Neuritis: Symptoms, Causes, and Comprehensive Treatment Options

Do you feel tingling or numbness that comes and goes in your feet? Do you experience electric shock-like sensations in your feet, especially at night? Does even the light touch of a blanket on your feet hurt at bedtime? If you answered yes, neuritis may be the cause. Keep reading this article to learn more about neuritis, its symptoms, causes, and treatment options.

What Is Neuritis and What Are Its Main Types?

Neuritis, also known as "neuropathy," is a condition that occurs due to nerve damage, which may cause pain, weakness, numbness, or tingling in one or more areas of the body. Nerve damage may result from:

• Certain diseases.

• Infections.

• Injuries.

• Use of certain medications.

• Long-term alcohol abuse.

In some cases, no clear cause is identified

Types of Neuritis

There are many types of neuropathies, and each type is often named based on:

• The affected body part or region.

• The cause of nerve damage.

• The number of nerves involved.

Autonomic Neuropathy

Occurs when the nerves that control the body's involuntary functions — such as digestion, blood pressure, and bladder function — are damaged.

Diabetic Neuropathy

A complication of diabetes, commonly affecting the nerves in the hands and feet. It can also impact the nerves that control automatic body functions or those in the hips and thighs.

Peripheral Neuritis

This type affects the nerves located in the body's extremities, such as the feet, legs, hands, and arms.

Focal or Mononeuropathy

Targets a single nerve. Examples include carpal tunnel syndrome and Bell’s palsy.

Polyneuropathy

Affects multiple nerves at the same time and is the most common form of neuropathy among patients.

Understanding Neuritis and Its Impact on the Body

Neuritis gradually affects the body's functions and progresses through several stages that vary in severity and impact:

• Early Stage:

Symptoms are mild at this stage, such as slight tingling or temporary numbness. Symptoms can often be managed without major intervention. This is the best time to seek medical advice and start treatment to prevent further deterioration.

• Intermediate Stage:

Symptoms become more noticeable and intense, potentially including disturbing pain and difficulty sleeping due to repeated nerve discomfort.

• Late Stage:

Symptoms become severe, including muscle weakness, constant pain, and numbness that may hinder movement. The risk of injuries and complications increases due to reduced sensation and advanced nerve damage.

Symptoms of Neuritis: How to Recognize Them?

The symptoms of neuritis vary depending on the type of nerves affected and the stage of the condition. In the early stages, symptoms may be mild or unclear, while they tend to worsen as the condition progresses. This may lead to permanent nerve damage or, in some cases, loss of mobility.

Common Symptoms of Neuritis

Sensory symptoms of neuritis may include:

• Stabbing pain or burning sensations that come and go, often worse at night.

• Numbness.

• Tingling, similar to "pins and needles".

• Electric shock-like sensations.

As nerve damage progresses, chronic symptoms may appear, such as:

• Muscle weakness.

• Loss of sensation or movement.

• Balance problems.

If neuritis affects autonomic nerves, it may cause disruptions in internal body functions, including:

• Digestive issues (e.g., early satiety).

• Bowel disorders (e.g., diarrhea or constipation).

• Bladder problems.

• Sexual dysfunction (e.g., erectile dysfunction).

• Sweating abnormalities.

• Dizziness or lightheadedness.

Detailed Symptoms of Peripheral Neuritis

Peripheral neuritis symptoms vary widely depending on the case. It may affect a single nerve, a group of related nerves, or multiple nerves in different body areas. Symptoms depend on the type of nerve signals involved, which may include more than one type.

Symptoms of peripheral neuritis are classified into:

• Motor symptoms.

• Sensory symptoms.

• Autonomic symptoms.

Motor Symptoms

The peripheral nervous system transmits motor signals from the brain to the muscles, allowing voluntary movement. Muscle health and function rely on this continuous nerve connection.

Motor symptoms of peripheral neuritis may include:

• Muscle twitches or involuntary spasms.

• Weakness or paralysis in specific muscles.

• Gradual muscle wasting.

• Difficulty lifting the front of the foot and toes while walking (foot drop).

Sensory Symptoms

Peripheral nerves carry sensory information from the external environment to the brain. Inflammation may disrupt this process, leading to abnormal sensation transmission.

Key sensory symptoms of peripheral neuritis include:

• Tingling in the affected area.

• Numbness or reduced sensitivity to pain or temperature, often in the feet.

• Burning or sharp pain, especially in the feet.

• Pain from light touches that normally shouldn’t hurt (e.g., a light touch).

• Loss of balance or difficulty with coordination due to impaired awareness of hand or foot position.

