Scottsdale Pain Management Specialists
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How to Diagnose Neuropathy

We have been talking about neuropathy a lot on this blog. You may have it or know someone who does. Usually, they’ve been diagnosed with the disease already by their physician. What about those that have symptoms of neuropathy, numbness, tingling, burning, altered sensations–like wearing a wet sock or a marble under the balls of the feet. You may be wondering if you too, have neuropathy or possibly something else. This blog post will discuss the methods that are used to diagnose neuropathy. 

Electromyograms are often used in the diagnosis of neuropathy. This test is done traditionally by neurologists and physiatrists in an office based setting. The machine is connected to several wires, these wires have very thin needles on the end that are inserted into various muscles in the extremities. Electrical activity is measured with muscle contractions. Along with the electromyogram, most people performing the test will also apply patches to skin and test the nerves for their response to electrical stimulation. This is called a nerve conduction test. Results will be given to the ordering physician, typically, one of the discussion points for the results are whether or not peripheral neuropathy exists.


There are other nerve tests that can be administered to detect issues on these nerves. These tests are autonomic reflex tests. They can measure the sweat on the skin, as this can be an issue with neuropathy. They can also measure how your nerves respond to heat, touch, cold, and vibrations. Positive results in these tests show that there are abnormalities in the nerves. 

Another way to diagnose neuropathy is with the use of a biopsy. The biopsy can be of the skin or to evaluate for a reduction in nerve endings. This test is especially useful for the evaluation of small fiber neuropathy. Nerve biopsies can look for and evaluate issues of sensory nerves. If abnormalities exist, then neuropathy is likely.

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Imaging studies like CT scans and MRIs can cause issues in the spine or periphery. Spine issues like herniated discs can mimic neuropathy but the treatment for the discs is different than that of neuropathy. A negative study on CT or MRI doesn’t mean that neuropathy is unlikely, it only rules out disorders that can have similar symptoms, like bulged or herniated discs.  

Blood tests can be used, but not a true test for neuropathy. These tests can look for reasons that neuropathy was brought on. Blood glucose levels, vitamin deficiencies, and immunological issues can all be causes of neuropathy. Once neuropathy is diagnosed, it is important to find the root cause. If, for example, the neuropathy is in part due to diabetes, then treating the diabetes is necessary. The same holds true for vitamin deficiencies or immunological ailments.