Dr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.
This condition is an umbrella term used to describe a number of diseases characterized by inflammation of peripheral nerves. Neuritis, or peripheral neuropathy, causes pain, weakness, numbness, sensation changes, paralysis, disability and muscle atrophy. To better understand, peripheral nerves are nerves that are outside of the brain and spinal cord (central nervous system). Yet, they are responsible for carrying sensory information and motor signals to the central nervous system and muscle groups. Thus, when these nerves are affected by inflammation, they break down, and individuals experience disturbances in sensation and muscle function.
With the identification of many types of neuritis, peripheral and optic neuritis remain the most common. Even so, other varieties are listed below:
- Brachial neuritis
- Polyneuritis multiplex
- Intercostal neuritis
- Ulnar neuritis
- Lumbosacral neuritis
- Occipital neuritis
- Vestibular neuritis
- Cranial neuritis
- Arsenic neuritis
- Sensory motor polyneuropathy
- Granulomatous neuritis of leprosy
Causes of Neuritis
There is some degree of uncertainty regarding the exact causes of neuritis. Yet, research suggests that women ages 55 and older are at a greater risk for developing neuritis. This is especially true if they suffer from impaired blood flow to the nerves or experience vitamin and nutrient deficiencies. Even so, the following represent possible causes for neuritis:
While compression of a nerve or an invasive nerve injury can lead to inflammation and the development of neuritis, a common nerve injury is carpal tunnel syndrome. With this syndrome, pain and numbness are experienced in the thumb or index finger. Similarly, women that wear high-heel shoes may notice pain and numbness in their toes as a result of a compression-type nerve injury. Yet, chemical injury to a nerve from injections or metallic poisoning (arsenic) may occur as adjacent nerves become damaged. In this case, neuritis develops as a side effect of a chemical injury. In turn, radiation from certain cancers may contribute to brachial neuritis, which is a form of neuritis and a common complication of radiation.
Vitamin B Deficiencies
Notably, deficiencies such as thiamine (vitamin B1), riboflavin (vitamin B2), pyridoxine (vitamin B6) and cyanocobalamin (vitamin B12) are connected to peripheral neuritis.
The following infections may result in neuritis:
- Lyme disease
- Cat scratch disease
- Herpes Simplex
Related Diseases and Conditions
A number of preexisting diseases and/or conditions are believed to predispose individuals to neuritis. Some include:
- Autoimmune diseases (associated with optic neuritis)
With multiple connections across many body systems, neuritis is a broad-based inflammatory condition that is often difficult to pinpoint. Yet, symptoms may include stabbing pain, muscle weakness and burning or tingling sensation as nerve function is inhibited. In cases of optic neuritis, individuals may experience some visual changes such as blurred vision, loss of color vision, sensitivity to light and eye pain.
Treatment and Rehabilitation of Neuritis
While neuritis and conditions of the peripheral nerves are ongoing, treatment is designed to actively manage symptoms. Physiatrists are best positioned to lead and direct treatment and rehabilitation for peripheral neuropathic conditions, as they are trained and educated across multiple disciplines. As a result, they give specialized attention to the whole body—not one symptom or area.
Initial treatment of neuritis may consist of over the counter or prescription pain relievers, non-steroidal anti-inflammatory medication, anti-seizure medication or topical patches to relieve pain. Also effective in treating pain, particularly in cases where diabetes is a suspected cause of neuritis, are SSRI’s, or serotonin and norepinephrine reuptake inhibitors. Antidepressants are believed to relieve pain by changing chemical processes in the brain and spinal cord that cause individuals to sense pain.
When pain becomes managed, rehabilitation and therapy are selectively combined to ease the symptoms associated with neuritis. Some include a TENS machine, which emits low-level electrical currents at different frequencies to areas of pain. In some instances, plasma exchanges are performed that suppress immune system responses. This involves taking antibodies out of the blood and replacing them with proteins that act as antibodies. Also effective is the use of acupuncture, which improves body functions and promotes natural healing and pain relief.
Physical therapy for neuritis and/or peripheral neuropathy are geared toward strengthening muscles, which proves to naturally reduce pain and help control blood sugar levels. Specifically, aerobic exercises, flexibility training, strength training and balance conditioning prove effective at minimizing symptomatic pain.
At the Howard Liss, M.D. Rehabilitation Institute in Tenafly, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their functioning.
Contact our office today to schedule your consultation with Dr. Liss.