Peripheral Nerve Disease

Peripheral nerve disease, also known as peripheral neuropathy, happens when damage affects nerves outside the brain and spinal cord - usually in the limbs. This can cause weakness, numbness or pain, typically starting in the hands and feet. In some cases, it can also affect muscles in your arms or legs. People with peripheral neuropathy often describe the pain as stabbing, burning or tingling.

The peripheral nervous system includes three main types of nerves: motor nerves, sensory nerves and autonomic nerves. 

• Motor nerves carry instructions from the brain and spinal cord to control muscle movement. 
• Sensory nerves send information like touch, temperature and pain back to the brain.
• Autonomic nerves control automatic functions like your heartbeat and digestion.

These nerves create a communication highway between your brain, spinal cord and the rest of your body.

What are the symptoms of peripheral neuropathy?

When these nerves get damaged, depending on which types of nerves are affected, you may notice symptoms of peripheral neuropathy like:

• Numbness or tingling that often starts in the hands or feet and spreads to other areas
• Burning or shooting pain
• Muscle weakness 
• Loss of sensation
• Difficulty with walking because of decreased sensation or leg weakness
• In some cases, the autonomic nervous system is affected, leading to changes in sweating or blood pressure
• Difficulty with fine motor tasks, such as buttoning shirts or picking up small objects

Symptoms can be mild, moderate or severe. They can affect one or more nerves. If you notice any of these symptoms, contact a health care provider.

How is peripheral neuropathy categorized?

Peripheral neuropathy can be categorized in a few ways:

• Affected nerves: Motor nerves control muscles (which can cause weakness), sensory nerves transmit feeling (leading to tingling or numbness) and autonomic nerves manage automatic functions (which may affect digestion or blood pressure).
• Causes: Diabetes, infections and vitamin deficiencies are common causes. Some types are inherited, and sometimes the cause is unknown (idiopathic neuropathy).

What causes peripheral neuropathy?

Various health conditions can cause peripheral neuropathy, including:

• Diabetes and metabolic syndrome: The most common cause of peripheral neuropathy. More than half of people with diabetes will develop some type of neuropathy.
• Autoimmune diseases: Conditions like Sjogren's syndrome, lupus and rheumatoid arthritis where the immune system mistakenly attacks healthy tissues, including nerves.
• Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP): Specific autoimmune disorders that directly target the nerves.
• Vasculitis: Inflammation of blood vessels that can damage nerves by reducing blood flow.
• Paraneoplastic syndromes: Rare conditions where some cancers trigger autoimmune responses affecting the nerves.
• Inherited disorders: Some neuropathies are inherited, such as Charcot-Marie-Tooth disease.
• Other diseases: Metabolic conditions such as kidney disease, liver disease or hypothyroidism.

Who is at risk for peripheral neuropathy?

Peripheral neuropathy risk factors include:

• Diabetes, especially if your blood sugar levels are not well controlled
• Alcohol use disorder
• Low levels of vitamins, particularly vitamin B-12
• Kidney, liver or thyroid disorders
• Exposure to toxins
• Family history of neuropathy

If you are experiencing symptoms of peripheral neuropathy or think you may be at risk, talk with your health care provider. 

Learn more about how peripheral neuropathy is diagnosed and treated.