Autonomic Symptoms

The body performs several automatic functions without conscious control, such as sweating, digestion, and blood pressure regulation. Autonomic nerve fibers regulate these functions, and damage to them can cause serious disruptions.

Autonomic symptoms of peripheral neuritis may include:

• Constipation or diarrhea, often worsening at night.

• Nausea, abdominal bloating, frequent burping.

• Low blood pressure, causing dizziness or fainting upon standing.

• Rapid heartbeat.

• Excessive sweating or lack of sweating.

• Sexual problems such as erectile dysfunction in men.

• Difficulty emptying the bladder.

• Loss of bowel control.

Symptoms of Neuritis in the Feet Specifically

Symptoms of foot neuritis may include:

• Gradual numbness or tingling in the feet, which may spread to the legs.

• Burning, stabbing, or shooting pain.

• Hypersensitivity in the feet, even to light touch like a bedsheet

• Pain when touching or putting pressure on the feet, even during normally painless activities

• Muscle weakness, difficulty moving the foot or ankle, possibly causing foot drop

• Balance problems due to impaired sensation in the feet

• Unusual sensations like feeling as if wearing socks when not

• Skin problems or ulcers from unnoticed injuries, increasing the risk of infection and complications

Causes of Neuritis: An In-Depth Look

There are many causes of Neuritis, with diabetes being the most common. In some cases, the cause may be genetic or due to underlying health conditions that lead to nerve damage. Sometimes, no clear cause can be identified.

Main Causes of Neuritis

The primary causes of Neuritis include:

• Diabetes: The most common cause, especially with elevated blood sugar and lipid levels.

• Nerve Compression: Such as carpal tunnel syndrome and ulnar neuropathy.

• Genetic Causes: Like Charcot-Marie-Tooth disease.

• Autoimmune Diseases: Including lupus and rheumatoid arthritis.

• Injuries: Such as accidents, falls, and fractures.

• Infections: Including HIV, Lyme disease, and herpes.

• Kidney Disease: Due to the accumulation of toxins in the body.

• Certain Medications: Especially cancer treatments (chemotherapy and radiation).

• Toxins: Such as exposure to mercury or lead.

• Malnutrition: Due to deficiencies in vitamins like B12 and thiamine.

• Prolonged ICU Stay: Especially with limited mobility or severe infections.

• Tumors: When pressing on nerves.

• Guillain-Barré Syndrome: An autoimmune disorder that causes nerve weakness and pain.

In some cases, the exact cause of Neuritis remains unknown.

Risk Factors for Developing Neuritis

Several risk factors increase the likelihood of developing neuropathy, including:

• Diabetes (considering duration and age of onset).

• Diabetic retinopathy.

• Family history of the condition.

• Insulin resistance.

• High blood sugar.

• High blood pressure.

• High body mass index (BMI).

• Obesity.

• Physical inactivity.

• Prediabetes.

• Vitamin deficiencies.

• Smoking.

• Alcohol use.

• Repetitive movements.

Diagnosing Neuritis

Early diagnosis of Neuritis is crucial, as it helps prevent worsening of symptoms and permanent nerve damage. Ignoring treatment after a correct diagnosis may lead to increased pain and nerve weakness that may become irreversible.

1. Medical History

The doctor will begin by asking about your symptoms: when they started, their severity, and whether they worsen or improve under certain conditions. They will also inquire about your overall health, current medications or treatments, family medical history, lifestyle, and diet.

2. Physical Examination

Next, a general physical exam will be conducted to assess vital signs and review your health history. This is followed by a specialized neurological exam to evaluate sensation, movement, and reflexes. It may include a pinprick test to assess sensory nerve response, especially in the feet and ankles.

3. Diagnostic Tests

• To uncover underlying causes, your doctor may order blood tests to check for immune disorders, vitamin deficiencies, toxins, or conditions like diabetes.

• In some cases, imaging tests such as MRI or ultrasound may be done to detect nerve damage, inflammation, tumors, or injuries.

• Electrodiagnostic tests like electromyography (EMG) and nerve conduction studies may be used to evaluate how well nerves are functioning.

• If a clear diagnosis isn’t reached, genetic testing may be recommended to identify hereditary causes.

• In certain situations, a skin biopsy may be performed to analyze the density of small nerve fibers and assess the extent of peripheral nerve involvement.

