Peripheral neuropathy occurs when nerves outside the brain and spinal cord become damaged or do not function properly. It commonly affects the hands and feet and may cause numbness, tingling, burning pain, weakness or increased sensitivity to touch.
Diabetes is one of the common causes of peripheral neuropathy, but nerve damage can also result from nutritional deficiencies, autoimmune conditions, infections, certain medicines, toxins, inherited disorders and other medical conditions.
Treatment depends on the underlying cause, type of nerve involvement and severity of symptoms. A detailed neurological evaluation can help identify the possible cause and guide an individualized treatment plan.
Peripheral neuropathy refers to damage or dysfunction of nerves outside the brain and spinal cord.
Peripheral nerves carry information between the brain, spinal cord and the rest of the body. Depending on which nerves are affected, neuropathy can cause problems with sensation, movement or certain automatic body functions.
Sensory nerve involvement may cause numbness, tingling, burning or pain. Motor nerve involvement can result in muscle weakness or difficulty with movement. In some cases, autonomic nerve involvement may affect functions such as sweating, blood pressure, digestion or bladder function.
The symptoms and progression can vary considerably between patients, making accurate evaluation important.
Symptoms depend on the type and location of the affected nerves.
Common symptoms include:
Some patients may also develop symptoms related to autonomic nerve involvement, such as changes in sweating, blood pressure or digestion.
Peripheral neuropathy has many possible causes.
Diabetes is one of the most common causes of peripheral neuropathy. Persistently elevated blood sugar can damage nerves over time.
Deficiencies of certain vitamins, including vitamin B12, can contribute to nerve problems.
Certain autoimmune disorders can cause inflammation or damage affecting peripheral nerves.
Some infections can affect peripheral nerves and lead to neuropathy.
Certain medicines, including some chemotherapy drugs, and exposure to certain toxic substances can cause nerve damage.
Some peripheral neuropathies are associated with inherited neurological conditions.
Physical injury, pressure or compression of a nerve can also produce peripheral nerve symptoms.
In some patients, a specific cause cannot be identified despite appropriate evaluation.
Diabetic peripheral neuropathy is nerve damage associated with diabetes and commonly affects the feet and legs, although the hands and other areas can also be affected.
Symptoms may include:
Good blood sugar management is an important part of reducing the risk of progression of diabetic neuropathy.
Patients with reduced sensation in their feet should also pay attention to foot care because injuries may be less noticeable.
A neurological evaluation may be appropriate if you experience:
Early evaluation can help identify potentially treatable causes and guide appropriate management.
Diagnosis begins with a detailed medical history and neurological examination. Additional tests may be recommended depending on the symptoms and suspected cause.
The evaluation may include:
The examination may assess:
Blood tests may help identify conditions associated with neuropathy, including diabetes, vitamin deficiencies, metabolic disorders and other possible causes.
A nerve conduction study measures how electrical signals travel through peripheral nerves.
It can provide information about nerve function and help identify the type and extent of nerve involvement.
EMG measures electrical activity in muscles and is commonly performed alongside nerve conduction studies when evaluating suspected nerve or muscle disorders.
Depending on the clinical situation, further tests such as MRI, autonomic testing or other specialized investigations may be considered.
Not every patient requires every test.
Treatment depends primarily on what is causing the neuropathy and which nerves are affected.
Treatment may involve:
The treatment plan is individualized according to the patient’s symptoms, diagnosis and overall health.
Neuropathic pain can feel burning, shooting, stabbing or electric-like.
Depending on the individual patient, doctors may consider medicines specifically used for neuropathic pain.
Treatment selection depends on:
Patients should take prescription medicines only as directed by their healthcare professional.
Peripheral neuropathy can sometimes cause muscle weakness, walking difficulties or balance problems.
Physical therapy may help with:
Assistive devices or braces may sometimes be recommended when necessary.
Reduced sensation in the feet can make it difficult to notice cuts, blisters, burns or pressure injuries.
Good foot care is particularly important for people with diabetes-related neuropathy.
Recommended measures may include:
The outcome depends on the underlying cause and extent of nerve damage.
Some neuropathies may improve when the underlying cause is identified and treated. In other cases, treatment focuses on controlling symptoms, preventing further nerve damage and maintaining function.
Early identification of a treatable cause can therefore be important.
Your symptoms, medical history and possible causes are reviewed.
Strength, reflexes, sensation, coordination and balance may be assessed.
Blood tests, EMG, nerve conduction studies or imaging may be recommended depending on the clinical findings.
The evaluation focuses on determining whether diabetes, nutritional deficiency, medication, autoimmune disease, nerve compression or another condition may be contributing.
Treatment is planned according to the underlying cause, symptoms and overall health.
Follow-up helps monitor symptoms, treatment response and progression.
Long-term management depends on the underlying cause.
Helpful measures may include:
The cost of peripheral neuropathy evaluation and treatment varies depending on the patient’s symptoms, underlying cause and investigations required.
Factors may include:
An accurate estimate depends on the individual treatment requirements.
Peripheral neuropathy occurs when nerves outside the brain and spinal cord are damaged or affected. It commonly causes numbness, tingling, pain or weakness in the hands and feet.
Common symptoms include numbness, tingling, burning pain, increased sensitivity, muscle weakness and balance or walking difficulties.
Yes. Diabetes is one of the most common causes of peripheral neuropathy. Good blood sugar management can help reduce the risk of nerve damage progressing.
Diagnosis may involve a neurological examination, blood tests, EMG and nerve conduction studies. Additional tests may be recommended depending on the suspected cause.
Treatment focuses on addressing the underlying cause and managing symptoms. Depending on the cause, treatment may include medication, physical therapy and management of associated medical conditions.
Some forms may improve when the underlying cause is identified and treated, while other forms require long-term symptom management and prevention of further nerve damage.
