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
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Many health conditions can cause peripheral neuropathy. The damage may the result of:
Health conditions that can damage peripheral nerves include:
Having certain health conditions may increase your chance of getting peripheral neuropathy.
Damage to the peripheral nerves often results in sensory and motor symptoms in the:
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.
Peripheral neuropathy may cause:
If untreated, peripheral neuropathy can lead to:
If you have motor or sensory neuropathy, you may also have autonomic neuropathy. This is associated with symptoms, such as:
The doctor will ask about your symptoms and medical history. A physical exam will be done. It may include examining:
Additional tests may also include:
Tests of your bodily fluids and tissues:
Evaluation of your nerves and muscles:
Imaging tests to evaluate nerves and other structures:
Your doctor may need to evaluate other family members for this condition.
Talk with your doctor about the best treatment plan for you. Options may include:
Treating the underlying illness can decrease symptoms or make them go away. For instance, if it is caused by diabetes, controlling blood sugar levels may help. In some cases, neuropathy caused by medications or toxins is completely reversed when these substances are stopped or avoided. Correction of vitamin B12 deficiency often improves symptoms.
Certain exercises may help stretch shortened or contracted muscles and increase joint flexibility. In long-standing cases, splinting the joint may be required to protect and rest it, while maintaining proper alignment.
Orthotics, such as supports and braces, may help with:
Maintaining physical activity is also important.
Prescription and over-the-counter pain medications are often used to ease discomfort. Botulinum toxin A injections may also be given to help reduce pain.
Medications used to treat depression and prevent convulsions can relieve neuropathy symptoms.
For severe and potentially life-threatening cases, such as Guillain-Barre syndrome, treatment includes:
These therapies are aimed at reducing symptoms:
Surgery can relieve the pressure on nerves. For example, surgeons commonly release fibrous bands in the wrist to treat carpal tunnel syndrome.
To help reduce your chance of peripheral neuropathy:
American Chronic Pain Association
The Neuropathy Association
Canadian Diabetes Association
Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. 2010;9(8):807-819.
Diabetic neuropathies: The nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/Diabetes/diabetic-neuropathies-nerve-damage-diabetes/Pages/diabetic-neuropathies-nerve-damage.aspx. Updated November 26, 2013. Accessed May 30, 2014.
Karlsson P, Møller AT, Jensen TS, Nyengaard JR. Epidermal nerve fiber length density estimation using global spatial sampling in healthy subjects and neuropathy patients. J Neuropathol Exp Neurol. 2013;72(3):186-193.
Peripheral neuropathy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T474253/Peripheral-neuropathy. Updated November 27, 2015. Accessed September 14, 2016.
10/5/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T474253/Peripheral-neuropathy: Feng Y, Schlösser FJ, Sumpio BE. The Semmes Weinstein monofilament examination as a screening tool for diabetic peripheral neuropathy. J Vasc Surg. 2009;50(3):675-682.
12/1/2016 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T474253/Peripheral-neuropathy: Attal N, de Andrade DC, et al. Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomized, double-blind, placebo-controlled trial. Lancet Neurol. 2016 May;15(6):555-565.
Last reviewed September 2016 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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