Chronic high alcohol consumption causes peripheral neuropathy, which results in damage and destruction of the nerves of the extremities due to the direct toxic effects of alcohol and partly due to a lack of vitamins and minerals. Scientific literature suggests that neuropathy is present in 25–66 % of people with alcoholism.
Initially, numbness of both feet develops, followed by paresthesia (burning, tingling sensation, crawling sensation), especially at night. Paresthesias progress slowly, rise above and become painful. Paresthesias of fingers and hands can manifest when the symptoms in the feet extend above the ankle level. Symptoms of numbness and paresthesia predominate, but muscular weakness and muscle loss may also bother.
Gait and balance disturbances may also occur, as well as frequent falls (due to impaired function of deep sensibility), and, rarely, vegetative dysfunction (pressure drop when changing the position of the body to upright, neurogenic bladder, erectile dysfunction, gastroparesis, and difficult constipation) may also develop.
Most cases of alcoholic neuropathy have a long onset, but some are associated with an acute, rapidly progressive onset.
People who drink alcohol may be deficient in essential nutrients and vitamins, or have an impaired absorption of these nutrients in the gastrointestinal tract due to direct exposure to alcohol.
If there are concomitant diseases that also affect the limbs (pancreatic diabetes, diseases of veins or arteries of the limbs, etc.), the course of the disease may be more severe.
To find an effective treatment, it is very important to find a doctor whom you can trust and tell about the real amount of alcohol you drink. A doctor may also need to conduct additional examinations, namely tests for:
The main point in treatment will be the solution to the problem of alcohol consumption. A psychotherapist or, in some cases, a psychiatrist-narcologist will support you and find ways to solve this problem.
Elimination of pain and paresthesias is carried out by the doctor’s prescription of certain pain medications, depending on the specific situation. In cases of critical pain, you may need to call an ambulance.
Physical therapy and occupational therapy will be useful to restore limb function and reduce pain. Vigilant foot care and the use of soft, loose shoes are beneficial for preventing leg ulcers.
The use of warm or hot foot baths is potentially dangerous for alcoholic neuropathy, as it can cause burns, which is associated with impaired sensitivity of the limbs.
Article author - Tatiana Anikieieva, M.D.
Publication date: 31.07.2020
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