers over time. Also vitamin b12 supplements can be very helpful in decreasing the symptoms by taking either oral pills or vitamin b12 shots monthly given in our office. Laser therapy performed in our office at weekly intervals has also been shown to decrease the severity of the symptoms within a few weeks. The worst cases may require a surgical decompression of the nerve.