Peripheral Neuropathy
What is Peripheral Neuropathy?
Overview
Peripheral neuropathy refers to a disorder affecting the peripheral nervous system, which includes nerves outside the brain and spinal cord. It is characterized by damage or dysfunction of these peripheral nerves, leading to a variety of symptoms depending on the specific nerves involved.
Peripheral neuropathy is a broad term encompassing a wide range of conditions that occur when nerves in the arms and legs are damaged, irritated, and/or not working properly.
The peripheral nervous system consists of sensory, motor, and autonomic nerves. Sensory nerves transmit information such as touch, pain, and temperature from the body to the brain, allowing for sensory perception. Motor nerves, on the other hand, enable muscle movement by conveying signals from the brain and spinal cord to the muscles. Autonomic nerves regulate involuntary functions such as heart rate, blood pressure, digestion, and bladder control.
Who is Affected?
Peripheral neuropathy can affect people of all ages, but it is most common in older adults. Genetic predisposition, trauma, or exposure to toxins may also make some people more susceptible.
- People with diabetes: Diabetic neuropathy affects up to 50% of those with long-standing diabetes.
- Individuals with autoimmune or thyroid disorders: These can trigger nerve damage.
- Those undergoing chemotherapy: Certain cancer treatments cause neuropathy as a side effect.
- Individuals with vitamin deficiencies or alcohol use disorder: These factors increase risk.
Peripheral Neuropathy Symptomsrn& Causes
Symptoms
The symptoms of peripheral neuropathy are diverse and may include numbness, tingling, burning sensations, muscle weakness, muscle wasting, and changes in sensation or perception of touch, pain, or temperature. Depending on the specific nerves affected, these symptoms can manifest in a symmetrical or asymmetric pattern, involving the hands, feet, or other parts of the body. Neuropathic pain, described as a shooting or electric shock-like sensation, can also be a prominent feature of peripheral neuropathy.
Many patients experience other symptoms, which can include:
- Dizziness upon standing (Orthostatic hypotension)
- Weakness of the arms and legs
- Difficulty holding onto things
- Difficulty maintaining balance
Causes
There are numerous causes of peripheral neuropathies. Peripheral neuropathy can arise from various factors, including genetic disorders, metabolic abnormalities, infections, autoimmune conditions, exposure to toxins, trauma, and certain medications.
Diabetes mellitus is a common cause of peripheral neuropathy, known as diabetic neuropathy, and it affects a significant number of individuals with diabetes. In developed countries, diabetes and impaired glucose tolerance (or prediabetes) represent the most common cause. Often neuropathy is the first sign of prediabetes, and early control of blood sugar is the best way to improve neuropathy. The reduction of sugars later after development of neuropathy is less likely to improve neuropathy.
Other causes:
- Alcohol; even as little one drink a day increase the risk of neuropathy, and cessation of alcohol has been shown to improve nerve function
- Including medications (especially chemotherapy)
- Vitamin deficiencies (most commonly vitamin B12)
- Medical conditions (including over- or under-activity of the thyroid gland and autoimmune conditions such as Lupus)
Two other broad categories include autoimmune neuropathies, in which the immune system makes proteins (antibodies) that irritate nerves, and genetic neuropathies, in which there is usually a family history.
When to See a Doctor
Early evaluation can prevent further nerve damage and help manage symptoms effectively. Seek medical attention if you experience:
- Dizziness or fainting upon standing
- Persistent numbness or tingling in your hands or feet
- Sudden or progressive weakness in your arms or legs
- Balance problems or frequent falls
- Unexplained pain, especially burning or shooting pain
Peripheral Neuropathy Diagnosis
There are two stages in the process of diagnosing neuropathies.
The first is to determine if symptoms are indeed from a neuropathy. This includes a careful discussion of symptoms, one’s personal medical history and that of family members, and a review of current and prior medications.
We conduct a detailed physical exam, testing coordination, reflexes, strength, balance, and especially one’s ability to feel temperature, light touch, and other forms of sensation.
Secondly, based on the information gathered, physicians will probably order a number of tests, including blood work and, sometimes, nerve and muscle function tests called electromyograms and nerve conduction studies (EMG/NCS).
Radiculopathies and spinal stenosis (pinched nerves in the neck and back) can often present with similar symptoms. In these cases our specialists will likely also order imaging tests of the spine, usually magnetic resonance imaging (MRI).
Peripheral Neuropathy Treatmentrn& Outcomes
Treatment Options
- In many instances, an easily correctable cause can be found and remedied with a simple solution, such as supplementation for low vitamin levels.
- If diabetes is found, avoidance of sugars and simple carbohydrates (such as white bread and rice), increased exercise, and working with one’s primary doctor would be the treatment.
- Our neurologists can work with a number of specialists, including rheumatologists and endocrinologists to correct other medical conditions that predispose to neuropathy.
- There are some forms of neuropathy that can be treated with intravenous treatments, usually corticosteroids or intravenous immunoglobulin gamma (IVIG).
Regardless of the cause, physicians are also able to manage and treat the symptoms created by neuropathy.
For difficulty with hand control from neuropathy, occupational therapy can be helpful, and for balance trouble and leg weakness, physical therapy is recommended. In both instances, participation in the home exercises the therapist recommends is essential.
For treatment of neuropathy pain, there are a number of oral and topical medications that are effective and well established for relief. These have various combinations of additional benefits and/or side effects, so your physician can work with you on tailoring a plan that is best suited for your individual situation.
Patient Outcomes
With early diagnosis and treatment, many patients experience symptom relief and improved quality of life. While some neuropathies are reversible (e.g., from vitamin deficiencies or alcohol), others are chronic but manageable with appropriate care. Long-term outcomes depend on the underlying cause, how early treatment begins, and adherence to lifestyle changes.
Managing Peripheral Neuropathy
Our team provides guidance for day-to-day management and long-term monitoring to help you stay active and independent. Living with peripheral neuropathy requires:
- Regular follow-ups with your neurologist.
- Lifestyle adjustments, such as reducing alcohol, improving diet, and exercising.
- Preventive foot care to avoid injuries (especially in diabetic neuropathy).
- Engaging in home exercise programs to maintain balance and mobility.
Experience Compassionate, Expert Care
The specialists at the Pacific Brain Health Center in Santa Monica, California are trained experts ready to evaluate and treat you, helping you to stay involved with the activities and people who matter to you.
Learn More About Peripheral Neuropathy
Relief depends on treating the underlying cause, using medications for pain control, and participating in physical and occupational therapy.
In developed countries, diabetes and prediabetes are the leading causes.
It is a condition where nerves outside the brain and spinal cord are damaged, leading to pain, numbness, weakness, and other symptoms.
Some forms are reversible (e.g., from vitamin deficiency or alcohol), while others are chronic but can be managed with treatment.
Life expectancy depends on the underlying cause. Neuropathy itself isn’t fatal, but managing contributing conditions like diabetes is essential for long-term health.
Foot care, exercise, a balanced diet, and avoiding alcohol can help. Discuss home strategies with your neurologist before starting.
Resources
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At Pacific Neuroscience Institute, we provide personalized evaluation and treatment for all forms of peripheral neuropathy, using advanced diagnostics, evidence-based therapies, and a multidisciplinary approach.
Written and reviewed by:
The Pacific Neuroscience medical and editorial team
We are a highly specialized team of medical professionals with extensive neurological and cranial disorder knowledge, expertise and writing experience.
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