What is Peripheral Neuropathy

Peripheral neuropathy is a type of nerve damage. It affects nerves that carry signals between the spinal cord and the arms, legs, and the rest of the body (peripheral nerves).

It does not affect nerves in the spinal cord or brain. In peripheral neuropathy, one nerve or a group of nerves may be damaged. Peripheral neuropathy is a broad category that includes many specific nerve disorders, like diabetic neuropathy, hereditary neuropathy, and carpal tunnel syndrome.

What are the causes?

This condition may be caused by:

• Diabetes. This is the most common cause of peripheral neuropathy.
• Nerve injury.
• Pressure or stress on a nerve that lasts a long time.
• Lack (deficiency) of B vitamins. This can result from alcoholism, poor diet, or a restricted diet.
• Infections.
• Autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus.
• Nerve diseases that are passed from parent to child (inherited).
• Some medicines, such as cancer medicines (chemotherapy).
• Poisonous (toxic) substances, such as lead and mercury.
• Too little blood flowing to the legs.
• Kidney disease.
• Thyroid disease.

In some cases, the cause of this condition is not known.

What are the signs or symptoms?

Symptoms of this condition depend on which of your nerves is damaged. Common symptoms include:

• Loss of feeling (numbness) in the feet, hands, or both.
• Tingling in the feet, hands, or both.
• Burning pain.
• Very sensitive skin.
• Weakness.
• Not being able to move a part of the body (paralysis).
• Muscle twitching.
• Clumsiness or poor coordination.
• Loss of balance.
• Not being able to control your bladder.
• Feeling dizzy.
• Sexual problems.

How is this diagnosed?

Diagnosing and finding the cause of peripheral neuropathy can be difficult. Your health care provider will take your medical history and do a physical exam. A neurological exam will also be done. This involves checking things that are affected by your brain, spinal cord, and nerves (nervous system). For example, your health care provider will check your reflexes, how you move, and what you can feel.

You may have other tests, such as:

• Blood tests.
• Electromyogram (EMG) and nerve conduction tests. These tests check nerve function and how well the nerves are controlling the muscles.
• Imaging tests, such as CT scans or MRI to rule out other causes of your symptoms.
• Removing a small piece of nerve to be examined in a lab (nerve biopsy). This is rare.
• Removing and examining a small amount of the fluid that surrounds the brain and spinal cord (lumbar puncture). This is rare.

How is this treated?

Treatment for this condition may involve:

• Treating the underlying cause of the neuropathy, such as diabetes, kidney disease, or vitamin deficiencies.
• Stopping medicines that can cause neuropathy, such as chemotherapy.
• Medicine to relieve pain. Medicines may include:
  • Prescription or over-the-counter pain medicine.
  • Antiseizure medicine.
  • Antidepressants.
  • Pain-relieving patches that are applied to painful areas of skin.
• Surgery to relieve pressure on a nerve or to destroy a nerve that is causing pain.
• Physical therapy to help improve movement and balance.
• Devices to help you move around (assistive devices).

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider. Do not take any other medicines without first asking your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Lifestyle

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. Smoking keeps blood from reaching damaged nerves. If you need help quitting, ask your health care provider.
• Avoid or limit alcohol. Too much alcohol can cause a vitamin B deficiency, and vitamin B is needed for healthy nerves.
• Eat a healthy diet. This includes:
  • Eating foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limiting foods that are high in fat and processed sugars, such as fried or sweet foods.

General instructions

• If you have diabetes, work closely with your health care provider to keep your blood sugar under control.
• If you have numbness in your feet:
  • Check every day for signs of injury or infection. Watch for redness, warmth, and swelling.
  • Wear padded socks and comfortable shoes. These help protect your feet.
• Develop a good support system. Living with peripheral neuropathy can be stressful. Consider talking with a mental health specialist or joining a support group.
• Use assistive devices and attend physical therapy as told by your health care provider. This may include using a walker or a cane.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have new signs or symptoms of peripheral neuropathy.
• You are struggling emotionally from dealing with peripheral neuropathy.
• Your pain is not well-controlled.

Get help right away if:

• You have an injury or infection that is not healing normally.
• You develop new weakness in an arm or leg.
• You fall frequently.

Summary

• Peripheral neuropathy is when the nerves in the arms, or legs are damaged, resulting in numbness, weakness, or pain.
• There are many causes of peripheral neuropathy, including diabetes, pinched nerves, vitamin deficiencies, autoimmune disease, and hereditary conditions.
• Diagnosing and finding the cause of peripheral neuropathy can be difficult. Your health care provider will take your medical history, do a physical exam, and do tests, including blood tests and nerve function tests.
• Treatment involves treating the underlying cause of the neuropathy and taking medicines to help control pain. Physical therapy and assistive devices may also help.