Peripheral Neuropathy

Peripheral neuropathy is a condition in which the peripheral nerves are damaged.

While peripheral neuropathy can affect the peripheral nerves anywhere in the body, the hands and feet are most often affected. The peripheral nerves are responsible for sending messages throughout the body that originate in the central nervous system.



There is not a single cause of this condition. Several conditions or factors might play a role. The following are possible peripheral neuropathy causes:
  • Autoimmune diseases, such as lupus, Sjogren’s syndrome, or rheumatoid arthritis
  • Toxin exposure
  • Infections, including bacterial and viral types
  • Pressure on the peripheral nerves or trauma
  • Vitamin deficiencies, especially B vitamins, niacin, and vitamin E
  • Alcoholism
  • Diabetes
  • Medications, such as those used for chemotherapy
  • Inherited disorders, such as Charcot-Marie-Tooth disease
  • Tumors that press on the peripheral nerves or develop on these nerves
  • Bone marrow disorders
  • Certain other health issues, such as liver disease, hypothyroidism, kidney disease, or connective tissue disorders
In addition to the possible causes, there are also risk factors that can increase a person’s chances of developing this condition. These factors include a family history of the condition and repetitive motion. In some cases, the cause of this condition is not identified. In these instances, the peripheral neuropathy is considered idiopathic.

The different nerves that are part of the peripheral nervous system all have their own functions. The symptoms that a patient experiences depends on which nerves are damaged. The following symptoms are possible:

  • Jabbing, freezing, burning, sharp, or throbbing pain
  • Falling and reduced coordination
  • Numbness that comes on gradually
  • The tingling and numbness can start in the foot and move up the leg
  • Extreme sensitivity to touch
  • If motor nerves are affected, people may experience muscle paralysis or weakness

When this condition is not maintained, there is the risk for complications including:

  • Infection: This condition can reduce sensation in the feet which can result in minor injuries not being noticed until they become infected
  • Skin trauma or burns: Numbness increases the risk of these issues on the feet and ankles
  • Falls: Sensation loss and weakness can make it harder to maintain proper balance when walking

Since medical conditions and certain medications are a common cause of peripheral neuropathy, it is common to start the diagnostic process with a medical history. This will let the doctor see if the patient has a condition that is associated with this disorder. After this, the doctor might perform a physical examination, paying close attention to the feet or other area affected by this condition.

A neurological examination allows the doctor to better assess the patient’s nerve functioning. This testing may include evaluating the patient’s muscle tone and strength, coordination, tendon reflexes, posture, and ability to detect sensations. Other tests might include:

  • Imaging tests
  • Nerve biopsy
  • Blood testing
  • Nerve function testing
  • Skin biopsy

It is important that the underlying condition be managed to reduce the risk of peripheral neuropathy becoming worse. To help alleviate a patient’s symptoms, the following medications might be recommended:

  • Antiseizure medications to help alleviate pain. Examples include pregabalin and gabapentin.
  • Antidepressants to help reduce a person’s pain. Examples include tricyclic antidepressants, such as doxepin, amitriptyline and nortriptyline.
  • Pain relievers may be considered. These could be over-the-counter choices such as acetaminophen or ibuprofen.
  • Topical treatments may help to reduce pain. Capsaicin cream is a common choice.

There are certain treatments that might be considered for people with peripheral neuropathy. These may include:

  • Intravenous immune globulin and plasma exchange
  • Surgery
  • Transcutaneous electrical nerve stimulation
  • Physical therapy

The best way to reduce the risk of developing this condition is to make sure that your general health is maintained. For example, if you have diabetes, maintaining good blood sugar control can reduce the risk of peripheral neuropathy. Other preventative measures include:

  • Exercise regularly
  • Eat a diet that incorporates plenty of vegetables, leans proteins, fruits and whole grains
  • Avoid doing things that can contribute to nerve damage, such as cramped positions, smoking, repetitive motions, exposure to toxic chemicals, and drinking too much alcohol
  • Get enough vitamin B12 to help protect nerve health

If you suspect that you may have peripheral neuropathy, you should talk to their doctor. As the condition progresses, it can make it hard to walk or increase the risk of infection in the foot. Proper management can help people to take better care of the affected areas.

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