Reviewed by Varnada Karriem-Norwood on June 15, 2012


Gregory Esper, MD, Director of General Neurology, Assistant Professor of Neurology, Emory University School of Medicine. National Institutes of Health.

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Video Transcript

Narrator: It's believed that over 20 million Americans suffer from some form of damage to their nerves, or neuropathy. For the afflicted, pain, tingling or numbness often begins in the hands or feet.

Gregory Esper, MD, MBA: I would say that a person should be concerned if a certain type of numbness, tingling or pain is not going away, certainly after 24 to 48 hours.

Narrator: Though it is the nerves which ultimately sense pain—it must first be determined whether the cause of the agony is actually originating in the nerves themselves…

Gregory Esper, MD, MBA: We can determine pretty well: is the pain from nerves? Is the pain coming from a joint, like knee pain? Is the pain coming from the muscles? Is the pain coming from the brain or the spinal cord? A very important question.

Narrator: Neurologists, like Emory's Gregory Esper make that determination first by studying a patient's medical history, and then by conducting a thorough physical exam

Gregory Esper, MD, MBA: In neurology we localize the pain first and then we try to identify what is the cause of that pain.

: Just Relax

Narrator: State-of-the-art tests like Electro Myography, nerve conduction studies and nerve or skin biopsies may corroborate or refute a doctor's initial suspicions that the pain is in fact caused by damaged nerve cells.

: Deep breathes in and out—relax

Narrator: However, care must be taken to ensure a proper reading; In inexperienced or inept hands, such data has sometimes led to misdiagnosis.

Gregory Esper, MD, MBA: We have to make sure that a very technical test is done appropriately and well because the diagnosis and treatment depends on it.

Narrator: Alleviating the hurt is often the first step in healing: A battery of therapies is available to treat pain including, physical therapy, bio-feedback and acupuncture. And medicines from over-the-counter topicals to prescription drugs have been used to help with nerve pain once it's diagnosed—but…

Gregory Esper, MD, MBA: Ultimately when you have a cause that's identified, you want to treat the cause not just treat the symptoms with medication.

Narrator: There can be any number of causes of neuropathy from trauma to chronic illnesses. But oftentimes adopting healthier habits can directly impact the root cause of nerve pain. In fact, common triggers of nerve pain like uncontrolled diabetes, vitamin deficiencies and alcoholism can all be improved to some degree with lifestyle changes. When severe nerve pain gets in the way of healthy behavior, however, aggressive therapy is the rule.

Gregory Esper, MD, MBA: It often is required of the physician to recognize it and treat the pain so that the person can become more active and live the lifestyle that is going to make them better in the long run.

Narrator: For WebMD, I'm Damon Meharg.