Peripheral Neuropathy

Peripheral neuropathy is damage to the peripheral nerves. These are the nerves that connect your spinal cord to the rest of your body.

  • Causes

    Many health conditions can cause peripheral neuropathy. The damage may occur due to:

    • Trauma
      from
      nerve compression or inflammation
    • Certain medications, such as chemotherapy treatments for cancer
    • Vitamin deficiencies
    • Hereditary syndromes

    • Exposure to toxins and heavy metals, such as
      lead,
      mercury, or pesticides
    • Exposure to cold or radiation
    • Prolonged treatment in the intensive care unit

    Health conditions that can damage peripheral nerves include:

    • Type 1
      or
      type 2
      diabetes

    • Infections, such as
      Lyme disease, HIV, tuberculosis, or leprosy

    • Chronic
      kidney failure
    • Alcoholism

    • Autoimmune disorders, such as
      rheumatoid arthritis
    • Acute or chronic
      demyelinating polyneuropathy
    • Porphyria
    • Paraneoplastic syndromes

  • Definition

    Peripheral neuropathy is damage to the peripheral nerves. These are the nerves that connect your spinal cord to the rest of your body.

    Peripheral Nerves of the Foot
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. It may include examining:

    • Muscle strength
    • Reflexes
    • Balance
    • Coordination
    • Ability to feel vibration, temperature, and light touch
    • Semmes-Weinstein monofilaments test—measures sensation in the feet using a fine flexible wire

    Additional tests may also include:


    • Tests of your bodily fluids and tissues. This can be done with:

      • Blood tests, such as glucose, vitamin B12 level, and thyroid function tests
      • Serum/urine electrophoresis
      • Genetic testing
      • Lumbar puncture
      • Nerve fiber density skin biopsy

      • Nerve or muscle
        biopsy

    • You may need to have your nerves and muscles tested. This can be done with:

      • Electromyography
        (EMG)
      • Nerve conduction studies
        (NCS)

    • You may need to have pictures taken of your bodily structures. This can be done with:

      • MRI scan
      • CT scan
    • Your doctor may need to evaluate other family members for this condition.

  • Prevention

    To help reduce your chance of getting peripheral neuropathy, take these steps:

    • Manage chronic medical conditions with the help of your doctor. If you have diabetes, make sure you have regular foot exams.

    • Eat a
      healthy diet
      that is low in saturated fat and rich in whole grains, fruits, and vegetables.
    • Limit your alcohol intake to a moderate level. This means two or fewer drinks per day for men and one or fewer for women.
    • Avoid

      toxic chemicals.

  • Risk Factors

    Having certain health conditions may increase your chance of getting peripheral neuropathy.

  • Symptoms

    Damage to the peripheral nerves often results in sensory and motor symptoms in the:

    • Arms
    • Legs
    • Hands
    • Feet

    Other parts of the body can also be affected. Symptoms depend on which nerves are involved. They can range from mild to severe and may seem worse at night. Sensations and pain may occur in the upper or lower limbs and move toward the trunk, such as from the feet to the calves.

    Symptoms include:

    • Numbness or reduced sensation
    • Tingling
    • Pain, often a burning or sharp, cutting sensation
    • Sensitivity to touch
    • Muscle twitches
    • Muscle weakness
    • Difficulty with walking
    • Loss of coordination or balance
    • Paralysis

    If untreated, peripheral neuropathy can lead to:

    • Loss of reflexes and muscle control
    • Muscle atrophy—loss of muscle bulk
    • Foot deformities
    • Injuries to the feet that go unnoticed and become infected

    If you have motor or sensory neuropathy, you may also have autonomic neuropathy. This is associated with symptoms such as:

    • Problems regulating blood pressure
    • Constipation
    • Erectile dysfunction
    • Difficulty breathing

  • Treatment

    Talk with your doctor about the best treatment plan for you. Options may include: