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Loss of sensation
Tingling
Numbness in lower leg
My hands and feet are clumsy
I can't move my arms
Hand tingling
Weak
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What is Chronic Inflammatory Demyelinating Polyneuropathy?
Chronic inflammatory demyelinating polyneuropathy (CIDP) or chronic relapsing polyneuropathy happens when the immune system attacks the myelin sheaths (protective fatty coverings) around the nerves. The exact triggers are unclear but could be systemic conditions like liver disease, diabetes, infections, cancer, immune system disorders, etc.
Typical Symptoms of Chronic Inflammatory Demyelinating Polyneuropathy
- Whole body pain
- Difficulty pronouncing words clearly
- Difficulty with fine motor control or coordination in hands and feet
- Numbness in the region from shoulder to elbow
- Numbness anywhere from the knees to the ankles
- Both arms feel weak or difficult to move
- Numbness anywhere from the elbow to the wrist
- Both legs feel weak or difficult to move
Diagnostic Questions for Chronic Inflammatory Demyelinating Polyneuropathy
Your doctor may ask these questions to check for this disease:
- Do you have pain all over your body?
- Do you have difficulty pronouncing words clearly?
- Do you have difficulty with fine motor control or coordination in your hands and feet?
- Do you have numbness from shoulder to elbow?
- Do you have numbness in your lower legs?
Treatment of Chronic Inflammatory Demyelinating Polyneuropathy
Treatment for CIDP includes physiotherapy, steroids, immune-suppressing drugs, and intravenous immunoglobulin. Physiotherapy aims to improve function and prevent shrinkage of muscles and tendons.
Reviewed By:
Benjamin Kummer, MD (Neurology)
Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Sep 2, 2025
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Symptoms Related to Chronic Inflammatory Demyelinating Polyneuropathy
Diseases Related to Chronic Inflammatory Demyelinating Polyneuropathy
FAQs
Q.
Is it CIDP? Why Your Nerves Fail & Medically Approved Next Steps
A.
CIDP is a rare but treatable autoimmune neuropathy where the immune system damages the myelin insulating peripheral nerves, making signals slow or fail and causing gradually progressive, usually symmetric weakness, numbness, balance problems, and reduced reflexes over 8 or more weeks. Diagnosis and next steps require a neurologist’s evaluation with nerve conduction studies, EMG, and often spinal fluid testing, and timely treatments like IVIG, corticosteroids, or plasma exchange can prevent long-term damage; there are several factors to consider, so see the complete guidance below for look-alike conditions, urgent warning signs, and how to choose your next steps.
References:
* Rajabally YA. Chronic inflammatory demyelinating polyneuropathy: update on diagnosis, pathophysiology and treatment. Front Neurol. 2021 Jul 20;12:701700. doi: 10.3389/fneur.2021.701700. PMID: 34385973; PMCID: PMC8342417.
* Press R, Dhand A, Harel A. Chronic inflammatory demyelinating polyradiculoneuropathy: A review of current treatment guidelines. J Neurol Sci. 2023 Mar 15;446:120593. doi: 10.1016/j.jns.2023.120593. Epub 2023 Feb 8. PMID: 36806509.
* Van den Bergh PYK, van Doorn PA, Hahn A, Léger JM, Nobile-Orazio E, Rajabally YA, Sommer C, Pareyson D. Diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: a European Academy of Neurology/Peripheral Nerve Society guideline update. Eur J Neurol. 2021 Jul;28(7):1852-1875. doi: 10.1111/ene.14931. Epub 2021 Jun 25. PMID: 34105809.
* Doneddu PE, Fregoni S, Sabatelli M, Nobile-Orazio E. Immunopathogenesis of Chronic Inflammatory Demyelinating Polyneuropathy: Mechanisms and Implications for Therapeutic Strategies. J Clin Med. 2023 Jul 11;12(14):4591. doi: 10.3390/jcm12144591. PMID: 37510705; PMCID: PMC10382220.
* Seneviratne U. Chronic Inflammatory Demyelinating Polyradiculoneuropathy: Challenges in Diagnosis and Treatment. Front Neurol. 2021 May 26;12:693575. doi: 10.3389/fneur.2021.693575. PMID: 34122329; PMCID: PMC8187834.
Q.
Numbness or Weakness? What is CIDP: Why Your Nerves Fail & Medically Approved Next Steps
A.
CIDP is a chronic autoimmune neuropathy in which your immune system attacks the myelin insulating peripheral nerves, slowing signals and causing progressive, often symmetric numbness and weakness over at least 8 weeks; it is serious but very treatable when found early. Next steps include prompt evaluation by a doctor and referral to a neurologist for a focused exam, nerve conduction studies and possibly a lumbar puncture, with evidence-based treatments such as corticosteroids, IVIG, or plasma exchange, and urgent care if weakness rapidly worsens or if breathing or swallowing are affected. There are several factors to consider, and complete guidance on tests, treatments, and red flags is provided below.
References:
* Van den Bergh PYK, van Doorn PA, Hadden RDM, Avau B, Viala K, Dalakas MC, et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint task force—Second revision. J Peripher Nerv Syst. 2021 Jun;26(2):174-200.
* Dyck PJ, Dyck PJB, Klein CJ. Chronic inflammatory demyelinating polyradiculoneuropathy: update on diagnosis and treatment. Curr Opin Neurol. 2020 Oct;33(5):549-556.
* Hsieh ST, Chiu YH, Chen C, Chang SC, Lin KP. Chronic inflammatory demyelinating polyradiculoneuropathy: current concepts and treatment. J Biomed Sci. 2021 May 26;28(1):42.
