Drinking a lot of alcohol over a long period of time causes nerve damage that can lead to the onset of alcoholic neuropathy. Heavy and chronic drinking is also often tied to nutritional deficiencies. Someone who struggles with alcoholism may replace meals with alcohol, take in a lot of empty calories, and not maintain a healthy and balanced diet. Alcohol can also deplete the body of essential nutrients, and thiamine (vitamin B1) deficiency is common in people who battle alcoholism. Malnutrition due to alcoholism can contribute to nerve damage and alcoholic polyneuropathy as well. The US National Library of Medicine (NLM) warns that around 50 percent of long-term heavy drinkers will suffer from alcoholic neuropathy.
The nerves that run outside of the spinal cord and brain are called peripheral nerves. They work to send signals throughout the central nervous system and the rest of the body. Nerves help you to move (motor nerves) and feel physical sensations (sensory nerves). Some of your bodily functions are autonomic, which means that you don’t directly control them. Nerves that are part of the autonomic nervous system help to regulate heart rate, body temperature, respiration, and blood pressure. Polyneuropathy involves damage to more than one nerve at the same time, usually multiple nerves throughout the peripheral nervous system and all over the body.
What Are the Causes of This Type of Nerve Damage?
It is not completely understood what exactly causes alcoholic polyneuropathy; however, the British Journal of Clinical Pharmacology proposes that ethanol (the active chemical in alcohol beverages) has direct toxic effects on nerves that can harm nerve cells with repeated and excessive alcohol consumption. The journal further reports that alcoholic polyneuropathy is likely caused by nutritional deficiencies and the depletion of thiamine that is caused by heavy and long-term drinking. It is most likely that drinking a lot of alcohol over several years causes direct damage to nerve cells and can also contribute to nutritional deficiencies in the body; these may both be factors in the onset of alcoholic polyneuropathy.
Signs and Symptoms
Alcoholic polyneuropathy builds up slowly over time and doesn’t just “hit” a person all at once. Symptoms are likely to start slowly, and with continued drinking, the damage gets worse as do the symptoms. Signs of alcoholic polyneuropathy include:
- Tingling sensation in the arms, legs, hands, and feet
- Numbness of the legs and arms
- Feeling of “pins and needles”
- Burning, stabbing, shooting, or freezing pains
- Difficulties using arms and legs
- Lack of motor coordination
- Falling down often
- Inability to feel pain or recognize temperature changes
- Sensitivity to touch
- Muscle weakness, cramps, spasms, and aches
- Unsteady gait and troubles walking
- Difficulties urinating and leaking urine (incontinence)
- Constipation or diarrhea
- Impotence (problems getting an erection)
- Intolerance to heat
- Nausea and vomiting
- Trouble swallowing, eating, and/or talking
- Digestive issues
- Excessive sweating
- Irregular blood pressure and heart rate
- Breathing problems
- Skin and nail infections
These symptoms usually start small and build up over time, especially with continued alcohol abuse and poor eating habits. Muscle strength and feelings that occur as a result of alcoholic polyneuropathy generally happen on both sides of the body and most commonly affect the legs. Alcoholic neuropathy is then sometimes referred to as “alcohol leg.”
Progressive & Permanent Side Effects
Alcoholic polyneuropathy is progressive and gets worse over time, as the damage to the nerves increases with continued alcohol abuse. The problems that alcoholic neuropathy causes with muscle weakness, balance, and coordination can make a person more at risk for falling down and getting injured. Not being able to tell when things are too hot because of the way the nerve damage interferes with the ability to sense temperature changes can make one more susceptible to burns. In the same manner, numbness and lowered ability to feel pain sensations can make people more apt to cut themselves or otherwise damage the skin. Often, individuals may not even realize that they are burned or cut because they just don’t feel it, which can elevate the risk for infection.
Often, the side effects of alcoholic polyneuropathy are permanent. They get worse with more alcohol consumption, so if you stop drinking and seek professional medical attention, you can manage the symptoms of the disorder and potentially keep the nerve damage from worsening.
Peripheral Neuropathy And Alcohol
Peripheral neuropathy refers to damage or disease of the nerves that carry messages to and from the brain or spinal column and the rest of the body. Peripheral neuropathy can have many causes unrelated to alcohol consumption, and it was previously thought that when it was found in alcoholics it was merely the result of poor nutrition in alcoholics as well as alcohol’s direct impact on nutrients. More recent research, however, suggests that alcohol can directly damage nerves. The evidence points toward alcohol-related peripheral neuropathy being a form of toxic neuropathy, rather than nutritional neuropathy.
Treatment Options for Alcoholic Neuropathy
It is important to stop drinking if you suffer from alcoholic polyneuropathy in order to stop the disease from getting worse and to correct the nutritional imbalance that is damaging the nerves and interfering with the nervous system. A medical detox program followed by a comprehensive alcohol rehab program can manage alcoholism and help a person to get sober and stay that way. Many alcohol rehab programs help to manage co-occurring disorders, such as alcoholic polyneuropathy. A program that caters to co-occurring disorders ensures that the alcoholism is being treated and so are any other medical or mental health issues. Medical, mental health, and substance abuse providers all work together to form and carry out a treatment plan that helps to manage all disorders at the same time.
Medical News Today publishes that medical procedures and therapies, medications, and adjunctive and alternative therapies are commonly used to treat alcoholic polyneuropathy. To diagnose alcoholic neuropathy, medical professionals will generally perform a few tests or exams to determine the severity of the disorder and what can be done to treat and manage the symptoms. Your doctor may perform a neurological exam, take a blood test to check for nutritional deficiencies (such as thiamine), perform an electromyography (EMG) that checks how well the muscles and nerves that control them are working, run a nerve conduction test to see how the electrical signals are moving through the nerves, remove a piece of the nerve for examination through a nerve biopsy, or run a series of lab tests to check on other bodily and nerve functions.
The Center for Peripheral Neuropathy at the University of Chicago publishes that the following are beneficial treatments for alcoholic polyneuropathy:
- Treatment for alcoholism
- Pain medication to address nerve pain and associated discomfort, which will be managed carefully and given in the lowest possible dose to minimize the potential for abuse and addiction
- Physical therapy to improve muscle function and strength as well as to manage pain
- Diet supplements that include vitamins E, B1, folate, and B12
- Considerations to manage loss of sensation and to prevent accidents and injuries
- Use of orthotic appliances like splints to keep arms and legs in proper positions and to offer needed support and improved muscle function
Medications like antidepressants and anticonvulsants are often used to treat peripheral neuropathy; however, these drugs are prescribed sparingly and with close supervision for those suffering from alcoholic polyneuropathy because of the risk for abuse and addiction. Instead, non-medication-based therapies are often preferred.
Electrical nerve stimulation sends a small electrical current through the skin and nerves that can help with sensitivities and pain, making it an option for treatment. Alternative therapies like chiropractic care, body manipulation, acupuncture, meditation, and massage therapy can be helpful in managing pain and symptoms of alcoholic polyneuropathy. The main goal of a treatment program for alcoholic polyneuropathy is to improve quality of life and offer relief from symptoms.