Medical News Today: Understanding and treating alcoholic neuropathy

Alcoholic neuropathy is a severe condition caused by excessive alcohol use. Damage to the nerves leads to unusual sensations in the limbs, reduced mobility, and loss of some bodily functions. Recognizing the symptoms and seeking treatment early can reduce the risk of permanent disability.

In this article, we look at what alcoholic neuropathy is, what causes it, and how it may feel. We also explore how the condition is diagnosed and treated.

What is alcoholic neuropathy?

man passed out at the bar
The peripheral nerves can be damaged by drinking excessive amounts of alcohol.

A person who drinks alcohol in excess may start to feel a tingling sensation in their limbs. This happens when alcohol has damaged the peripheral nerves.

These nerves connect the brain and spinal cord to the muscles, limbs, and sensory organs. Through the peripheral nerves, the brain is able to control the body and receive sensory information.

When alcohol is responsible for damage to the peripheral nerves, a person has alcoholic neuropathy. People who drink heavily on a regular basis are at risk of developing this condition.

Some researchers estimate that 65 percent of people in the United States who have been diagnosed with alcohol use disorder also have alcoholic neuropathy.


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How does alcohol cause neuropathy?

Excessive, long-term consumption of alcohol can lead to malnutrition as well as nerve damage, and both contribute to the development of alcoholic neuropathy.

Alcohol can impede the processing, transportation, and absorption of essential nutrients. Some people with alcohol use disorder also have inadequate food intake. This can lead to deficiencies in:

Deficiencies in these nutrients can harm overall health and stop nerves from functioning correctly.

Symptoms

Alcoholic neuropathy shows itself in different ways. Some may experience only one symptom, while others experience several.

People who drink heavily on a regular basis and have one or more of the following symptoms should contact a doctor.

Below are symptoms of alcoholic neuropathy, organized by the parts of the body most affected:

Limbs

  • cramps
  • loss of movement
  • muscle atrophy
  • muscle spasms or contractions
  • muscle weakness
  • numbness
  • loss of sensation
  • pins and needles
  • tingling or prickling

Bowel and urinary system

Other areas of the body

  • difficulty swallowing
  • abdominal bloating
  • dizziness or fainting
  • impaired speech
  • infertility, in men
  • sexual dysfunction, including problems with erections or lubrication
  • temperature sensitivity, to hot or cold
  • vomiting or nausea


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Diagnosis

man having upper endoscopy examination
An esophagogastroduodenoscopy examination may be perfomed to help diagnose alcoholic neuropathy.

When speaking with a doctor, it is important to be honest about alcohol consumption. There are several possible causes of neuropathy, and knowing about a person’s alcohol intake can help the doctor to make an accurate diagnosis.

Several tests can be used to diagnose alcoholic neuropathy, and more than one may be necessary. They include:

  • Blood chemistry test. This can give an indication of a person’s overall health, including blood sugar levels and liver and kidney function.
  • Complete blood count (CBC). There are several types of blood cells, as well as platelets, which help with clotting. The CBC can show how well the immune system is working and how much oxygen is traveling throughout the body.
  • Esophagogastroduodenoscopy. A thin tube with a camera is passed down the throat and used to check for causes of nausea and vomiting.
  • Electromyography. Needles are inserted into areas of the skin and muscles to measure electrical activity. This can reveal signs of alcoholic neuropathy.
  • Nerve biopsy. A doctor will remove a small sample of a person’s nerve tissue, which is tested for damage. People usually undergo this procedure with a local anesthetic.
  • Nerve conduction test. This involves placing electrodes on the skin, which are used to measure the speed and strength of a person’s nerve signals.
  • Neurological examination. A doctor will conduct a physical examination to test a person’s reflexes, muscle strength, coordination, and sensory function.
  • Upper gastrointestinal and small bowel series. This set of X-rays is used to examine the functioning of the digestive tract.

A doctor may also want to test the functioning of the kidneys, liver, and thyroid. In addition, they may order blood tests to check for vitamin and nutrient deficiencies.

Treatment

tramadol capsules
Over-the-counter and prescribed medications can help to relieve pain associated with alcoholic neuropathy.

The best thing a person with alcoholic neuropathy can do is to stop or significantly reduce their alcohol intake. It will likely be the first thing a doctor suggests. Some doctors may insist on it before testing or treatment continues.

An inpatient detox may be suggested when a person’s alcohol use disorder is very severe. Others may opt for an outpatient rehab.

Community-based support is also available from organizations such as Alcoholics Anonymous and Self-Management and Recovery Training. A doctor may also recommend other options.

Alcoholic neuropathy can make daily life difficult, so it is essential to begin by managing the symptoms. Individuals have different needs, and a treatment plan may involve one or more of the following:

  • Vitamin supplements, involving vitamins E, B6, and B12, among others
  • Over-the-counter pain relief, for minor discomfort associated with alcoholic neuropathy
  • Prescription pain relief, such as capsaicin cream, tramadol, anticonvulsants, and gabapentin
  • Medicines for urinary problems, including duloxetine, imipramine, tolterodine, and solifenacin
  • Physical therapy, because gentle exercises and activities can help with muscle and balance problems
  • Orthopedic appliances to aid with mobility, including pull bars in the bathroom, stair lifts, and orthotic devices, such as raised heels in shoes
  • Other safety measures, including practical advice for people who experience a loss of sensation

If a person can benefit from exercise, a doctor can likely recommend a physiotherapist who specializes in neuropathy.

When significantly limiting or cutting off alcohol consumption, receiving ongoing support is essential.


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Outlook

Alcoholic neuropathy is a severe condition that can lead to chronic pain, loss of some bodily functions, and permanent disability. However, recognizing the symptoms and seeking medical attention early can minimize the impact of the condition.

A person can improve their outlook by significantly reducing or cutting off their alcohol intake and ensuring that they are receiving the right balance of nutrients. A wide range of support networks and medical treatments are available.

Individuals with alcoholic neuropathy often make a partial or full recovery, depending on the extent and duration of their alcohol consumption.

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