Proximal neuropathy is a form of nerve damage that occurs as a complication of diabetes and primarily affects the nerves in the hips, buttocks, thighs, and legs. Since there is no cure for proximal neuropathy, treatment is centered on symptom management, treating the pain and weakness caused by this condition. This type of diabetic neuropathy is also known as lumbar plexopathy, diabetic amyotrophy, and diabetic femoral neuropathy, among other names.
Although the exact cause of proximal neuropathy is not known, when blood glucose levels remain high for prolonged periods of time, nerve communications and blood vessel health both become jeopardized. A disruption in signal transmission combined with compromised blood flow, due to weakened capillaries, can result in extensive nerve damage. In the presence of inflammation or a neuropathic predisposition, nerve fibers become starved for the nutrients oxygenated blood delivers, slowly break down, and lose functionality. Once nerves are damaged, that harm is usually irreparable.
Proximal neuropathy most often occurs in older patients with Type 2 diabetes. A patient with this condition may experience numbness, pain, and tingling in his hips, thighs, and buttocks. Often, this includes weakness in the legs. The patient may have trouble standing up from a sitting position.
One type of diabetic neuropathy, proximal neuropathy is generally diagnosed following a physical examination and a battery of diagnostic tests. A variety of tests, including an electromyography (EMG) and nerve conduction study, may be performed to evaluate nerve and muscle functionality. Sensory tests may also be utilized to assess the patient's nerve response to temperature variation and sensation. If symptoms indicate impaired nervous system function, autonomic testing may be performed to evaluate blood pressure and its relation to symptoms.
In the absence of a cure, treatment for proximal neuropathy is centered on symptom management. Individuals are encouraged to closely monitor their blood sugar levels, adhere to a strict diet, and engage in appropriate, regular exercise. The key to slowing neuropathic progression is taking proactive, healthy measures, including avoiding alcohol consumption and stopping smoking. In some cases, prescription strength analgesic medications may be given, including opioids like tramadol.
Even with improved glucose control and exercise, most patients do not fully recover from proximal neuropathy. Most do find relief from the pain, however, and can recover some strength in their legs. Whether or not improved control over a patient's blood sugar is an effective treatment for this condition, it is important for preventing other diabetes complications.