How long does it take for alcohol to cause neuropathy?

Drinking a lot of alcohol over a long period of time causes nerve damage that can lead to the onset of alcoholic neuropathy. Heavy and chronic drinking is also often tied to nutritional deficiencies. Someone who struggles with alcoholism may replace meals with alcohol, take in a lot of empty calories, and not maintain a healthy and balanced diet. Alcohol can also deplete the body of essential nutrients, and thiamine (vitamin B1) deficiency is common in people who battle alcoholism. Malnutrition due to alcoholism can contribute to nerve damage and alcoholic polyneuropathy as well. The US National Library of Medicine (NLM) warns that around 50 percent of long-term heavy drinkers will suffer from alcoholic neuropathy.

The nerves that run outside of the spinal cord and brain are called peripheral nerves. They work to send signals throughout the central nervous system and the rest of the body. Nerves help you to move (motor nerves) and feel physical sensations (sensory nerves). Some of your bodily functions are autonomic, which means that you don’t directly control them. Nerves that are part of the autonomic nervous system help to regulate heart rate, body temperature, respiration, and blood pressure. Polyneuropathy involves damage to more than one nerve at the same time, usually multiple nerves throughout the peripheral nervous system and all over the body.

What Are the Causes of This Type of Nerve Damage?

It is not completely understood what exactly causes alcoholic polyneuropathy; however, the British Journal of Clinical Pharmacology proposes that ethanol (the active chemical in alcohol beverages) has direct toxic effects on nerves that can harm nerve cells with repeated and excessive alcohol consumption. The journal further reports that alcoholic polyneuropathy is likely caused by nutritional deficiencies and the depletion of thiamine that is caused by heavy and long-term drinking. It is most likely that drinking a lot of alcohol over several years causes direct damage to nerve cells and can also contribute to nutritional deficiencies in the body; these may both be factors in the onset of alcoholic polyneuropathy.

Signs and Symptoms

Alcoholic polyneuropathy builds up slowly over time and doesn’t just “hit” a person all at once. Symptoms are likely to start slowly, and with continued drinking, the damage gets worse as do the symptoms. Signs of alcoholic polyneuropathy include:

• Tingling sensation in the arms, legs, hands, and feet
• Numbness of the legs and arms
• Feeling of “pins and needles”
• Burning, stabbing, shooting, or freezing pains
• Difficulties using arms and legs
• Lack of motor coordination
• Falling down often
• Inability to feel pain or recognize temperature changes
• Sensitivity to touch
• Muscle weakness, cramps, spasms, and aches
• Unsteady gait and troubles walking
• Difficulties urinating and leaking urine (incontinence)
• Constipation or diarrhea
• Impotence (problems getting an erection)
• Intolerance to heat
• Nausea and vomiting
• Trouble swallowing, eating, and/or talking
• Dizziness
• Digestive issues
• Excessive sweating
• Irregular blood pressure and heart rate
• Breathing problems
• Skin and nail infections

These symptoms usually start small and build up over time, especially with continued alcohol abuse and poor eating habits. Muscle strength and feelings that occur as a result of alcoholic polyneuropathy generally happen on both sides of the body and most commonly affect the legs. Alcoholic neuropathy is then sometimes referred to as “alcohol leg.”

Progressive & Permanent Side Effects

Alcoholic polyneuropathy is progressive and gets worse over time, as the damage to the nerves increases with continued alcohol abuse. The problems that alcoholic neuropathy causes with muscle weakness, balance, and coordination can make a person more at risk for falling down and getting injured. Not being able to tell when things are too hot because of the way the nerve damage interferes with the ability to sense temperature changes can make one more susceptible to burns. In the same manner, numbness and lowered ability to feel pain sensations can make people more apt to cut themselves or otherwise damage the skin. Often, individuals may not even realize that they are burned or cut because they just don’t feel it, which can elevate the risk for infection.

Often, the side effects of alcoholic polyneuropathy are permanent. They get worse with more alcohol consumption, so if you stop drinking and seek professional medical attention, you can manage the symptoms of the disorder and potentially keep the nerve damage from worsening.

