(WGHP) — Burning, tingling and numbness in your extremities is a painful thing.

That’s a reality for people suffering from various types of neuropathy.

Dr. Jim Caress, professor of neurology at Atrium Health Wake Forest Baptist, discusses neuropathy and what people living with it can do.

What is neuropathy?

Neuropathy just means sickness or damage to nerves. When people use this word, they usually mean milder classic forms of neuropathy, but there are severe forms also called Guillain-Barre Syndrome.

For most people with typical neuropathy, it affects the sensory nerves to the feet most prominently resulting in numbness, tingling, and burning of the feet. More severely affected patients may be weak in their feet as well. Rarely, neuropathy can involve the upper extremities.

How do I know it’s neuropathy and not something else?

Sometimes pinched nerves in the lower back can mimic neuropathy but there is usually associated back pain and the symptoms are brought out by movement whereas neuropathy is often worst when the patient is relaxing or trying to go to sleep.

Carpal tunnel syndrome can also mimic neuropathy with numbness and tingling of the hands and nerve conduction testing can distinguish between these two things.

What can cause this condition?

The most common cause is diabetes and pre-diabetic conditions. Severe vitamin deficiencies and heavy alcohol use can also cause this. More rarely, the condition can be hereditary.

In patients over the age of 50, neuropathy can be an early symptom of multiple myeloma (a form of bone cancer) so we recommend screening for this in patients over 50 who do not have other obvious risk factors. Most forms of neuropathy are lifelong and without treatment are progressive. The progression of diabetic neuropathy can be controlled by tightly controlling blood sugar.

Is there a danger to leaving neuropathy untreated?

The tingling and burning symptoms can usually be at least partly alleviated with neuropathic pain medicines. The most commonly prescribed are gabapentin, Cymbalta, and Lyrica.

In diabetic neuropathy, if blood sugar is not controlled, patients may develop complete absence of sensation in their feet and develop severe weakness in the lower legs and hands that is disabling. These patients may require a walker but rarely a wheelchair.