Treatment of Neuritis: Diverse Options to Improve Quality of Life

The treatment of Neuritis primarily depends on addressing the underlying cause. Managing the root condition can help reduce symptoms and promote the recovery of damaged nerves. Doctors may also recommend additional treatments such as medications to relieve pain or muscle weakness. Some medications have antidepressant or anticonvulsant properties, and topical pain relievers may benefit certain patients.

Various Methods for Treating Neuritis

1. Lifestyle Modifications

Reducing sugar, gluten, and refined carbohydrates, and following a low-fat plant-based diet may help alleviate symptoms.

2. Regular Exercise

Exercise helps regulate blood sugar and improve circulation, which can protect peripheral nerves from damage. However, it is advised to consult a doctor before starting any exercise program.

3. Medications

Common drugs include amitriptyline, duloxetine, pregabalin, and gabapentin—also used for depression, anxiety, and epilepsy. High doses may cause side effects. Topical creams, anticonvulsants, and antidepressants may also be prescribed.

4. Plasma Exchange (Plasmapheresis)

This procedure removes inflammatory substances from the blood and replaces them with clean plasma. It is used in autoimmune diseases like Guillain-Barré syndrome to treat nerve damage in the limbs.

5. Transcutaneous Electrical Nerve Stimulation (TENS)

TENS reduces pain by sending mild electrical pulses to affected nerves.

6. Surgery

Indicated for conditions such as carpal tunnel syndrome or nerve compression. Peripheral nerve surgery may be considered when other treatments fail.

Rehabilitation

Rehabilitation includes physical and occupational therapy to help patients regain the ability to perform daily tasks. In rehab programs, the healthcare team works with the patient to:

• Develop a personalized plan to maintain or improve function.

• Recommend assistive devices (e.g., crutches, walkers, wheelchairs, braces) and adapt the home environment to enhance mobility.

• Provide guidance on modifying activities and conserving energy.

• Suggest exercises to strengthen the legs and feet, such as recumbent cycling or knee-strengthening tools.

What Is the Treatment for Peripheral Neuritis?

Treatment depends on the underlying cause and may include:

• Pain Relief and Improving Quality of Life:

Various therapies may help relieve pain and enhance the ability to perform daily activities. Combining multiple treatments may be most effective.

• Over-the-Counter Painkillers:

• Acetaminophen (Tylenol).

• Anti-inflammatories like aspirin and ibuprofen.

Caution: Long-term use can affect the liver or stomach.

• Over-the-Counter Topical Medications:

• Absorbine Jr.: Contains menthol and herbal components to relieve muscle pain.

• Capsaicin Cream: Contains hot pepper extract that helps reduce pain.

• Neuragen PN: A plant-based cream specifically for nerve pain in hands and feet.

• Sore No More: A herbal anesthetic that may ease nerve discomfort.

• Prescription Medications:

• Lidocaine patches.

• Pregabalin (used for epilepsy).

• Duloxetine (an antidepressant).

• Steroids.

• Opioids (used cautiously).

• For nerve damage-related erectile dysfunction, a doctor may prescribe:

• Sildenafil.

• Vardenafil.

• Tadalafil.

• Avanafil.

• Other Medical Treatments:

• Plasmapheresis: Removes irritating antibodies from the blood (used for autoimmune conditions like Guillain-Barré).

• Local Nerve Blocks: Injecting an anesthetic directly into the nerve to relieve pain.

• TENS Therapy.

• Splints and Braces:

Used to support weak muscles and stabilize joints, which reduces pain and improves balance. For example, a wrist splint may relieve carpal tunnel symptoms during sleep.

Neuritis Treatment Options for the Feet

• Medications: To relieve pain—these may include antidepressants, anticonvulsants, and analgesics.

• Physical and Occupational Therapy: Aims to improve strength, balance, and reduce pain.

• Assistive Devices: Like braces or crutches to aid mobility.

• Complementary Therapies: Such as acupuncture and massage, which may help some people manage symptoms.

• Managing Underlying Conditions: For example, controlling blood sugar levels in diabetes.

Importance of Consulting a Doctor to Determine the Right Treatment Plan

Seeing a doctor is crucial at the onset of Neuritis symptoms, as early intervention may prevent permanent nerve damage or even reverse it. Ongoing communication with a specialist allows for symptom monitoring and evaluating treatment effectiveness, as well as adjusting the plan if side effects or life changes occur.

Medical follow-up is vital for preventing complications, especially when sensation is lost in the feet, increasing the risk of foot ulcers, skin infections, and bone or joint issues. It also helps avoid balance problems and falls. Serious complications can also arise if nerves controlling vital functions—such as breathing, blood pressure, and heart rate—are affected, making a precise treatment plan and regular medical monitoring essential.