Peripheral Neuropathy And Alcohol

Peripheral neuropathy refers to damage or disease of the nerves that carry messages to and from the brain or spinal column and the rest of the body. Peripheral neuropathy can have many causes unrelated to alcohol consumption, and it was previously thought that when it was found in alcoholics it was merely the result of poor nutrition in alcoholics as well as alcohol’s direct impact on nutrients. More recent research, however, suggests that alcohol can directly damage nerves. The evidence points toward alcohol-related peripheral neuropathy being a form of toxic neuropathy, rather than nutritional neuropathy.

Treatment Options for Alcoholic Neuropathy

It is important to stop drinking if you suffer from alcoholic polyneuropathy in order to stop the disease from getting worse and to correct the nutritional imbalance that is damaging the nerves and interfering with the nervous system. A medical detox program followed by a comprehensive alcohol rehab program can manage alcoholism and help a person to get sober and stay that way. Many alcohol rehab programs help to manage co-occurring disorders, such as alcoholic polyneuropathy. A program that caters to co-occurring disorders ensures that the alcoholism is being treated and so are any other medical or mental health issues. Medical, mental health, and substance abuse providers all work together to form and carry out a treatment plan that helps to manage all disorders at the same time.

Medical News Today publishes that medical procedures and therapies, medications, and adjunctive and alternative therapies are commonly used to treat alcoholic polyneuropathy. To diagnose alcoholic neuropathy, medical professionals will generally perform a few tests or exams to determine the severity of the disorder and what can be done to treat and manage the symptoms. Your doctor may perform a neurological exam, take a blood test to check for nutritional deficiencies (such as thiamine), perform an electromyography (EMG) that checks how well the muscles and nerves that control them are working, run a nerve conduction test to see how the electrical signals are moving through the nerves, remove a piece of the nerve for examination through a nerve biopsy, or run a series of lab tests to check on other bodily and nerve functions.

The Center for Peripheral Neuropathy at the University of Chicago publishes that the following are beneficial treatments for alcoholic polyneuropathy:

• Treatment for alcoholism
• Pain medication to address nerve pain and associated discomfort, which will be managed carefully and given in the lowest possible dose to minimize the potential for abuse and addiction
• Physical therapy to improve muscle function and strength as well as to manage pain
• Diet supplements that include vitamins E, B1, folate, and B12
• Considerations to manage loss of sensation and to prevent accidents and injuries
• Use of orthotic appliances like splints to keep arms and legs in proper positions and to offer needed support and improved muscle function

Medications like antidepressants and anticonvulsants are often used to treat peripheral neuropathy; however, these drugs are prescribed sparingly and with close supervision for those suffering from alcoholic polyneuropathy because of the risk for abuse and addiction. Instead, non-medication-based therapies are often preferred.

Electrical nerve stimulation sends a small electrical current through the skin and nerves that can help with sensitivities and pain, making it an option for treatment. Alternative therapies like chiropractic care, body manipulation, acupuncture, meditation, and massage therapy can be helpful in managing pain and symptoms of alcoholic polyneuropathy. The main goal of a treatment program for alcoholic polyneuropathy is to improve quality of life and offer relief from symptoms.

Alcoholic neuropathy, also known as alcoholic peripheral neuropathy, refers to damage of the nerves due to chronic and excessive alcohol consumption. Affected nerves include the peripheral nerves, primarily located in the arms and legs, and the autonomic nerves, which help regulate our internal body functions. About 46% of chronic alcohol users will eventually develop this condition.

This article reviews alcoholic neuropathy and its symptoms, causes, and treatment.

The exact cause of alcoholic neuropathy is unclear. However, it is known to be directly related to heavy and long-term alcohol consumption. Overconsumption of alcohol may directly harm and hinder the nerves' ability to communicate information from one body area to another.

Poor nutrition is often associated with heavy alcohol use. Research shows that decreased thiamine (a B vitamin) plays a role, while others suggest an overall nutritional deficiency may play a role. However, alcoholic neuropathy can also occur without the presence of malnutrition.

Symptoms of alcoholic neuropathy are usually related to nerve dysfunction and may include:

• Numbness of the extremities, most commonly in the legs
• A tingling or pins-and-needles sensation in the extremities
• Pain or burning sensation in the arms or legs
• Difficulty walking
• Cramps, aches, or weakness of the muscles
• Difficulty talking or swallowing
• Nausea and vomiting
• Erection difficulties
• Difficulty urinating or incontinence
• Constipation or diarrhea
• Heat intolerance
  

Most symptoms generally begin as mild. However, they usually worsen over time as the neuropathy progresses.

