Peripheral neuropathy

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What is peripheral neuropathy?

Peripheral neuropathy is when there is damage to the peripheral nerves. These are the nerves away from the centre of your body, such as those in the hands and feet.

There are 3 types of nerves:

sensory nerves carry signals about touch, taste, sight, hearing and smell
motor nerves carry signals to help you move
autonomic nerves carry signals to help with balance, sweating, digestion and many of the things you do without thinking

Peripheral neuropathy usually affects the sensory nerves in your hands, feet, arms or legs. Some people find it affects only a small part of their body, like a finger or a toe.

But the autonomic nerves and motor nerves can also be damaged.

What are the symptoms of peripheral neuropathy?

Common symptoms of peripheral neuropathy include:

pain
pins and needles
numbness
tingling
a burning sensation
aching, cramps and weakness

Symptoms can be mild or severe. Symptoms often begin in the toes and fingertips and move up towards the knees and elbows. Symptoms are often worse at night.

What causes peripheral neuropathy?

The most common cause of peripheral neuropathy is diabetes, either type I diabetes or type 2 diabetes. This is called diabetic neuropathy.

Other causes of peripheral neuropathy include:

heavy alcohol use over a long time
damage to the nerves caused by injury, surgery or repetitive actions
low levels of vitamin B12 and other vitamins
an underactive thyroid gland
infections such as lyme disease, shingles, diphtheria and HIV
chronic liver disease or kidney disease
some cancers
autoimmune diseases such as rheumatoid arthritis, lupus, vasculitis and Guillain-Barre syndrome
inherited disorders
some medicines, especially those used to treat cancer (chemotherapy)
toxins such as lead, mercury and arsenic

When should I see my doctor?

Call your doctor if you have:

weakness and numbness in your hands and feet
unusual tingling in your hands and feet
pain or a feeling of burning in your hands and feet

How is peripheral neuropathy diagnosed?

Your doctor will:

Discuss your symptoms with you and examine you.
They might recommend some blood tests to check for things like diabetes or vitamin deficiency.
Your doctor might also refer you to a specialist doctor.

How is peripheral neuropathy treated?

The type of treatment will depend on what is causing the problem.

If you have a condition such as diabetes or a vitamin deficiency, your doctor will be advise you to have treatment for that condition.
Sometimes there might not be a clear cause.
Sometimes there might be a cause but no specific treatment.

If a cause cannot be found, then your doctor will aim to treat the symptoms.

If you have mild pain from peripheral neuropathy, this can usually be controlled with simple pain relief medicines, such as paracetamol and ibuprofen. If you experience more severe pain, you should talk to your doctor about other forms of pain relief. These can include:

Pain medications used on the skin. These can be helpful for small painful areas. Capsaicin cream, which is made from a natural extract from chilli peppers may provide temporary pain relief.
Anti-epileptic medications
Certain anti-depressant medicines
Medications that help cramps or spasms
Acupuncture or massage such as reflexology

Techniques such as psychological therapy may also be required to help manage the pain.

Can peripheral neuropathy be prevented?

This depends on the cause. For example:

You can prevent or delay peripheral neuropathy due to diabetes by controlling the sugar levels in your blood.
You can prevent or delay peripheral neuropathy due to heavy alcohol use by reducing the amount of alcohol you drink.

Other neuropathies, such as hereditary neuropathy, cannot be prevented.