Why does polyneuropathy CAUSE PAIN?
FEWER SIGNALS AND STILL PAIN? WHY DOES POLYNEUROPATHY HURT?
Polyneuropathy causes damage to the nerves, which leads to fewer signals from the periphery (mostly hands and feet) reaching the brain.
The fact that this causes pain is somewhat confusing as, logically, fewer signals should simply mean less sensation and not more pain.
In addition, it is quite common that polyneuropathy does not actually cause pain, but simply leads to a lack of awareness of the toes, feet and fingertips. Why do people with the same condition experience completely opposite symptoms?
In this article, I therefore explore the question: "Why does polyneuropathy cause pain?"
THE FEELING ORIGINATES IN THE BRAIN
In order to feel a touch in the tips of the toes, this pressure in the toes must be perceived by a nerve. It reports its perception by sending a signal to the brain.
In the brain there is an area for each nerve and each part of the body that receives and interprets the signals. It is this interpretation that creates the feeling we experience as touch. This interpretation also determines exactly how a touch feels.
Whether you feel a touch as a light caress or strong pressure, as a tickle or a scratch, depends on how the signals from the nerves are interpreted in the brain.
Pain originates in the brain, not in the feet!
POLYNEUROPATHY AFFECTS THE BRAIN!
When a nerve is damaged by polyneuropathy, it sends misleading signals to the brain.
This means that if, for example, a light touch was previously reported, this signal is now disturbed and changed by the nerve damage. What still arrives in the brain can no longer be clearly interpreted as before because the data transmission is disturbed along the way.
It is similar to what happens when there is interference with mobile or radio reception: The receiver no longer understands the signal and instead of a clear sound, only crackles and static noise arrive.
HYPERSENSITIVE AREAS OF THE BRAIN CAUSE PAIN
The nervous system reacts by making the receiver more sensitive. The areas of the brain that receive and interpret the signals from the damaged nerve become more sensitive in the literal sense. They develop a higher basic activity as more nerve cells grow there and the reaction to the nerve signals is intensified.
This has the unpleasant consequence that normal everyday stimuli are felt in excess and trigger pain. This is why even rough socks or light touches can sometimes hurt.
If you have pain as soon as your feet touch the floor or even the bedspread on your feet triggers painful pressure, this is therefore not only due to problems in the feet, but instead in the brain.
The same applies if you have heat sensations, tingling or other sensations:
Polyneuropathy also causes problems in the brain, not just in the hands or feet!
If you want to read more on the subject, here is a scientific study that describes the interconnections: Domingues et al. 2018
Those who train the brain have less pain
IF YOU TRAIN YOUR BRAIN, YOU WILL IMPROVE YOUR POLYNEUROPATHY!
This is the reason why treating the feet or hands is of little use. You can achieve some degree relief by using foot baths and creams or other wellness treatments. However this only helps in the short term; the pain will still come back.
A better way to manage the discomfort is to train the brain to reduce hypersensitivity. Balance Training is an excellent way to do this. This means nothing other than training your balance.
In order to keep your balance safely, you have to be constantly aware of your body and feel it precisely. You also have to react appropriately to sensations such as pressure on the soles of your feet. This improves your body's perception and makes the brain's processes more efficient.
Maintaining balance is one of the most complicated tasks we manage in everyday life - even if we are often unaware of it. It is necessary to perceive, evaluate and react appropriately to all parts of the body which involves their position in relation to each other and the tension of the muscles with the utmost accuracy.
This means that in order to maintain one's balance, signals from the body must be constantly received, transmitted and interpreted.
By doing so, this then leads to less pain.
87% of patients report less pain and discomfort after training
According to Streckmann et al. 2014
TRAINING COMPENSATES FOR THE NERVE DAMAGE
In a study at the University of Freiburg, balance training was tried out with people suffering from polyneuropathy (see the study here Streckmann et al. 2014).
As expected, the training improved the patients' balance. 87.5% of the patients reported fewer symptoms of polyneuropathy meaning that the pain and discomfort got better!
