Peripheral Neuropathy

Peripheral neuropathy, sometimes called peripheral nerve disease, occurs when nerves outside the brain and spinal cord become damaged. These nerves connect your brain and spinal cord to the rest of your body, including your hands, feet, arms and legs. 

When these nerves are damaged, signals between the brain and body may not work properly. This can lead to numbness, tingling, burning pain or weakness, most often starting in the hands or feet. Some people also experience sharp, stabbing or electric-like pain. 

Peripheral neuropathy can affect how you move, feel sensations and control certain body functions. Symptoms may develop slowly over time or appear more suddenly depending on the cause. 

The peripheral nervous system includes three main types of nerves: 

Motor nerves 

Motor nerves carry signals from the brain and spinal cord to control muscle movement. Damage to these nerves can cause muscle weakness, cramps or difficulty moving parts of the body. 

Sensory nerves 

Sensory nerves send information about touch, temperature, vibration and pain back to the brain. When sensory nerves are damaged, people may experience numbness, tingling or burning sensations. 

Autonomic nerves 

Autonomic nerves control automatic functions such as heart rate, digestion, blood pressure and sweating. Damage to these nerves may lead to digestive problems, abnormal sweating or dizziness when standing. 

Together, these nerves form a communication network between your brain, spinal cord and the rest of your body. 

Symptoms of peripheral neuropathy 

Peripheral neuropathy symptoms depend on which nerves are affected and how severe the nerve damage is. Symptoms may start gradually and become worse over time. 

Common symptoms of peripheral neuropathy include: 

• Numbness or tingling that usually begins in the hands or feet 
• Burning, stabbing or shooting nerve pain 
• Increased sensitivity to touch 
• Muscle weakness in the arms or legs 
• Loss of sensation or reduced ability to feel temperature changes 
• Balance problems or difficulty walking 
• Difficulty with fine motor tasks such as buttoning clothing or picking up small objects 

If autonomic nerves are affected, symptoms may also include: 

• Changes in sweating 
• Digestive problems 
• Dizziness or lightheadedness due to blood pressure changes 

Symptoms can range from mild to severe and may affect a single nerve or multiple nerves. 

If you notice symptoms such as persistent numbness, tingling or nerve pain, talk with a health care provider. 

How peripheral neuropathy is categorized 

Peripheral neuropathy can be categorized in several ways depending on the type of nerve involved and the number of nerves affected. 

By the type of nerve affected 

• Motor neuropathy affects muscle movement and may cause weakness or muscle cramps. 
• Sensory neuropathy affects feeling and can cause numbness, tingling or burning pain. 
• Autonomic neuropathy affects involuntary body functions such as digestion, heart rate and blood pressure. 

By the number of nerves involved 

• Mononeuropathy affects a single nerve. 
• Polyneuropathy affects multiple nerves and is the most common type of peripheral neuropathy. 

By cause 

Peripheral neuropathy may develop because of an underlying health condition, infection, vitamin deficiency or inherited disorder. In some cases, the cause cannot be identified. This is called idiopathic neuropathy. 

Causes of peripheral neuropathy 

Many different health conditions can damage peripheral nerves. 

Common causes of peripheral neuropathy include: 

Diabetes and metabolic syndrome 

Diabetes is the most common cause of peripheral neuropathy. High blood sugar levels over time can damage nerves, especially in the feet and legs. 

Autoimmune diseases 

Conditions such as Sjogren’s syndrome, lupus and rheumatoid arthritis may cause the immune system to attack nerve tissue. 

Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) 

These autoimmune disorders cause inflammation that damages peripheral nerves. 

Vitamin deficiencies 

Low levels of vitamin B-12 and other B vitamins can damage nerves and lead to neuropathy. 

Infections 

Certain infections, including shingles, Lyme disease and HIV, can affect nerve function. 

Exposure to toxins or medications 

Heavy metals, toxins and certain medications, including some chemotherapy drugs, may damage peripheral nerves. 

Inherited disorders 

Some neuropathies are inherited, such as Charcot-Marie-Tooth disease. 

Other medical conditions 

Kidney disease, liver disease and hypothyroidism can also contribute to nerve damage. 

Who is at risk for peripheral neuropathy?

Several factors can increase the risk of developing peripheral neuropathy.

Risk factors include:

• Diabetes, especially if blood sugar levels are not well controlled
• Alcohol use disorder
• Vitamin deficiencies, particularly vitamin B-12
• Kidney, liver or thyroid disease
• Exposure to toxins or heavy metals
• Certain medications, including chemotherapy drugs
• Family history of neuropathy

If you have risk factors for nerve damage or are experiencing symptoms, talk with your health care provider.

Learn more about how peripheral neuropathy is diagnosed and treated and the treatment options available to help manage symptoms and improve your quality of life.