How do nerves heal
 

I have a question about how nerves generally heal, my numbness and tingling started in my feet and moved progressively up to affect my whole body in a matter of months, although I am feeling worse than ever since this started several months ago, I am hoping someday this will get better, but how does that generally happen? I'm sure this is a hard question to answer, do the first nerves that get damaged, for me it started in my feet, do those nerves start to heal first, or are the last nerves damaged the first to heal, or is it different for everyone? I do understand some people never really get better, but for those of you who have how did the healing process progress? Thanks, Jan

The healing process--
 

--is likely as individual as each person's neuropathy (assuming one does get healing or arrests the progression).

That's not to say there aren't patterns that many experience--the most common being a reverse "grow back" in those who have length-dependent neuropathy, especially from metabolic or toxic causes (when these heal, the nerves farthest from the center of bodily circulation, which are the first to become symptomatic, are often the last to improve).

One major factor is how far new connections have to grow. In the case of, say, small fibers growing from the dorsal root ganglia that have been damaged or dies altogether, one will often sprout new connection if conditions are optimal and if the originating factor has been removed. But these fibers may have to travel a meter or more (especially if going to the feet) and then do so very slowly--about a millimeter per day--so it may take years. And, seldom do the pathways taken follow the "original" ones. Since these nerve growth cones have to traverse around and trough other body tissue, they are prone to compressive forces while growing or even after reaching their targets, and one will often get all sorts of weird parastheses and sensations--painful and otherwise--as they go. In fact, it's very difficult to tell this from worsening neuropathy except in long-term retrospect or through improved test results (we've been able to track my slowly improving intraepidermal small-fiber density through skin biopsies), which is a good reason to keep symptom and test result journals.