Condition Basics

What is peripheral neuropathy?

Peripheral neuropathy is a problem that affects the peripheral nerves. These are the nerves that lead from the spinal cord to other parts of the body. These nerves control your sense of touch, how you feel pain and temperature, and your muscle strength. Most of the time the problem starts in the fingers and toes. As it gets worse, it moves into the limbs, causing pain and loss of feeling in the feet, legs, and hands.

When you have peripheral neuropathy, you may have less feeling in your fingers and toes. You may have trouble with your balance. It may be hard to do things that require coordination, such as walking or fastening buttons.

What causes it?

Doctors don't always know what causes peripheral neuropathy. It is often caused by other health problems. It can also run in families.

The most common cause is diabetes. Having your blood sugar too high for too long a time can damage the nerves.

Other problems can also cause peripheral neuropathy, such as:

Kidney problems.

These can lead to toxic substances in the blood that damage nerves.

Vitamin deficiencies and alcohol use disorder.

Not getting enough nutrients, such as vitamin B-12, can damage nerves. Overuse of alcohol and not eating a healthy diet can lead to these vitamin deficiencies.

Infectious or inflammatory diseases.

Diseases, such as HIV or Guillain-Barré syndrome, can damage the central and peripheral nerves.

Exposure to toxic substances.

Arsenic and certain medicines, such as those used for chemotherapy, can damage nerves.

What are the symptoms?

Symptoms of peripheral neuropathy can occur slowly over time. The most common ones are:

• Numbness, tightness, and tingling, especially in the legs, hands, and feet.
• Loss of feeling.
• Burning, shooting, or stabbing pain in the legs, hands, and feet. Often the pain is worse at night.
• Weakness and loss of balance.

How is it diagnosed?

To diagnose peripheral neuropathy, your doctor will ask you about:

• Your symptoms.
• Your medical history. This may include your use of alcohol, risk of HIV infection, or exposure to toxic substances.
• Your family's medical history, including nerve disease.

Your doctor will check your nerves. The doctor may check your muscle strength and ability to feel touch, temperature, and pain.

Sometimes nerve tests are needed. These include electromyography and nerve conduction tests.

You may also have blood tests. These tests will help the doctor find out if you have conditions that can cause neuropathy. Examples are diabetes, vitamin deficiencies, thyroid disease, and kidney problems.

How is it treated?

Treatment for peripheral neuropathy can relieve symptoms. This is done by treating the health problem that's causing it. For example, if you have diabetes, keeping your blood sugar within your target range may help. Or maybe your body lacks certain vitamins caused by drinking too much alcohol. In that case, treatment may include eating a healthy diet, taking vitamins, and stopping alcohol use.

You may have physiotherapy. This can increase muscle strength and help build muscle control. Over-the-counter medicine can relieve mild nerve pain. Your doctor may also prescribe medicine to help with severe pain, numbness, tingling, and weakness. If you have neuropathy in your feet, it's a good idea to have them checked during each office visit. This can help prevent problems.

Some people find that physiotherapy, acupuncture, or transcutaneous electrical nerve stimulation (TENS) helps relieve pain.

How can you care for yourself?

Adopting healthy habits can reduce the effects of peripheral neuropathy. Be sure to eat a healthy diet, get regular exercise, avoid alcohol, and quit smoking.

It's also a good idea to take care to avoid injury.

• When your feet or legs feel numb, it's easier to lose your balance and fall. At home:
  • Remove throw rugs and clutter.
  • Install sturdy handrails on stairways.
  • Put grab bars near your shower, bathtub, and toilet.
  • Use a cane or walker if needed.
  • Use night-lights to help you see better.
• To protect your hands:
  • Use pot holders, and avoid hot water when you are cooking.
  • Always check your bath or shower using a part of your body that can feel temperature normally, such as your elbow.
• Check your feet every day (or have someone else check for you):
  • Look at all areas of your feet, including your toes.
  • Use a hand-held mirror or a magnifying mirror attached to the bathroom wall near the baseboard to inspect your feet.