Sjögren’s disease is best known for causing dryness in the eyes and mouth. But the condition can also affect other systems in the body beyond just the tear ducts and salivary glands. For some people, Sjögren’s can also cause issues like nerve and joint pain, dry skin, and problems with the liver and kidneys. When neuropathy (nerve inflammation or damage) happens, it can lead to pain that sends you on a search for relief.

Living with Sjögren’s and neuropathy can be challenging. If you have nerve pain that negatively impacts your quality of life, take heart. Certain treatments, such as medication and physical therapy, may help relieve your neuropathy pain.

Below, we’ll look at six ways people with Sjögren’s can soothe neuropathy pain.

What Is Neuropathy?

Neuropathy refers to nerve inflammation or damage, which may cause symptoms like weakness, numbness, coldness, or a burning sensation.

Your nervous system has two parts: the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS includes the brain and spinal cord, while the PNS consists of the nerves outside these areas. The nerves of the PNS connect the spinal cord to muscles in the body and send messages from the CNS to the rest of the body.

Neuropathy can affect either the CNS or the PNS. When peripheral nerves are impacted, it’s referred to as peripheral neuropathy. Peripheral neuropathy is more common in people with Sjögren’s than neuropathy affecting the CNS.

There are three types of peripheral nerves:

• Motor nerves — Responsible for moving muscles
• Sensory nerves — Allow you to feel sensations from the skin, such as a touch or temperature
• Autonomic nerves — Regulate automatic functions within the body, such as heart rate and blood pressure

Symptoms of peripheral neuropathy depend on the type of nerve that’s affected and its location. Peripheral neuropathy symptoms may include:

• Tingly, prickly, or numb sensations in the hands or feet that develop slowly over time
• Skin that’s very sensitive to touch
• Pain that may feel sharp, stabbing, burning, or throbbing
• Pain during simple tasks, such as putting weight on your feet to stand
• Muscle weakness or not being able to move
• Clumsiness or falling
• Sensations that feel like socks or gloves are on your feet or hands when there’s nothing there

If autonomic nerves are affected (a condition called autonomic neuropathy), symptoms may include issues with blood pressure, sweating, or gastrointestinal problems.

Peripheral neuropathy can be caused by many different conditions, including Sjögren’s and other autoimmune diseases like lupus and rheumatoid arthritis. Other conditions that can cause neuropathy include diabetes, infections, tumors, genetic conditions, and bone marrow disorders. Additionally, certain medications, alcohol use disorder, exposure to toxins, vitamin deficiencies, and pressure or trauma to the nerve can also lead to neuropathy.

How Sjögren’s Disease Can Affect Nerves

The primary role of the immune system is to protect your body from germs, irritants, and other invaders that mean to harm you. However, in people with autoimmune diseases, the immune system doesn’t function quite right. Instead of only attacking invaders, the immune system mistakenly targets healthy cells, thinking they’re threats.

Sjögren’s disease — previously called Sjögren’s syndrome — is an autoimmune disorder. In Sjögren’s, immune system dysfunction often affects the eyes and mouth first, specifically, the moisture-producing glands — the tear ducts and the salivary glands. These attacks cause inflammation that damages the glands, preventing them from working correctly. The lack of tears and saliva is what causes common symptoms like dry eyes and dry mouth.

However, Sjögren’s can also cause the immune system to attack healthy cells and tissues in other parts of the body, including the nervous system. Inflammation in the nerves can affect their ability to properly transmit messages, such as sensations on the skin. If the immune system damages larger nerves, it can lead to symptoms like numbness and weakness. When smaller nerves are targeted, you may feel burning, tingling, or stabbing pain.

Neuropathy is reported to affect between 5 percent and 10 percent of people with Sjögren’s. However, some studies suggest that nerve involvement may be more common. It’s important to note that nerve pain can show up even when symptoms of dryness are mild or before dry eyes or dry mouth develop.

