Peripheral Neuropathy

Peripheral neuropathy is a condition that results from damage to nerves, most commonly in the feet and lower legs. Nerve damage can also sometimes occur in the arms and hands or other places in the body.

With peripheral neuropathy, people lose sensation and experience weakness in the feet and legs, which can lead to balance problems and falls. Numb feet and hands are easy to injure and can become infected, so it is important to protect them and to look for injuries often.

Symptoms people typically experience with peripheral neuropathy are:

• Numbness, tingling, stabbing, burning, or pinprick sensations (most common)
• Muscle weakness
• Changes in skin color or temperature
• Changes in how much you sweat in some areas of the body

Contact your doctor if you have:

• Symptoms of peripheral neuropathy
• Consistent pain that does not get better with medicines prescribed
• Balance problems or falls
• An injury or infection in your feet

Besides those with diabetes, other at-risk groups are those who have:

• Poor blood flow to the legs
• An underactive thyroid gland
• Been exposed to toxic chemicals or heavy metals (such as lead)
• Had some types of infections (such as HIV/AIDS, hepatitis C, or shingles)
• Low levels of vitamin B1, B6, B12, or other vitamins
• Chronic diseases (such as metabolic or chronic kidney disease)
• Immune system diseases (such as rheumatoid arthritis or lupus)
• Tumors or bone marrow disorders
• Certain genetic (inherited) conditions

Your doctor will ask you about your symptoms and perform a physical examination.

You will likely have some blood work and other tests. More blood work might be ordered to determine a cause.

Your doctor may order these tests to determine the cause of your peripheral neuropathy or rule out other problems:

• A nerve conduction study, called electromyography (or EMG), which is a test that checks the health of the muscles and the nerves that control the muscles
• A magnetic resonance imaging test (or MRI), which uses a large magnet and radio waves to look at the brain or spine

Your doctor will work with you to treat any cause of peripheral neuropathy such as diabetes. In this case, controlling your blood sugar will help with the symptoms and keep the neuropathy from getting worse.

Painful sensations can be treated with many different medicines, but these usually do not make all pain go away. Medicines will likely improve your quality of life and increase the things you can do, but they will not erase all pain. Habit-forming pain medicines are not recommended for treatment of painful neuropathy unless other options have failed.

Balance problems or muscle weakness that could put you at risk for falls can be treated with physical therapy or by using a cane, walker, or other type of assistive equipment.

• The Foundation for Peripheral Neuropathy
• American Academy of Neurology
• American Diabetes Association
• Medline Plus