* Rajabally YA. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP): A Comprehensive Review of Pathophysiology, Diagnosis, and Treatment. Cells. 2020 Nov 16;9(11):2478.
* Donofrio PD. Update on Pathogenesis, Diagnosis, and Treatment of Chronic Inflammatory Demyelinating Polyneuropathy. Curr Neurol Neurosci Rep. 2022 Mar;22(3):141-152.
Q.
Celecoxib After 65: Balancing Heart & Joint Health
A.
For adults over 65, celecoxib can ease arthritis pain and improve function, often with fewer stomach issues than older NSAIDs, but it requires balancing potential risks to the heart, kidneys, and gut. There are several factors to consider, including using the lowest effective dose for the shortest time, monitoring blood pressure and kidney function, avoiding risky drug interactions, knowing who should not take it, and considering alternatives. See the complete guidance below for benefits, precautions, red flags, and next steps to discuss with your clinician.
References:
* Nissen SE, et al. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. N Engl J Med. 2016 Dec 29;375(25):2519-2529. doi: 10.1056/NEJMoa1613493. Epub 2016 Nov 13. PMID: 27959716.
* Castellsague J, et al. Cardiovascular and gastrointestinal safety of celecoxib versus diclofenac in a population-based study of patients with osteoarthritis. Br J Clin Pharmacol. 2021 Aug;87(8):3211-3224. doi: 10.1111/bcp.14781. Epub 2021 Apr 22. PMID: 33765108.
* Rinde LB, et al. The Cardiovascular Safety of NSAIDs in Patients with Comorbidities: A Systematic Review. Drug Saf. 2021 Jun;44(6):627-649. doi: 10.1007/s40264-021-01064-0. Epub 2021 Mar 13. PMID: 33713386.
* Singh G, et al. Meta-analysis of celecoxib versus placebo in patients with symptomatic osteoarthritis. BMC Musculoskelet Disord. 2021 Sep 14;22(1):795. doi: 10.1186/s12891-021-04666-6. PMID: 34521404; PMCID: PMC8439169.
* Bjarnason I, et al. Risk of serious GI and CV events with celecoxib and diclofenac in patients with osteoarthritis: A meta-analysis. Arthritis Res Ther. 2020 Feb 28;22(1):47. doi: 10.1186/s13075-020-2139-4. PMID: 32106961; PMCID: PMC7048749.
Q.
Celecoxib for Women: Relief for Chronic Inflammation
A.
Celecoxib is a COX-2 NSAID that can ease chronic inflammatory pain in women from osteoarthritis, rheumatoid arthritis, musculoskeletal issues, and some menstrual-related conditions, often with less stomach irritation than older NSAIDs; however, it still carries risks such as cardiovascular events, high blood pressure, kidney problems, and drug interactions, plus pregnancy and breastfeeding considerations, so it should be used at the lowest effective dose under medical guidance. There are several factors to consider. See below to understand more.
References:
* Wang H, Zhao T, Xu C, et al. Celecoxib for the treatment of endometriosis: current evidence and future perspectives. J Pain Res. 2022;15:2361-2374.
* Rabe K, Hachulla L, Hachulla E. Celecoxib for the management of pain and inflammation in osteoarthritis: a systematic review and meta-analysis. Ther Adv Musculoskelet Dis. 2018;10(10):197-208.
* Iacovides S, Avidon I, Bentley J, et al. Pharmacological treatment of primary dysmenorrhoea: a comprehensive review. BJOG. 2020;127(9):1063-1076.
* Ahmad S, Ahmad N, Khan MA. COX-2 Selective Nonsteroidal Anti-inflammatory Drugs: A Narrative Review. Pain Res Manag. 2021;2021:6677940.
* Somigliana E, Viganò P, Filippi F, et al. Medical management of endometriosis: a systematic review. Hum Reprod Update. 2021;27(1):89-114.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Kuwabara S, Misawa S. Chronic Inflammatory Demyelinating Polyneuropathy. Adv Exp Med Biol. 2019;1190:333-343. doi: 10.1007/978-981-32-9636-7_21. PMID: 31760654.
https://link.springer.com/chapter/10.1007/978-981-32-9636-7_21Lehmann HC, Burke D, Kuwabara S. Chronic inflammatory demyelinating polyneuropathy: update on diagnosis, immunopathogenesis and treatment. J Neurol Neurosurg Psychiatry. 2019 Sep;90(9):981-987. doi: 10.1136/jnnp-2019-320314. Epub 2019 Apr 16. PMID: 30992333.
https://jnnp.bmj.com/content/90/9/981Rodríguez Y, Vatti N, Ramírez-Santana C, Chang C, Mancera-Páez O, Gershwin ME, Anaya JM. Chronic inflammatory demyelinating polyneuropathy as an autoimmune disease. J Autoimmun. 2019 Aug;102:8-37. doi: 10.1016/j.jaut.2019.04.021. Epub 2019 May 6. PMID: 31072742.
https://www.sciencedirect.com/science/article/abs/pii/S0896841119300435?via%3DihubMuley SA, Jacobsen B, Parry G, Usman U, Ortega E, Walk D, Allen J, Pasnoor M, Varon M, Dimachkie MM. Muscle Nerve. 2020 May;61(5):575-579. doi: 10.1002/mus.26804. Epub 2020 Jan 21. PMID: 31922613.
https://onlinelibrary.wiley.com/doi/10.1002/mus.26804