Symptoms that occur in the arms and legs typically affect both sides.

Since symptoms of alcoholic neuropathy can vary greatly, diagnosis may take time. It usually involves a combination of the following:

• Medical history: Your healthcare provider will collect data involving past medical history and all current symptoms.
• Physical exam: This exam aims to uncover other medical conditions contributing to symptoms, like diabetes or high blood pressure.
• Neurological exam: This is a noninvasive exam to determine the location and extent of neurological damage. Your healthcare provider may ask you to complete a series of small movements and ask several questions to check neurological function.
• Blood and urine tests: These tests can detect diabetes, liver and kidney problems, infections, vitamin deficiencies, and other conditions that may cause neuropathic conditions.
  

Chronic alcohol use can also affect how the body stores and uses vitamins that are needed for healthy nerve function. In addition to thiamine, vitamin levels that your healthcare provider may check include:

• Pyridoxine, or vitamin B6
• Pantothenic acid
• Vitamin A
• Biotin
• Folic acid
• Niacin, or vitamin B3

Fortunately, after receiving a diagnosis, people with alcoholic neuropathy can make healthy changes to minimize symptoms and receive help for chronic alcohol use.

The first step in treating alcoholic neuropathy includes stopping alcohol use altogether. If your drinking is out of your control, know that many treatment options are available.

Talk to your healthcare provider about what options are best for you. Treatment may include:

• Therapy
• Medication
• Social support from groups like Alcoholics Anonymous (AA)
• In-patient or outpatient rehab

Likely a combination of treatments will be needed.

Other treatment options to manage alcoholic neuropathy involve symptom management and preventing further injuries. These options may include:

• Adding vitamins and supplements to your diet
• Physical therapy
• Orthopedic splints to maintain limb function and positioning
• Medications to reduce pain and discomfort
• Wearing compression stockings
• Keeping your head elevated while sleeping
• Intermittent catheterization or manual expression of urine for people with difficulty urinating
• Eating extra salt (only for those without hypertension)

People with any type of neuropathy may have reduced sensitivity in the legs and arms. If this occurs, additional steps need to be taken to prevent other injuries, such as:

• Ensuring that bath and shower water is not too hot to prevent burns
• Wearing special footwear to prevent foot injuries
• Checking feet daily for wounds
  

This condition is typically not life-threatening, but the nerve damage from alcoholic neuropathy is usually permanent. It will certainly worsen with continued alcohol use.

Alcoholic neuropathy damages the nerves due to prolonged and excessive alcohol consumption. This damage prevents the nerves from communicating information from one body area to another.

Most symptoms generally start as mild. However, they usually worsen over time as the neuropathy progresses. Some of the most common symptoms are numbness or tingling sensation of the extremities, pain or a burning sensation in the extremities, difficulty walking, difficulty urinating, and difficulty talking or swallowing.

Diagnosis usually involves a healthcare provider collecting a medical history, performing a medical and neurological exam, and performing blood and urine tests. Treatment options include steps to quit alcohol use and managing symptoms of the disease.

Quitting drinking can seem like an overwhelming task. But if you have developed neuropathy as a result of alcohol use, it's important to stop drinking as soon as possible. Treatment can help. Professional and peer help through programs such as Alcoholics Anonymous or other substance abuse programs can help you reduce your alcohol consumption. Talk to your healthcare provider about the best treatment plan to start on your road to recovery.

Frequently Asked Questions

• Is alcoholic neuropathy curable?

  There is no cure for alcoholic neuropathy, and the nerve damage is usually permanent. This condition is typically not life-threatening. However, it will worsen with continued alcohol use.

• How long does it take to develop alcoholic neuropathy?

  How long it takes for alcoholic neuropathy to develop depends on many factors, including the amount of daily alcohol consumed, a person's overall health, their nutritional intake, and other individual factors. But in most cases, alcoholic neuropathy takes several years or even decades to develop, depending on the amount of alcohol consumed.

• How common is alcoholic neuropathy?

  Alcoholic neuropathy affects people who consume excessive amounts of alcohol over a long period of time. About 46% of all chronic alcohol users may eventually develop this condition.