Alcoholic Neuropathy

Alcoholic Neuropathy & Treatment, Symptoms of Alcoholic Neuropathy, Causes, Exams & Tests


Alcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.  The exact number of people affected by this disease is unknown, but studies have shown that up to 66% of patients with chronic alcohol use disorder may have the condition.  [1]

The cause is multifactorial, from both nutritional deficiencies and alcohol metabolism’s direct toxic impacts on neurons.  Because of the various influences of alcohol on the body, these patients should be managed by an interprofessional team.  In addition, the treatment rests on abstaining from alcohol and the replacement of essential nutrients.

Alcoholic Neuropathy
Alcoholic Neuropathy treatment should focus on how to stop alcohol abuse.

As of now, the management of alcoholic neuropathy is not satisfactory.  Unfortunately, patient compliance is also poor resulting in relapse, and the condition often progresses, leading to poor quality of life.  To clarify, even in patients who quit alcohol, residual neuropathy is still common.

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Symptoms of Alcoholic Neuropathy

Alcoholic neuropathy can affect both movement and sensation.  In addition, symptoms vary from slight discomfort to disability.  Although the condition is not life-threatening, it can lower your quality of life.  Furthermore, some areas of the body affected by alcoholic neuropathy include:

Arms and Legs

  • Numbness
  • Tingling and Burning
  • Prickly Sensations
  • Muscle Spasms and Cramps
  • Muscle Weakness and Atrophy
  • Loss of Muscle Functioning
  • Movement Disorders

Changes in muscle strength or sensation usually occur on both sides of the body and are more common in the legs than in the arms.  And then, symptoms typically develop gradually and become worse over time.

Urinary and Bowel

  • Incontinence
  • Constipation
  • Diarrhea
  • Problems starting urination
  • Feeling that the bladder hasn’t been emptied fully

Other

  • sexual Dysfunction
  • Impotence
  • Impaired Speech
  • Difficulty Swallowing
  • Heat Intolerance, particularly following exercise
  • Vomiting and Nausea
  • Dizziness or Lightheadedness

On the other hand, early diagnosis and treatment make it more feasible that you will be able to recover.  Call your doctor if you are experiencing neuropathy symptoms.

Causes of Alcoholic Neuropathy

Your peripheral nerves help your body manage essential sensory and motor functions, including:

  • Bowel and Urinary Elimination
  • Walking
  • Sexual Arousal
  • Arm and Leg Movement
  • Speech

Alcoholic neuropathy is the result of injury to these nerves.  The damage may be the direct result of long periods where you drank too much alcohol.  In addition, nutritional problems linked to alcohol use, such as vitamin deficiency, can also cause nerve damage.

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Exams and Tests

The health care provider will perform a physical exam and ask about your symptoms.  Consequently, an eye exam may also show eye problems.  [2]

Moreover, excessive alcohol use usually makes the body unable to use or store specific vitamins and minerals.  Given that, blood tests will be required to check for a deficiency (lack) of:

  • Thiamine (vitamin B1)
  • Pyridoxine (vitamin B6)
  • Pantothenic Acid and Biotin
  • Vitamin B12
  • Folic Acid
  • Niacin (vitamin B3)
  • Vitamin A

Other Tests May be Ordered to Rule Out Other Possible Causes of Neuropathy.  These tests may include:

  • Electrolyte Levels
  • Electromyography (EMG):  To check the health of the muscles and the nerves that control the muscles
  • Liver and kidney function tests
  • Thyroid function tests
  • Levels of vitamins and minerals in the body
  • Nerve conduction Tests:  To check how fast electrical signals move through a nerve
  • Nerve Biopsy:  To remove a small piece of a nerve for examination
  • Upper G.I. and small bowel series
  • Esophagogastroduodenoscopy (EGD):  To examine the lining of the esophagus, stomach, and first part of the small intestine
  • Voiding Cystourethrogram:  An x-ray study of the bladder and urethra

Treatment for Alcoholic Neuropathy

The most crucial thing you can do to treat this condition is to stop drinking.  Firstly, Treatment may focus on problems with alcoholism.  And, for some people, this may demand inpatient rehab. 

