If you have numbness or pain in your hands and feet and don't know why, you may have peripheral neuropathy. But if you're like most Americans, you've probably never heard of this often debilitating disease. A new national survey reveals that, when asked, only 7 percent of adults said they knew about peripheral neuropathy.

This severe lack of awareness about an illness that affects some 20 million Americans was the most significant finding of the survey conducted by Roper Starch for The Neuropathy Association, which was formed three years ago to provide support and education to people suffering from the disease.

Sometimes called the secret disease, peripheral neuropathy is not easily detectable. Even those who have the disease may not be aware of its presence, and their doctors may not recognize it either.

Diabetes is one of the most common causes of this disease. But the causes are diverse and in many cases unknown. peripheral neuropathy has been associated with toxins; autoimmunity, a side effect of medication; vitamin deficiency; and some types of cancer, among other causes.

Among diabetics surveyed, only 22 percent said they were familiar with it, even though neuropathy is one of the most common complications of diabetes. Many of the respondents said they thought peripheral neuropathy was some kind of visual problem, and only a few actually knew what it was.

Nearly 8 percent of the respondents without diabetes said they experienced symptoms suggestive of neuropathy, such as numbness, weakness or pain in the hands or feet, lasting more than six months. Among diabetics, 33 percent said they experienced such symptoms.

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"Since there are some 200 million adults in the United States, 10 percent of whom have diabetes, this translates to about 22 million people with neuropathy," association officials said. "This is a much higher number than previously suspected."

Those who reported symptoms of neuropathy frequently did not recognize them as such; 34 percent said they did not know what caused the symptoms, and others mentioned a wide variety of reasons such as "the way I slept on my arm or foot," "exposure to cold or frostbite," "injury or accident" or "an illness."

In contrast to this glaring lack of understanding of the disease, 78 percent of those with peripheral neuropathy said it had a substantial impact on their ability to enjoy a normal life, and 61 percent said it affected their ability to do their job.

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Neuropathy Association

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