Proximal neuropathy is a type of nerve damage caused by diabetes that affects the hips, buttocks, thighs, and legs. There is no cure, but treatment focuses on managing symptoms, such as pain and weakness. High blood glucose levels and compromised blood flow can cause extensive nerve damage. Treatment includes monitoring blood sugar levels, adhering to a strict diet, and exercise. Most patients do not fully recover, but can find relief from pain and regain some leg strength.
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. Because there is no cure for proximal neuropathy, treatment focuses on managing symptoms, 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 extended periods of time, nerve communications and blood vessel health are both impaired. An interruption in signal transmission combined with compromised blood flow, due to weakened capillaries, can result in extensive nerve damage. In the presence of inflammation or neuropathic predisposition, the nerve fibers are starved of the nutrients supplied by the oxygenated blood, they slowly degrade and lose functionality. Once nerves are damaged, that damage is usually irreparable.
Proximal neuropathy occurs more often in older patients with type 2 diabetes. A patient with this condition may experience numbness, pain, and tingling in the hips, thighs, and buttocks. Often, this includes leg weakness. The patient may have difficulty standing up from a seated position.
A type of diabetic neuropathy, proximal neuropathy is usually diagnosed after a physical exam and battery of diagnostic tests. A variety of tests may be done to evaluate nerve and muscle function, including an electromyography (EMG) and a nerve conduction study. Sensory tests can also be used to evaluate the patient’s nervous response to temperature change and sensation. If symptoms indicate impaired nervous system function, autonomic tests may be done to evaluate blood pressure and its relationship to symptoms.
In the absence of a cure, treatment for proximal neuropathy is focused on managing symptoms. Individuals are encouraged to monitor their blood sugar levels closely, adhere to a strict diet, and engage in appropriate and regular exercise. The key to slowing neuropathic progression is to take proactive and healthy steps, including avoiding alcohol and quitting smoking. In some cases, prescribed pain-relieving drugs, including opioids such as tramadol, may be given.
Even with improved glucose control and exercise, most patients do not fully recover from proximal neuropathy. Most find relief from the pain, however, and can regain some strength in their legs. Whether or not improving a patient’s blood sugar control is an effective treatment for this condition, it is important for preventing other complications of diabetes.
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