Peripheral Neuropathy

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What is peripheral neuropathy?

Peripheral neuropathy is a common condition caused by damage to the peripheral nerves of the nervous system. The peripheral nerves spread out from the brain via the spinal cord. The peripheral nerves relay nerve impulses and sensory information from the body to the spinal cord, where they are then carried to the brain. The peripheral nerves also carry motor signals for muscle movement and other functions from the brain and spinal cord to the rest of the body including the organs.

Damage to the peripheral nerves interferes with normal functioning of the peripheral nervous system. Typical symptoms include unusual or abnormal sensations of the extremities, which commonly occur in the feet. A wide variety of other symptoms can occur as well because there are many types of peripheral nerves with specialized functions that can be affected by peripheral neuropathy.

A very common cause of peripheral neuropathy (diabetic neuropathy) is diabetes. Peripheral neuropathy can also result from certain metabolic disorders, infections, malignancy, inflammation, vitamin deficiencies, toxins, inherited conditions, and other abnormal processes. The goal of the clinical evaluation is to identify the root cause for peripheral neuropathy.

Treatment of peripheral neuropathy involves diagnosing and treating the underlying disease, disorder or condition. Some conditions can be successfully treated and cured, while others may require more intensive treatment.

Complications of untreated peripheral neuropathy can be serious and include muscle wasting, paralysis, serious infections, and gangrene. Seek prompt medical care if you have symptoms of peripheral neuropathy, such as changes in sensation, difficulty moving, or other unusual symptoms. Prompt diagnosis and treatment of peripheral neuropathy and its underlying cause reduces the risk of permanent nerve damage and serious complications.

Some complications of peripheral neuropathy can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have chest pain, difficulty breathing, or a change in alertness or passing out.

What are the symptoms of peripheral neuropathy?

Peripheral neuropathy generally develops slowly over a period of months as peripheral nerves are progressively damaged. A wide variety of symptoms can occur because there are many types of peripheral nerves with specialized functions that can be affected by peripheral neuropathy.

Symptoms that affect the limbs

Peripheral neuropathy commonly affects the arms and legs. Symptoms include:

  • Abnormal muscle reflexes

  • Muscle twitching

  • Muscle weakness and atrophy (wasting of muscle tissue)

  • Poor control of muscles and body movement

  • Poor coordination

  • Sores or lesions that do not heal

  • Unusual sensations, such as pain, numbness, pins and needles, tingling, or prickling that begin in the feet. In later stages of peripheral neuropathy, the hands can be affected as well. In some cases, the abnormal sensations can extend to the arms, legs and trunk.

Other symptoms of peripheral neuropathy

Peripheral neuropathy can also affect the transmission of involuntary or partially voluntary nerve impulses from the brain and spinal cord to certain areas of the body, such as the bladder, intestine or stomach. These nerves are called autonomic nerves, and they carry signals that regulate bodily functions, such as sweating and blood pressure. Symptoms of autonomic neuropathy include:

  • Abdominal bloating

  • Blurred vision

  • Constipation or diarrhea

  • Drop in blood pressure, leading to dizziness and passing out

  • Heat intolerance due to impaired sweating

  • Impotence in men

  • Nausea and vomiting

  • Problems with swallowing

  • Problems with urination, such as incontinence and hesitancy with urination

Serious symptoms that might indicate a life-threatening condition

Over time peripheral neuropathy can lead to serious and possibly life-threatening complications, such as cardiac arrhythmias, a serious infection, or gangrene. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms:

What causes peripheral neuropathy?

Peripheral neuropathy is caused by damage to the peripheral nervous system. The peripheral nerves carry motor signals for muscle movement and other functions from the brain and spinal cord to the rest of the body. The peripheral nerves also relay nerve impulses and sensory information back to the central nervous system (spinal cord and brain).

Widespread nerve damage can result from certain metabolic disorders, infections, malignancy, inflammation, vitamin deficiencies, toxins, inherited conditions, and other abnormal processes. A common cause of neuropathy is diabetes. Uncontrolled diabetes causes high blood sugar levels that interfere with adequate blood flow to nerves over time. Peripheral neuropathy can also be caused by long-term pressure on a particular nerve or nerves due to such conditions as a tight cast, long surgical procedures, or carpal tunnel syndrome.

What are the risk factors for peripheral neuropathy?

A number of factors increase the risk for peripheral neuropathy. Risk factors include:

Reducing your risk of peripheral neuropathy

You can lower your risk of peripheral neuropathy and permanent nerve damage by :

  • Avoiding exposure to toxins, such as insecticides, lead, mercury, glues, solvents and arsenic

  • Following your treatment plan for diabetes, hypothyroidism, and other diseases and conditions that can cause peripheral neuropathy

  • Not drinking alcohol or limiting alcohol intake to one drink per day for women and two drinks per day for men

  • Taking frequent breaks and using proper techniques for repetitive activities that can cause pressure or compression of a nerve, such as keyboarding or using a jackhammer

  • Using proper technique when using crutches and notifying your health care provider if a cast is too tight or if other orthopedic devices cause discomfort

How is peripheral neuropathy treated?

Treatment plans for peripheral neuropathy are individualized to the underlying cause, the presence of coexisting diseases and complications, the age of the patient, and other factors. Treatment generally involves a multifaceted plan that addresses the underlying cause of neuropathy, minimizes the pain and abnormal sensations, and reduces the risk of complications, such as gangrene. The ultimate goal is to help you achieve and maintain an independent and active life.

In addition to treating the underlying cause of peripheral neuropathy, treatment may include:

  • Medications to ease pain, inflammation, and other symptoms

  • Physical therapy and occupational therapy to maintain and increase strength and function

  • Surgery to relieve pressure on a nerve that is causing nerve damage

  • Walkers, canes, and other assistive devices, such as grab rails in the bathroom, to maintain independence and maximize safety

What are the possible complications of peripheral neuropathy?

Complications associated with peripheral neuropathy can be progressive and vary depending on the underlying cause. Untreated peripheral neuropathy can lead to serious complications. You can help minimize complications of peripheral neuropathy by following the treatment plan you and your health care provider design specifically for you. Complications of peripheral neuropathy include:

  • Cardiac arrhythmias

  • Choking due to problems with swallowing

  • Difficulty breathing

  • Falls

  • Gangrene and amputation

  • Impotence

  • Incontinence of urine and feces

  • Passing out

  • Permanent loss of nerve function

  • Poor healing and infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 30
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. About Peripheral Neuropathy: Facts. The Neuropathy Association. http://www.neuropathy.org/site/PageServer?pagename=About_Facts
  2. Peripheral Neuropathy. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000593.htm
  3. Peripheral Neuropathy. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001619/
  4. Peripheral Neuropathy Fact Sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm
  5. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.
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