What Is Alcoholic Neuropathy?

Alcoholic neuropathy is a condition in which the nerves become damaged as a result of years of heavy alcohol consumption. Symptoms include burning pain in the body, hyperalgesia (increased sensitivity to pain), and allodynia (a condition in which normal stimulus, like a soft touch, produces pain).

Both the toxicity of alcohol and nutritional deficiencies have been linked with alcoholic neuropathy, which is one of the most common but least recognizable consequences of heavy alcohol use. Learn more about this condition, including its symptoms, how it's treated, and ways to cope.

Signs and Symptoms of Alcoholic Neuropathy

Alcoholic neuropathy signs and symptoms can progress gradually and are usually subtle at first. In fact, a person who drinks heavily might not recognize that the symptoms they are experiencing are related to their alcohol consumption.

Signs and symptoms can include any combination of the following:

• Bruises, cuts, sores, or skin infections on the toes, feet, or fingers
• Constipation or diarrhea
• Decreased pain from injuries, especially on the feet or hands
• Decreased sensation of the toes, feet, legs, fingers, hands, or arms
• Dizziness, particularly when standing with eyes closed
• Lack of coordination of the feet or hands
• Loss of balance/unsteadiness when walking
• Pain, tingling, or other unusual feelings in the toes, feet, legs, fingers, hands, or arms
• Sexual dysfunction
• Trouble walking a straight line, even without recent alcohol use
• Urinary incontinence
• Weakness in the feet or hands
  

Effects of Alcoholic Neuropathy

Alcoholic neuropathy is a nerve disease caused by excessive alcohol consumption over a long period of time. The effects of alcoholic neuropathy are caused by nerve damage and fall into four main categories: decreased sensation, pain/hypersensitivity, muscle weakness, and autonomic effects.

Decreased Sensation

Alcoholic neuropathy damages sensory nerves. This results in decreased sensation in the hands and feet. If the sensation is decreased enough, you may feel actual numbness after drinking alcohol.

This may not sound like a terrible problem, but diminished sensation actually causes very serious consequences, including:

• Frequent bumps and scrapes: A diminished ability to feel the pain that would normally result from everyday minor injuries can make these injuries more likely.
• Infections and bleeding: Because of the absence of normal pain and discomfort, tender sores and wounds may be left unprotected, which can cause further injury. Eventually, wounds may bleed or become infected.
• Diminished sensory skills: The inability to balance and coordinate fine motor skills, such as walking and finger movements, can impair common activities such as walking, writing, and typing. Advanced alcoholic neuropathy can result in feeling off-balance, particularly with eyes closed, which can lead to dangerous falls.

Increased Pain and Hypersensitivity

Another prominent effect of alcoholic neuropathy involves painful and uncomfortable sensations. Alcoholic neuropathy can result in hypersensitivity to touch and even resting pain. Light touch can feel exaggerated and painful, particularly in the fingers and toes.

Constant pain in the hands or feet is one of the most bothersome aspects of alcoholic neuropathy. The pain can feel like burning, throbbing, or sharp pins and needles. As the condition progresses, the pain may vary in intensity, sometimes diminishing for months before worsening again.

Muscle Weakness

Severe alcoholic neuropathy may cause motor weakness due to nerve damage. Our muscles need to receive a message from nearby nerves in order to function. When this message is interrupted due to damaged nerves, the muscles cannot function as they normally would. This most often manifests with weakness of the hands and feet.

Autonomic Neuropathy

Autonomic nerves control functions of the body's organs, such as the bladder, stomach, and intestines. Alcoholic neuropathy can weaken the autonomic nerves, causing impairment of bowel and bladder function, and sexual dysfunction.

Causes of Alcoholic Neuropathy

In general, it takes years for alcoholic neuropathy to develop, so a long-standing history of heavy alcohol use is typical. Some people experience a faster onset and progression of alcoholic neuropathy than others. It's not completely clear why some people are more prone to this complication than others.

Alcoholic neuropathy is caused by nutritional deficiency, as well as toxins that build up in the body. Alcohol decreases the absorption of nutrients such as magnesium, selenium, and vitamins B1 and B2, causing significant deficits that affect many areas of the body, including the nerves.

Alcohol also alters the function of the stomach, liver, and kidneys in ways that prevent the body from properly detoxifying waste material. This waste then builds up and harms many regions of the body, including the nerves.

Nerve damage typically affects the axons, which are the projections that send electrical signals from one nerve to another. It also impacts the myelin, which is the fatty coating that protects the nerves.

Diagnosing Alcoholic Neuropathy

The diagnosis of alcoholic neuropathy involves a combination of medical history, physical examination, and possibly blood tests or nerve tests such as electromyography (EMG) and nerve conduction studies (NCV).