Once alcohol use has been addressed, your doctor can focus on the neuropathy itself because symptom management is essential.  Nerve damage can also make it hard for you to carry out the functions of daily life.  Moreover, nerve damage may even make injuries more apparent.

Treatment should be personalized because every person’s necessities are different.  Thus, treatment for neuropathy may involve one or many kinds of care.  These include:

  • Vitamin Supplements:  To improve nerve health (folate, thiamine, niacin, and vitamins B6, B12, and E)
  • Prescription Pain Relievers:  Tricyclic Antidepressants and Anticonvulsants
  • Medication for people with problems urinating
  • Physical Therapy to help with muscle atrophy
  • Orthopedic Appliances to stabilize extremities
  • Safety Gear, such as Stabilizing Footwear, to prevent injuries
  • Special Stockings for your legs to avoid dizziness

Treatment Goals

Treatment should be centered on therapy to stop alcohol abuse.  In fact, for several months up to a few years, abstinence has shown clinical examination and electroneurographic improvements, with most patients showing complete recovery of function.

Additional treatment includes replacing nutrients such as thiamine, vitamin-B12, and folic acid.  Furthermore, psychiatry referrals, alcohol abstinence abuse programs, and support groups have shown good ways to help clients recover from alcohol use disorder.  And then, physical therapy and occupational therapy can support the client as they regain movement and perform everyday functions.  [3]

Once the Alcohol Problem has been Addressed, Treatment Goals include:

  • Maximizing ability to function independently
  • Preventing injury
  • It is essential to supplement the diet with vitamins, including thiamine and folic acid
  • Physical therapy and orthopedic appliances (such as splints) may be needed to maintain muscle function and limb position
  • Medicines may be required to treat pain or uncomfortable sensations

Basically, people with alcoholic neuropathy have alcohol use problems.  Therefore, they will be prescribed the smallest dose of medication necessary to reduce withdrawal symptoms.  This may help prevent drug dependence and other side effects of chronic use because the client has a history of substance abuse such as alcoholism.

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Additional Relief for Body with Alcoholic Neuropathy

Alcoholic Neuropathy
To avoid Alcoholic Neuropathy, seek help with alcoholism now.

The positioning or using a bed frame that keeps the covers off the legs may help lessen pain.

Because when standing up (orthostatic hypotension), people with lightheadedness or dizziness may demand to try various treatments before finding one that successfully reduces their symptoms.  Treatments that may help include:

  • Wearing Compression Stockings
  • Eating Extra Salt
  • Sleeping with the head elevated
  • Using Medicines

Bladder Problems may be treated with:

  • Manual Expression of Urine
  • Intermittent Catheterization (male or female)
  • Medicines

Impotence, diarrhea, constipation, or other symptoms are treated when necessary.  Unfortunately, these symptoms often respond poorly to treatment in people with alcoholic neuropathy.

It is Essential to Protect Body Parts with diminished sensation from injury.  This may include:

  • Checking the temperature of bathwater to prevent burns
  • Changing footwear
  • Regularly inspecting the feet and shoes to minimize damage caused by pressure or objects in the shoes
  • Guarding the extremities to prevent damage from pressure

To emphasize, alcohol must be stopped to prevent the damage from getting worse.  Alcoholism treatment may also include counseling, social support such as Alcoholics Anonymous (A.A.), or medicines.  Above all, these are all available in an inpatient program.

Preventing Alcoholic Neuropathy

You can Avoid Alcoholic Neuropathy by:

  • Avoiding excessive drinking of alcohol
  • Not drinking alcohol if you have symptoms of alcoholic neuropathy
  • Seeking help if you are having difficulty avoiding alcohol
  • Eating a healthy and balanced diet
  • Taking vitamin supplements if you have deficiencies (always speak to your doctor before taking supplements)

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Sources:

 [1-2] Alcoholic neuropathy – U.S. National Library of Medicine
[3] Alcoholic Neuropathy – StatPearls Publishing LLC. National Center for Biotechnology Information, U.S. National Library of Medicine