Peripheral neuropathy is a nerve disorder. It may cause numbness, tingling, and weakness. It can also cause pain. These symptoms usually start in the longest nerves in the body and so first affect the feet and later the hands. This is sometimes called the “stocking-glove” pattern. The symptoms usually spread slowly and evenly up the legs and arms. Other body parts might also be affected. Most people who develop peripheral neuropathy are over age 55. But people can be affected at any age.
Peripheral neuropathy has many forms and causes. Some of the causes are still unknown. The most common cause is diabetes. Other common causes include alcohol abuse, poor nutrition, autoimmune processes (where the body’s own immune system attacks parts of the nerves), and genes. Exposure to certain drugs or toxins can lead to neuropathy. Direct pressure or compression of a single nerve—like in carpal tunnel syndrome—may cause it to malfunction.
The early symptoms of peripheral neuropathy include:
Over the years, nerve damage may worsen. Later symptoms can include:
Most types of neuropathy develop and progress slowly. But some types come on quickly. For instance, with Guillain-Barré syndrome, a disorder in which the body’s immune system attacks the nerves, neuropathy symptoms appear suddenly and progress rapidly. Then they slowly get better as damaged nerves heal.
Peripheral neuropathy is often first recognized because of the characteristic symptoms. A physician will look for medical conditions associated with neuropathy or medications that commonly cause neuropathy. A neurologic examination can confirm the diagnosis. Sometimes electrical tests of the nerves and muscles (electromyography and nerve conduction studies) help to confirm and classify the neuropathy. More tests may be needed to determine the cause of the neuropathy. Sometimes a specific cause is not identified.
For most types of neuropathy, no treatment is available that can cure or modify the disease. In these cases, treatments are available for the symptoms of the disease, especially pain. Treatments include analgesics, antiepileptic medications, antidepressants, capsaicin, and lidocaine. Physical therapy can help with balance problems and safety issues. Assistive devices, such as canes or walkers, can also be useful.
For some types of neuropathy, treatments are available that can help control the disease or prevent further nerve damage. For people with neuropathy caused by diabetes, controlling blood sugar levels may prevent further nerve damage. Medications that alter the immune system can be used to treat autoimmune neuropathies. Identification of a treatable associated medical cause such as a vitamin deficiency or imbalance of thyroid hormone may arrest or partially reverse the neuropathy.
Exercise may reduce nerve pain and improve overall health and mood. Daily walking, housework, gardening, and other daily chores all count as exercise. Transcutaneous electric nerve stimulation, or TENS, can help reduce the pain for some people. A TENS unit is a portable device. The device sends an electrical current to electrodes attached to the skin.
Talk to your physician about which treatments may be best for you.
Lifestyle changes may also help relieve symptoms.
Living with neuropathy can affect many parts of your life. Many people find relief and support from individual or group counseling specifically focused on pain and related issues. Chronic pain support groups may also help.