Peripheral Neuropathy – Symptoms and Causes

Overview

Peripheral neuropathy is a condition that affects nerves outside the brain and spinal cord. These nerves, called peripheral nerves, help transmit information between the central nervous system and the rest of the body.

When damaged, they can cause several uncomfortable symptoms.

People with this condition often experience:

• Numbness
• Weakness
• Pain (described as stabbing, burning, or tingling)
• Problems with bodily functions like digestion or urination

The damage typically affects the hands and feet first, but can spread to other areas.

Several factors can lead to peripheral neuropathy:

Causes	Examples
Injuries	Traumatic damage to nerves
Infections	Various bacterial or viral infections
Metabolic issues	Diabetes (most common cause)
Inherited conditions	Genetic disorders affecting nerves
Toxin exposure	Chemicals, medications, alcohol

For some people, symptoms may improve if the underlying cause can be treated. Pain management medications are available to help reduce discomfort when needed. Treatment approaches vary based on the specific cause and severity of the condition.

Signs and Symptoms

Peripheral nerves each have specific roles in your body. The symptoms you might feel depend on which type of nerves are affected. Your nervous system includes:

• Sensory nerves that detect feelings like pain, touch, temperature, and vibration.
• Motor nerves that help control your muscle movements.
• Autonomic nerves that manage automatic functions like heart rate, blood pressure, and digestion.

People with peripheral neuropathy often notice:

• Numbness, tingling, or prickling feelings that start in hands or feet and may spread up arms and legs
• Sharp, burning, or throbbing pain
• Being very sensitive to touch
• Pain from normal activities, such as feet hurting when you stand or when covered by blankets
• Poor balance and falling
• Weak muscles
• Feeling like you’re wearing socks or gloves when you’re not
• Trouble moving if motor nerves are affected

If the condition affects your autonomic nerves, you might experience:

• Difficulty handling heat
• Sweating too much or too little
• Problems with digestion, bladder, or bowels
• Dizziness when standing due to blood pressure drops

Peripheral neuropathy can affect one nerve (mononeuropathy), two or more nerves in different areas (multiple mononeuropathy), or many nerves (polyneuropathy). Most people have polyneuropathy, though some conditions like carpal tunnel syndrome affect just one nerve.

When to Get Medical Help

Don’t wait to see a doctor if you notice unusual tingling, weakness, or pain in your hands or feet. Getting diagnosed and treated early gives you the best chance to control symptoms and prevent further nerve damage.

These symptoms can worsen over time without proper care, so prompt medical attention is important.

Causes

Peripheral neuropathy develops when nerves outside the brain and spinal cord become damaged. Several health conditions can lead to this nerve damage.

Diabetes and metabolic syndrome represent the most common cause of peripheral neuropathy. More than 50% of people with diabetes will develop some form of nerve damage over time.

Autoimmune diseases can attack nerve tissues, causing neuropathy. These include:

• Sjogren’s syndrome
• Lupus
• Rheumatoid arthritis
• Guillain-Barre syndrome
• Chronic inflammatory demyelinating polyneuropathy
• Vasculitis

Some immune system-related cancers can trigger a condition called paraneoplastic syndrome, which damages nerves.

Infections that may cause peripheral neuropathy include:

• Lyme disease
• Shingles
• Hepatitis B and C
• Leprosy
• Diphtheria
• HIV

Inherited disorders like Charcot-Marie-Tooth disease pass through family lines and cause nerve damage.

Tumors, both cancerous and non-cancerous, can grow on nerves or press against them, leading to neuropathy symptoms.

Bone marrow disorders affecting nerve function include:

• Monoclonal gammopathies (abnormal proteins in blood)
• Lymphoma
• Amyloidosis
• Certain forms of myeloma

Other health conditions that damage nerves include kidney disease, liver disease, and hypothyroidism (underactive thyroid).

Lifestyle and environmental factors can also cause peripheral neuropathy:

Cause	How It Affects Nerves
Alcohol use disorder	Poor nutrition and vitamin absorption
Toxic exposure	Industrial chemicals and heavy metals like lead or mercury
Medications	Certain drugs, especially cancer chemotherapy
Physical injury	Direct nerve damage from accidents or repetitive motions
Vitamin deficiencies	Low levels of B vitamins (B-1, B-6, B-12), vitamin E, or copper

Sometimes doctors cannot identify the underlying cause of peripheral neuropathy. This is called idiopathic peripheral neuropathy.

What Raises Your Risk

Several factors can increase your chance of developing peripheral neuropathy:

• Diabetes – Especially with poorly controlled blood sugar levels.
• Heavy alcohol use
• Vitamin deficiencies – Particularly low B-12 levels.
• Certain infections – Including Lyme disease, shingles, hepatitis B and C, and HIV.
• Autoimmune conditions – Such as rheumatoid arthritis and lupus.

Kidney, liver, or thyroid problems can lead to nerve damage. Exposure to toxic substances and repetitive movements at work might harm nerves over time.

Some people have a family history of neuropathy, which can make them more likely to develop this condition.

Complications

Peripheral neuropathy can lead to several serious problems if not managed properly:

• Skin Injuries and Burns: When parts of your body lose feeling, you might not notice harmful temperature changes or painful sensations. This can result in accidental burns or wounds, especially on the feet.
• Infections: Areas with reduced sensation can develop injuries without your knowledge. This is particularly dangerous for people with diabetes. To prevent infections:
  • Check numb areas daily
  • Wear properly fitting, closed-toe shoes
  • Treat small injuries promptly before they worsen
• Falling Hazards: Weakness and numbness often affect balance, increasing fall risk. You can reduce this danger by:
  • Installing bathroom handrails
  • Using walking aids when necessary
  • Ensuring adequate lighting in all rooms

Ways to Prevent Nerve Damage

Control Your Medical Conditions

The most effective way to prevent nerve damage in your limbs is to properly manage any health conditions that increase your risk. Keeping diseases like diabetes under control helps protect your nerves from harm.

Choose Healthy Habits

Several daily choices can help keep your nerves healthy:

• Eat a balanced diet. A diet with plenty of fruits, vegetables, whole grains, and lean proteins can support nerve health.
• Include vitamin B-12 sources. You can find vitamin B-12 in meat, fish, eggs, low-fat dairy, and fortified cereals.
• Consider supplements if you follow a vegetarian or vegan diet. (Talk to your doctor first.)

Aim for 30-60 minutes of activity at least three times weekly. Also, make sure to get approval from your healthcare provider.

Avoid harmful factors that might damage your nerves:

• Repetitive movements
• Toxic chemical exposure
• Smoking
• Excessive alcohol consumption

These simple preventive measures can significantly reduce your risk of developing nerve problems.