Peripheral neuropathy is damage to the peripheral nerves. These are the nerves that connect your spinal cord to the rest of your body.
Peripheral Nerves of the Foot
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Many health conditions can cause peripheral neuropathy. The damage may occur due to: Trauma
nerve compression or inflammation
Certain medications, such as chemotherapy treatments for cancerVitamin deficienciesHereditary syndromes
Exposure to toxins and heavy metals, such as
, or pesticides
Exposure to cold or radiationProlonged treatment in the intensive care unit
Health conditions that can damage peripheral nerves include: Type 1
Infections, such as
Autoimmune disorders, such as
rheumatoid arthritisAcute or chronic
demyelinating polyneuropathyPorphyriaParaneoplatic syndromes
Having certain health conditions may increase your chance of getting peripheral neuropathy.
Damage to the peripheral nerves often results in sensory and motor symptoms in the: ArmsLegsHandsFeet
Other parts of the body can also be affected. Symptoms depend on which nerves are involved. They can range from mild to severe and may seem worse at night. Sensations and pain may occur in the upper or lower limbs and move toward the trunk, such as from the feet to the calves.
Symptoms include: Numbness or reduced sensationTinglingPain, often a burning or sharp, cutting sensationSensitivity to touchMuscle twitchesMuscle weaknessDifficulty with walkingLoss of coordination or balanceParalysis
If untreated, peripheral neuropathy can lead to: Loss of reflexes and muscle controlMuscle atrophy—loss of muscle bulkFoot deformitiesInjuries to the feet that go unnoticed and become infected
If you have motor or sensory neuropathy, you may also have autonomic neuropathy. This is associated with symptoms such as: Problems regulating blood pressureConstipationErectile dysfunctionDifficulty breathing
The doctor will ask about your symptoms and medical history. A physical exam will be done. It may include examining: Muscle strengthReflexesBalanceCoordinationAbility to feel vibration, temperature, and light touchSemmes-Weinstein monofilaments test—measures sensation in the feet using a fine flexible wire
Additional tests may also include:
You may need to have tests of your bodily fluids and tissues. This can be done with:
Blood tests, such as glucose, vitamin B12 level, and thyroid function testsSerum/urine electrophoresisGenetic testingLumbar punctureNerve fiber density skin biopsy
Nerve or muscle
You may need to have your nerves and muscles tested. This can be done with:
Nerve conduction studies
You may need to have pictures taken of your bodily structures. This can be done with:
MRICT scanYour doctor may need to evaluate other family members for this condition.
Talk with your doctor about the best treatment plan for you. Options may include:
Treating the underlying illness can decrease symptoms or make them go away. For instance, if it is caused by diabetes, controlling blood sugar levels may help. In some cases, neuropathy caused by medications or toxins is completely reversed when these substances are stopped or avoided. Correction of vitamin B12 deficiency often improves symptoms.
Certain exercises may help stretch shortened or contracted muscles and increase joint flexibility. In long-standing cases, splinting the joint may be required to protect and rest it, while maintaining proper alignment.
Orthotics, such as supports and braces, may help with: DeformitiesBalance issuesMuscle weakness
Maintaining physical activity is also important.
Prescription and over-the-counter pain medications are often used to ease discomfort.
Medications used to treat
and prevent convulsions can
relieve neuropathy symptoms.
For severe and potentially life-threatening cases, such as
, treatment includes:
—done to exchange plasma in the blood
These therapies are aimed at reducing symptoms: Relaxation trainingBiofeedbackWalking
and other exerciseYogaWarm bathsMassageAcupunctureTranscutaneous electronic nerve stimulation
Surgery can relieve the pressure on nerves. For example, surgeons commonly release fibrous bands in the wrist to treat
carpal tunnel syndrome
To help reduce your chance of getting peripheral neuropathy, take these steps: Manage chronic medical conditions with the help of your doctor. If you have diabetes, make sure you have regular foot exams.
that is low in saturated fat and rich in whole grains, fruits, and vegetables.
Limit your alcohol intake to a moderate level. This means two or fewer drinks per day for men and one or fewer for women.Avoid
Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment.
Karlsson P, et al. Epidermal nerve fiber length density estimation using global spatial sampling in healthy subjects and neuropathy patients.
J Neuropathol Exp Neurol
. 2013 Mar;72(3):186-93.
10/5/2009 DynaMed's Systematic Literature Surveillance
: Feng Y, Schlösser FJ, Sumpio BE. The Semmes Weinstein monofilament examination as a screening tool for diabetic peripheral neuropathy.
J Vasc Surg
Last reviewed July 2013 by Rimas Lukas, MD; Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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