• Physical examination: A complete physical and neurological examination tests reflexes, muscle strength, sensation (including light touch, pinprick, vibration, and position sense), and coordination. Usually, people with alcoholic neuropathy have diminished reflexes and diminished sensation. If this condition is advanced, weakness may be present too.
• Electromyography (EMG) and nerve conduction studies (NCV): EMG and NCV tests examine nerve function in detail. Characteristic patterns, such as decreased function in the hands and feet, low amplitude of nerve waves, and slowing of nerve function, are suggestive of alcoholic neuropathy. The nerve tests don't identify the cause of neuropathy, only the extent of nerve damage.
• Nerve biopsy: In rare instances, a doctor may suggest a nerve biopsy, which can show a pattern of nerve damage consistent with alcoholic neuropathy.
• Other tests: Additional assessments might include blood tests, urine tests, or imaging studies of the brain or spinal cord to rule out other causes of neuropathy symptoms.

Conditions That May Mimic Alcoholic Neuropathy

There are a number of other medical conditions that can be confused with alcoholic neuropathy. The most common of these include:

• Diabetic neuropathy
• Guillain-Barré syndrome
• Motor neuron disease, such as amyotrophic lateral sclerosis (ALS)
• Multiple sclerosis (MS)
• Muscle disease
• Peripheral vascular disease
• Spine disease

Treatment for Alcoholic Neuropathy

While peripheral neuropathy generally cannot be cured, there are several medical treatments that can be used to manage the pain of alcoholic neuropathy, aiding in your recovery. These include pain medications and antidepressants.

While not specifically approved for the treatment of alcoholic neuropathy, antidepressant medications are often prescribed to help control the pain. Anti-seizure medications are sometimes prescribed as a way to manage pain.

Since nutritional deficiencies are partly to blame for alcoholic neuropathy. To combat these deficiencies, supplementation with vitamin B12, folate, vitamin E, and thiamine may be recommended.

There are no medications that can help improve loss of sensation, strengthen muscle weakness, or assist with the coordination and balance problems caused by alcoholic neuropathy. However, some people notice an improvement in symptoms a few months after discontinuing alcohol intake.

Sometimes alcohol causes such severe damage to the body that a liver transplant may be necessary. In this case, there may be some improvement in the symptoms of alcoholic neuropathy after the liver transplant, but the neuropathy may also be so advanced that there may be little, if any, improvement, even after a transplant.

Coping With Alcoholic Neuropathy

Even though alcoholic neuropathy may not go away, there are things you can do to cope with this condition.

Get a Professional Caretaker

If you are diagnosed with alcoholic neuropathy and currently take care of yourself or have a loved one taking care of you, you might consider getting professional help. A nurse or professional caretaker can be part of your treatment team and visit you at home regularly to help with a variety of tasks, including:

• Assessing the results of your treatments
• Assessing your pain, sensory function, and motor function
• Helping you adjust to using a cane, walker, or wheelchair if needed
• Teaching you how to perform household tasks safely (e.g., wearing gloves to check the water temperature before bathing to prevent skin irritation)
• Working with other healthcare professionals such as physicians and physical therapists to monitor your progress and make adjustments as needed

Having a healthcare professional come to your house to assist with your needs can relieve a lot of added stress on you to keep track of your treatment plan alone.

Join a Support Group

In addition, a support group can help you cope with the life changes you're experiencing as a result of your condition. You might look for a support group specifically for alcoholic neuropathy or for people coping with chronic pain. You may also benefit from a support group to help you reduce your drinking or completely quit drinking alcohol.

Especially if you have been drinking heavily for many years, coping with alcohol use disorder is not easy. But with the proper resources to help, you are better set up for success with sobriety.

How to Prevent Alcoholic Neuropathy

Avoiding excessive amounts of alcohol is the primary way to prevent alcoholic neuropathy. If you notice you are developing signs of alcoholic neuropathy (such as numbness after drinking alcohol), in addition to seeing a physician, try to stay away from alcohol altogether. If you are having difficulty avoiding alcohol, there are resources that can help you quit.

Takeaways

Alcohol use disorder is a challenging condition. The medical community has recognized that addiction is a disease and some people are predisposed to it. As a result, it is usually necessary to get medical help to manage alcohol use disorder.

Some of the symptoms of alcoholic neuropathy can be partially reversed. But if the neuropathy becomes advanced, it might not be reversible.

Medication can help reduce some of the symptoms of alcoholic neuropathy. The most important strategy against alcoholic neuropathy lies in preventing the symptoms from getting worse by decreasing alcohol consumption as soon as possible.