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5 Things You Should Know About Peripheral Neuropathy

At one time or another, you’ve probably had numbness and tingling in your hands and feet after sleeping with your arm folded under your head or sitting with your leg tucked up under your body. To resolve, you get up and hobble it off or shake out your limbs to get blood flowing back with no problem.

Slight loss of feeling or numbness in the hands, legs and feet is common, but if it occurs more frequently—and the way you sit or sleep isn’t the cause—it could be a sign of nerve damage known as peripheral neuropathy.

“Peripheral neuropathy is a common condition that affects the peripheral nervous system, the network of nerves that sends information from your brain and spinal cord (your central nervous system) to the rest of your body,” said John Sollenberger, DO, an orthopedic sports medicine physician with Banner – University Orthopedic and Sports Medicine Institute.

It’s estimated that more than 20 million Americans suffer from neuropathy. It can affect any person of any age, but some people may be more at risk.

If you’ve got an inkling (or a tingling feeling) that something isn’t right, read on to learn more about common types of peripheral neuropathy, its causes, symptoms and treatment options.

What is peripheral neuropathy?

The peripheral nervous system is a vast network of motor nerves, sensory nerves and autonomic nerves that connect the brain and the spinal cord to the entire body. These nerves control how you sense touch and feel pain and temperature. Your nerves also control coordination, how your muscles move and things that your body does without you thinking about it. For example, your autonomic nerves control your breathing, digestion, sweating and blood pressure.

If any of these nerves are damaged, it can make it harder for them to send and receive messages.

What causes peripheral neuropathy?

“Peripheral neuropathy can affect anyone at any age, people with diabetes that have poorly controlled blood sugar are at the greatest risk,” Dr. Sollenberger said. “This is because high blood sugar levels can damage the nerves, resulting in diabetic neuropathy or retinopathy.”

Other risk factors for peripheral neuropathy include:

  • Vitamin deficiencies (not enough vitamin B12 or folate)
  • Alcoholism or heavy alcohol use
  • Side effects of chemotherapy treatment and certain types of medications
  • Infections such as Lyme disease and hepatitis C
  • Thyroid disorders
  • Trauma or injury from a car accident, sports accident or medical procedure
  • Autoimmune disorders, such as lupus
  • Pressure on a nerve, such as a repetitive use injury like carpal tunnel syndrome
  • Inherited disorders, such as Charcot-Marie-Tooth disease, are types of neuropathy that run in families (hereditary)

Sometimes, however, it can be challenging to determine the cause. When health care providers can’t identify the cause of this condition, they call it idiopathic peripheral neuropathy.

What are the symptoms of peripheral neuropathy?

These nerves are vast, but they are also fragile. When these nerves suffer an injury, they can no longer perform like they did before.

The symptoms of peripheral neuropathy can vary, from mild to severe, depending on the different causes and which type of nerves (motor, sensory, autonomic or a combination) were affected. The main symptoms to watch out for include:

  • Numbness or tingling (“pins and needles” feeling)
  • Burning or freezing pain
  • Sharp, shooting pain in the limbs
  • Muscle weakness, cramping or twitching
  • Loss of balance and coordination
  • Difficulty walking
  • Abnormal blood pressure or pulse
  • Loss of sensation in body parts

“Symptoms can develop over days, weeks or years,” Dr. Sollenberger said. “In some cases, symptoms can improve on their own but others, if they’re left untreated, can lead to further damage to the nerves and your body.”

How is peripheral neuropathy diagnosed?

Your health care provider will use an array of methods, including full body exams, blood tests and electrodiagnostic testing (such as electromyography and nerve conduction studies). Imaging (such as an MRI and ultrasound) can rule out other possibilities. However, there are more than 100 different types of peripheral neuropathy.

“There are many different types of peripheral neuropathy, each with its own set of symptoms and prognosis,” Dr. Sollenberger said. “Your provider will likely need to collaborate with other specialists to diagnose your condition.”

How is peripheral neuropathy treated?

“Although there is no definitive cure, there are things you can do to manage and improve your condition,” he said.

Some treatment options include the following:

  • Medications: Evidence-based oral “neuropathic” medications, such as antidepressants, anti-seizure medications, pain relievers and topical creams can help improve neuropathic pain symptoms.
  • Therapies: There are various therapies and procedures that might help ease signs and symptoms, including the use of a transcutaneous electrical nerve stimulation (TENS unit), plasma exchange and physical therapy.
    “Movement-based therapies can assist with improved circulation, muscle strength, stamina and balance,” Dr. Sollenberger said. “All of which helps with reactivating and improving peripheral nerve function and pain control.
  • Good foot care: “Any time there is impaired sensation to a body region, tissue damage can occur without the patient’s recognition,” Dr. Sollenberger warned. Having peripheral neuropathy can put you at greater risk for developing blisters, small abrasions or cuts on your feet.
    You can step on a foreign body (e.g., glass, splinters or needle) and not be aware because of the loss of “protective” sensation in the area. This puts you at higher risk of infection or life-threatening systemic infection and/or amputation of the limb if not recognized early.
    “Good foot care with daily foot inspections, including the bottom of the foot with use of a mirror can prevent such instances,” he added. “This is particularly important for those with diabetes.”
  • Surgery: In extreme cases, surgery can be used to destroy nerves or repair injuries that are causing pain or symptoms.
  • Alternative treatments: Your health care provider may suggest diet modifications, regular exercise and quitting the use of alcohol and tobacco.

“Ideally, the first line of treatment is prevention,” Dr. Sollenberger said. “Maintaining good blood sugar control if you’re diabetic and maintaining a healthy lifestyle with proper diet and exercise can help.”

Studies show that a low-fat diet full of whole grains, fruits and vegetables along with exercise can have a positive impact on neuropathy.

You may also benefit from acupuncture and taking certain vitamins and supplements, such as fish oil, alpha-lipoic acid and amino acids.

Can you prevent peripheral neuropathy?

Although some nerve pain and damage is the result of injury or surgery, in some cases neuropathy can be prevented – or at times slowed from spreading.

“The most important thing you can do to slow the progression of peripheral neuropathy is to see your health care provider if you’re experiencing any symptoms,” Dr. Sollenberger said.


Peripheral neuropathy is a type of damage to the peripheral nervous system and can affect one nerve or nerve type or a combination of nerves. It has many causes, but diabetes is the most common.

The good news is that there are several treatments for peripheral neuropathy, which can help improve your symptoms and slow the progression of the condition. If you think you might have peripheral neuropathy, talk with your health care provider to discuss your symptoms and potential treatment.

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