Ways To Soothe Neuropathy Pain

There are several ways to manage nerve pain with Sjögren’s. Work with your primary care or rheumatology provider to find the treatment option that’s right for you.

1. Medication

Doctors use several medications to help manage neuropathy and nerve pain. For neuropathy specific to Sjögren’s, hydroxychloroquine sulfate may be prescribed to help control the underlying disease. Corticosteroids (also called steroids) may also be prescribed for a short time to reduce inflammation and the nerve damage it can cause. Sometimes, immunosuppressants — drugs that calm the immune system — may be needed for longer periods. If this is the case, steroid-sparing agents like methotrexate may be used instead of steroids to reduce side effects.

Other medications your doctor may suggest for neuropathy pain include:

• Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) for mild nerve pain
• Anti-seizure medications, such as gabapentin or pregabalin
• Antidepressants

Medications applied directly to the skin may also be helpful for soothing nerve pain. These include capsaicin cream, lidocaine patches, and other pain relieving ointments.

2. Physical Therapy

Physical therapy can help reduce nerve pain, increase mobility, and improve your quality of life. A physical therapist can teach you exercises to manage your neuropathy pain, such as:

• Nerve glides, which help affected nerves move and heal
• Strength training activities to build muscle
• Activities to improve coordination, balance, and function

Your physical therapist can also explain your condition, prescribe braces if needed, and prevent complications. Make sure to look for a therapist who is board-certified and has experience treating neuropathy.

3. Keep Your Feet Comfortable

It’s common for people with Sjögren’s to have neuropathy pain in the feet. Wearing loose socks made from soft material like cotton and shoes with padding can help ease discomfort from nerve pain and protect your feet from injury.

If your feet are extra sensitive, you can use semicircular hoops to keep bedsheets from touching them while you sleep. Applying cold compresses to your feet or taking a cool bath may also help reduce pain.

4. Exercise

Getting regular exercise can also help. Exercising three times a week, like going for a walk, can be helpful for both relieving neuropathy pain and building muscle strength. Low-impact activities such as yoga and tai chi can also help reduce pain. Water exercises — like those done in a pool — can be especially soothing for neuropathy pain that affects the feet.

5. Eat Healthy

Eating a healthy diet and adopting other healthy habits can also play a part in managing pain. Choose whole grains, lean proteins, veggies, and fruits to make sure your body gets the nutrients it needs to work well.

If possible, avoid alcohol and cigarettes. These can make neuropathy symptoms worse and increase your risk of complications.

6. Try Acupuncture

Acupuncture may also help reduce neuropathy pain. Acupuncture is a form of traditional Chinese medicine that involves inserting small, flexible needles into specific parts of the body.

While more research is needed, some studies show that acupuncture may help manage peripheral neuropathy caused by chemotherapy. In two studies, acupuncture appeared to reduce neuropathy symptoms, prevent them from getting worse, and improve quality of life.

Keep in mind that you may need several acupuncture sessions before you notice improvements. When choosing an acupuncturist, look for a certified practitioner who uses clean, sterile needles.

When To Talk to Your Doctor

If you start to have symptoms of neuropathy or if existing symptoms worsen, talk to your doctor. Your healthcare provider may refer you to a neurologist for testing. To diagnose neuropathy, your doctor will likely ask you about your symptoms and perform a physical exam along with several tests.

Testing to confirm neuropathy and rule out other causes of symptoms may include:

• Neurological exam
• Blood tests
• Nerve function tests
• Imaging tests
• Nerve or skin biopsy

In people with Sjögren’s, inflammation can damage nerves over time. Because of this, early diagnosis and treatment of neuropathy symptoms is crucial. One study found that people with Sjögren’s who had neuropathy symptoms for longer than six months had a poorer response to treatment. Early treatment to reduce inflammation is essential to protect nerves from permanent damage and increase the chances of recovery.

Join the Conversation

On MySjogrensTeam, people share their experiences with Sjögren’s, get advice, and find support from others who understand.

How do you relieve neuropathy pain? Let others know in the comments below.