The Relationship Between Diabetic
Neuropathy And Nerve Compression
If you are diabetic you may already be familiar with many of the complications that come with this condition. Among the most common complications of diabetes is neuropathy. Although the symptoms of diabetic neuropathy are very similar to those of regular nerve compression, diabetic neuropathy arises from the nerve's response to abnormally high glucose levels.
Unfortunately, even when good blood sugar levels are
maintained, there is a 50% chance that neuropathy will occur.
Regular nerve compression, in contrast, usually involves one nerve in the arm or the leg, resulting in just a particular region in the arm or leg having symptoms of numbness. This difference in the pattern of numbness is the main reason why doctors have not previously associated symptoms of diabetic neuropathy with those of nerve compression.
A second difference between diabetic neuropathy and nerve compression is the fact that the Diabetic nerve is compressed due to a metabolic process, making the nerve itself inflammed, and not just due to many anatomically tight regions that are present in many people. So in diabetics, the nerve compression is superimposed upon the underlying progressive neuropathy. And when the neuropathy and nerve compression exist together, the symptoms of numbness, tingling and weakness exist due to the nerves being compressed.
Why are Diabetics Prone to Nerve Compression?
1. Metabolic neuropathy: Diabetic nerve compression is
primarily a result of metabolic imbalances in the nerve, and the tightness of
the surrounding anatomy produces symptoms secondary to the original neuropathy.
Consequently, one of the main reason's why a diabetic's nerves are susceptible
to compression is because the nerves in a diabetic are swollen.
2. Transport Mechanisms: The second reason for swelling is related to the transport systems within the diabetic nerve. The nerve is filled with a substance that allows important chemical messengers to move along it, enabling the one end of the nerve to know what is happening at the other end.
If the nerve becomes damaged, by compression, for example, its cell membranes need to be rebuilt. The building proteins are transported inside the nerve along tracks called tubulin. This mechanism, called the "slow anterograde component of axoplasmic transport" does not function normally in Diabetics. This means that the nerve is unable to repair itself properly, rendering it more likely to remain in trouble from compression.
What Benefits does Surgery have?
The surgery to decompress the nerve does not change the basic underlying metabolic (diabetic) neuropathy that makes the nerve susceptible to compression in the first place. When the surgical decompression is done early in the course of nerve compression, restoration of blood flow to the nerve will stop the numbness and tingling, and allow the nerve to recover. When decompression is done later in the course of nerve compression, and there have been extended periods of symptoms, then nerve fibers have begun to die; decompression will facilitate regrowth of the diabetic
While it is not fully understood as to how to prevent neuropathy from occurring, there are methods available to slow the natural course or history of diabetic neuropathy. This is done by removing the compression, or tight areas along the course of the nerve that are causing the symptoms of numbness and tingling you may feel in your hands and feet.
A. Lee Dellon, M.D. is the founder of The Dellon Institutes for Peripheral Nerve Surgery®. He is an accomplished Plastic Surgeon as well as a Professor of Plastic Surgery and Neurosurgery at the prestigious Johns Hopkins University School of Medicine, at the University of Maryland in Baltimore, Maryland and at the University of Arizona, Tucson, Arizona.
He specializes in the treatment of diabetic neuropathy as well as other painful peripheral nerve disorders and has trained many surgeons worldwide in the procedures he has developed to relieve pain.
Dr. Dellon completed his BS at John Hopkins University and received hi Medical Degree from Johns Hopkins University School of Medicine in 1970. He Completed General Surgery, Plastic Surgery and Hand Surgery Residencies at Columbia Presbyterian Hospital, John Hopkins Hospital and Union Memorial Hospital respectively. He has been in practice since 1978 and has been on the faculty of Johns Hopkins since that time.
Source: Diabetes In Control.com.