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Pain may occur with walking, standing, and back extension. Sitting and bending or leaning forward tend to provide relief. Patients may also report that pain is worse while walking down stairs and improved while walking up stairs or using a bicycle or shopping cart. [1]
Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves; e.g., inflammation (), compression (compression neuropathy), chemotherapy (chemotherapy-induced peripheral neuropathy).
Clinical diagnosis can often identify compression neuropathy on signs and symptoms alone. While there are variations in how nerves course and branch, the anatomical territory of major nerves do not change from patient to patient. Some forms of nerve entrapment can have characteristic symptoms, such as sitting and pudendal pain.
“Small-fibre polyneuropathy can interfere with the ability to feel pain or changes in temperature”. [4] For some individuals, neuropathic pain can be more prominent at night, which makes it harder to sleep and thus rest and recovery in order to rehabilitate nerve damage can be difficult. [4]
Peripheral artery disease and arthritis can also cause leg pain but this usually gets worse with movement. [11] There are less common differential diagnostic conditions included myelopathy, myopathy, vascular or neurogenic claudication, hypotensive akathisia, orthostatic tremor, painful legs, and moving toes. [12]
The causes of nerve damage are grouped into categories including those due to paraneoplastic causes (neuropathy secondary to cancer), immune mediated, infectious, inherited or degenerative causes and those due to toxin exposure. In idiopathic sensory neuronopathy no cause is identified. Idiopathic causes account for about 50% of cases. [2]
A great pair of walking shoes can help eliminate pressure that can affect your whole body—and if you suffer from neuropathy or nerve damage, finding a comfy, supportive pair is especially crucial.
The pain is often described as stabbing or burning, or abnormal skin sensations such as tingling or itchiness. In some individuals, the pain is more severe during times of rest or at night. The signs and symptoms of small fiber neuropathy can occur at any point in life depending on the underlying cause.