In the control group which did not exercise, however, not a single patient reported an improvement in symptoms at the same time.
Moreover, the researchers measured whether the nerves in the patients' legs had recovered. For this purpose, the nerve conduction velocity was measured, by which neurologists can recognise how severely a nerve is damaged. The measurements showed no change due to the training.
This means that the improvement in symptoms did not occur in the damaged nerves in the feet or hands, but in the brain!
THE BRAIN IS THE MOST ADAPTABLE ORGAN!
This is excellent news as it means that the nerve damage that occurs in the feet or hands can be compensated for by exercising the brain.
Unfortunately, there are still hardly any ways to heal the nerves that are damaged in polyneuropathy. Despite this, if you can improve the "data processing" in the brain, you can still reduce the pain!
SURPRISINGLY EASY EXERCISES
If you now think that such training is highly complex and difficult to implement, rest assured.
Training your balance is child's play. You can easily do this kind of training on your own at home - if you know how to.
The most important thing is to choose the right level of difficulty. Of course, someone who walks on a rollator cannot train at the same level as a healthy fit person.
On my page "Exercises for polyneuropathy" you will find numerous exercises at different levels of difficulty to try out. You will also find all the background information you need to get started right away.
You can also order a small booklet with loads more information with examples of exercise routines for all difficulty levels so that you can continuously improve as you get fitter.
Muscle pain and nerve pain intensify each other
THE PAIN IN POLYNEUROPATHY OFTEN COMES FROM THE MUSCLES!
Often the pain is not only triggered by the nerves - even if you suffer from polyneuropathy. This is because the pain caused by nerve damage is very often accompanied by pain from the muscles. Muscles that are cramped can cause incredible pain.
Most people have experienced this first hand. What not everyone knows is that in some cases the damage from muscle cramps cannot be reversed and can cause permanent pain. Unfortunately this happens without you even noticing that the muscle is cramping.
This is because they are tiny cramps, often as small as the head of a pin. Nevertheless, they can cause enormous pain in whole parts of the body. This is medically called myofascial pain syndrome and is one of the most common causes of pain.
PAIN RADIATING FROM THE MUSCLES
This problem arises particularly often when the interaction between muscles and nerves no longer functions properly and the muscles are overwhelmed. This is particularly common with polyneuropathy. Consequently, one reason why polyneuropathy hurts is that the nerve damage causes problems in the muscles.
The nervous system is not able to assign the pain to the right area. The pain is then felt in a different place than where the actual problem is located and so a radiating pain develops.
This happens particularly often with muscles in the lower leg. The pain triggered there is then often felt in the feet. For example, problems in the long toe flexor (flexor digitorum muscle) often cause pain in the toes, although the muscle itself is located in the calf.
NERVE AND MUSCLE PAIN ARE INDISTINGUISHABLE
Unfortunately, it is practically impossible to distinguish whether the pain you feel is caused by nerve damage or muscle problems. This is because your nervous system only tells you that pain is there, not which structure is emitting it. However, my personal experience is that almost all patients with polyneuropathy have an additional muscle problem.
This is actually good news. After all, we know how to improve the function of the muscles - through training. So if the nerves cannot be cured, at least the muscles can be improved.
MUSCLES ARE USUALLY IGNORED IN POLYNEUROPATHY
Unfortunately, few people think about the fact that one could also work on the muscles if one suffers from polyneuropathy. After all, polyneuropathy is a nerve disease and the connection with the muscles is only apparent at second glance.
Therefore, as a patient, it is very rarely pointed out that treating the muscles can help with the pain, even though it does not cure the polyneuropathy.
LEARN TO HELP YOURSELF!
The muscle problem cannot be solved with medication or a few hand movements by a professional. It is possible to treat the muscles with training, stretching and massage, but due to the nerve damage in polyneuropathy, the treatment is much more elaborate and difficult than in other patients.
Therefore, it is very difficult for therapists to make real progress. Especially because time is lacking and therapy sessions are too short. The best solution is therefore to learn what you can do for yourself and help yourself.