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The most common causes of peripheral neuropathy

If your nerves are damaged by a health condition or injury, it can lead to peripheral neuropathy. Peripheral neuropathy can manifest as numbness, pain or weakness in the feet, legs or hands.

What is peripheral neuropathy?

“Your peripheral nerves are located outside the brain and spine and run throughout the body,” says Tia Neely, M.D., a Piedmont family medicine physician. “Anything that damages the peripheral nerves can cause the nerves to send incorrect signals to the brain. And anything that disrupts the nerves’ ability to do their job and signal to the brain is considered neuropathy.”

What causes peripheral neuropathy?

Peripheral neuropathy can be caused by:

  • Uncontrolled diabetes (the most common cause)

  • Vitamin deficiencies, including vitamin B12 deficiency

  • Injury

  • Infections like shingles

  • Autoimmune diseases

  • Alcoholism

  • Chemotherapy

  • Carpal tunnel syndrome

  • Herniated disc

She has also seen patients who developed peripheral neuropathy after a significant COVID-19 infection and have no other underlying causes of neuropathy. She says more long-term research is needed to determine if this is a long COVID symptom and, if so, how long it persists.

Peripheral neuropathy symptoms

“The symptoms can differ from patient to patient,” says Dr. Neely. “Peripheral neuropathy typically affects the sensory nerves, which can cause skin sensations or numbness. It can also affect the motor nerves and cause weakness, though this is less common.”

Peripheral neuropathy symptoms can include the following skin sensations:

  • Pain

  • Burning

  • Tingling

  • Vibrating or crawling feeling

  • Temperature changes, such as feeling hot or cold

  • Numbness

It can also cause weakness in the body.

These symptoms most commonly affect the feet and legs, though neuropathy can also develop in the hands.

How is peripheral neuropathy diagnosed?

“We’ll make a diagnosis based solely on symptoms if a patient has diabetes and presents with burning and tingling in their feet,” says Dr. Neely. “If we’re uncertain of the cause, we can do diagnostic testing such as a nerve conduction study or electromyography (EMG) to determine if the nerves are functioning normally or not.”

How is neuropathy treated and managed? 

“Most often, we have to manage the underlying cause of neuropathy to prevent progression or to get a resolution of symptoms,” says Dr. Neely. “For many patients, it will become a chronic symptom we need to manage.”

Treatment options can include:

  • Pain medication, such as acetaminophen or ibuprofen  

  • Prescription medications used for seizure disorders, such as gabapentin or pregabalin, which can help calm irritated nerve endings

  • Compound creams with lidocaine or gabapentin

  • Capsaicin

  • Surgery to correct underlying causes like carpal tunnel syndrome or a herniated disc

What to do if you have peripheral neuropathy

If you have peripheral neuropathy, Dr. Neely recommends checking your feet regularly for sores or injuries you may not be able to feel. If you can’t see the bottoms of your feet, ask a family member or friend to check for you.

“People who don’t have normal sensation may have an injury and be unaware,” she says. “Some people have coordination issues because where you place your feet when walking is important for balance and fall prevention.”

Learn more about reducing your risk of falls.

How to reduce your risk of peripheral neuropathy

“The first thing I tell my patients with diabetes is that they can control their risk of neuropathy by controlling their blood sugar,” says Dr. Neely. “For people with alcoholism, discontinuing alcohol use and eating a healthy diet with plenty of vitamins and minerals can be helpful.”

If you drink frequently and think you may have alcohol-related neuropathy, talk to your doctor about the safest way to stop drinking.

She also says exercise can support nerve, muscle and joint health. And if you have peripheral neuropathy, regular exercise can improve your balance and mobility, reducing your risk of falls.

If you have symptoms of peripheral neuropathy, see your primary care provider. Need to make an appointment with a Piedmont physician? Save time, book online.

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