What is peripheral neuropathy?

Peripheral neuropathy is a problem that affects the peripheral nerves. These nerves lead from the spinal cord to other parts of the body. They control your sense of touch, how you feel pain and temperature, and your muscle strength.

Most of the time the problem starts in the fingers and toes. As it gets worse, it moves into the limbs. It can cause pain and loss of feeling in the feet, legs, and hands.

What causes it?

There are several causes of peripheral neuropathy:

• Diabetes. This is the most common cause. If your blood sugar is too high for too long, it can damage the nerves.
• Kidney problems. These can lead to toxic substances in the blood that damage nerves.
• Overusing alcohol and not eating a healthy diet. These can lead to your body not having enough of certain vitamins, such as vitamin B12. This can damage nerves.
• Infectious or inflammatory diseases. These include HIV and Guillain-Barré syndrome. These diseases can damage the nerves.
• Being exposed to toxic substances. These include certain medicines, such as those used for chemotherapy.
• Low levels of thyroid hormone (hypothyroidism).

Sometimes the cause is not known.

What are the symptoms?

Symptoms of peripheral neuropathy can occur slowly over time. The most common ones are:

• Numbness, tightness, and tingling, especially in the legs, hands, and feet.
• Loss of feeling.
• Burning, shooting, or stabbing pain in the legs, hands, and feet. Often the pain is worse at night.
• Weakness and loss of balance.

What can happen if you have it?

If peripheral neuropathy gets worse, it can lead to a complete lack of feeling in your hands or feet. This can make you more likely to injure them. It may lead to calluses and blisters. It can also lead to bone and joint problems, infection, and ulcers.

For instance, small, repeated injuries to the foot may lead to bigger problems. This can happen because you can't feel the injuries. Reduced feeling in the feet can also change your step, leading to bone or joint problems.

If untreated, foot problems can become so severe that the foot or lower leg may have to be amputated. But treatment can slow down peripheral neuropathy. And it's a good idea to take care to avoid injury.

How is it diagnosed?

To diagnose peripheral neuropathy, your doctor will ask you about:

• Your symptoms.
• Your medical history. This may include your use of alcohol, risk of HIV infection, or exposure to toxic substances.
• Your family's medical history, including nerve disease.

Your doctor will check your nerves. The doctor may check your muscle strength and ability to feel touch, temperature, and pain.

Sometimes nerve tests are needed. These include electromyography and nerve conduction tests.

You may also have blood tests. These tests will help the doctor find out if you have conditions that can cause neuropathy. Examples are diabetes, vitamin deficiencies, thyroid disease, and kidney problems.

How is it treated?

Treatment for peripheral neuropathy can relieve symptoms. This is done by treating the health problem that's causing it. For example, if you have diabetes, keeping your blood sugar within your target range may help. Or maybe your body lacks certain vitamins caused by drinking too much alcohol. In that case, treatment may include eating a healthy diet, taking vitamins, and stopping alcohol use.

You may have physiotherapy. This can increase muscle strength and help build muscle control. Over-the-counter medicine can relieve mild nerve pain. Your doctor may also prescribe medicine to help with severe pain, numbness, tingling, and weakness. If you have neuropathy in your feet, it's a good idea to have them checked during each office visit. This can help prevent problems.

Some people find that physiotherapy, acupuncture, or transcutaneous electrical nerve stimulation (TENS) helps relieve pain.