Menu

Primary Care
Internal Medicine
Our MissionOur Team
CardiovascularDermatologicEndocrineENTGastrointestinalGenito-UrinaryHematologyImmunologyMusculoskeletalNeurologicOphthalmologyPsychiatricPulmonaryGLP-1 Medications
All Health ConditionsCardiovascularDermatologicEndocrineENTGastrointestinalGenito-UrinaryHematologyImmunologyMusculoskeletalNeurologicOphthalmologyPsychiatricPulmonary
Medication GuidePatient FormsYour First VisitPatient ResourcesLab VisitsSupplementsPatient PortalHIPAA PrivacyLocal VitalsFAQ
Outbreaks
Contact Us
Back to Directory

Peripheral Neuropathy

Peripheral neuropathy is nerve damage that causes numbness, tingling, burning pain, or weakness, most often in the feet and hands; diabetes is the most common cause.

Neurologic
Peripheral neuropathy is damage to the nerves outside the brain and spinal cord — the nerves that carry sensation and movement signals to the limbs and organs. It most often affects the feet and hands, and it is common: millions of Americans live with some form of neuropathy. Because damaged nerves heal slowly, if at all, finding and treating the cause early makes a real difference. Symptoms range from mildly annoying tingling to pain, numbness, and weakness that interfere with walking, sleep, and quality of life. Causes: Many conditions can injure peripheral nerves, and sometimes more than one cause is present:
  • Diabetes: The most common cause in the United States. Longstanding high blood sugar from diabetes damages small nerve fibers, producing the distinct pattern known as diabetic neuropathy.
  • Vitamin B12 deficiency: Low B12 injures nerves and can also cause anemia; it is especially common in older adults and people taking metformin or acid-reducing medication long term.
  • Alcohol: Heavy, prolonged alcohol use is directly toxic to nerves and depletes key vitamins.
  • Thyroid disease: An underactive thyroid (hypothyroidism) can contribute to nerve dysfunction.
  • Medications and toxins: Certain chemotherapy drugs and some antibiotics can cause neuropathy.
  • Other causes: Autoimmune disease, infections, kidney disease, and inherited disorders. In a portion of cases, no cause is found despite thorough testing.
Symptoms: Symptoms usually begin gradually in the toes and feet and may spread upward in a "stocking-and-glove" pattern:
  • Numbness and tingling: Reduced feeling or pins-and-needles sensations in the feet or hands.
  • Burning or stabbing pain: Nerve pain that is often worse at night and can interfere with sleep.
  • Sensitivity to touch: Even bedsheets brushing the feet may be uncomfortable.
  • Weakness and balance problems: Unsteadiness, stumbling, or falls, especially in the dark.
  • Autonomic symptoms: When the nerves that regulate automatic functions are involved, symptoms can include dizziness on standing, digestive upset, and changes in sweating.
Diagnosis: Your physician will examine sensation, reflexes, strength, and balance, and check the feet for unnoticed injuries. Blood tests typically screen for diabetes and prediabetes, vitamin B12 deficiency, thyroid disease, and kidney function. When the picture is unclear or weakness is prominent, nerve-conduction studies and electromyography (EMG) can characterize the nerve damage. Rapidly worsening weakness is not typical of common neuropathy and warrants prompt evaluation. Because neuropathy can be the first clue to an undiagnosed medical condition, new nerve symptoms are always a reason to look for the cause rather than simply mask the discomfort. Treatment: Treatment has two goals — stop further nerve damage and relieve symptoms:
  • Treat the underlying cause: Tight blood-sugar control, vitamin B12 replacement, stopping alcohol, correcting thyroid disease, or adjusting an offending medication.
  • Nerve-pain medications: Gabapentin or pregabalin, and the antidepressant duloxetine, are proven options for neuropathic pain; ordinary pain relievers usually help little.
  • Topical treatments: Capsaicin or lidocaine products applied to the skin can take the edge off localized pain with few side effects.
  • Foot care: Daily foot checks, well-fitting shoes, and prompt attention to sores — numb feet can hide serious injuries.
  • Physical therapy: Balance and strength training reduces fall risk.
Peripheral neuropathy is best managed with steady follow-up. The internal-medicine team at Zimmer Medical Group can search for the cause, protect your feet, and tailor treatment — schedule an evaluation if you have persistent numbness or nerve pain. Bringing a list of your medications and supplements to the visit often provides important clues.

Related Medications

Commonly prescribed medications for this condition

GabapentinPregabalinDuloxetine

Related resources

Keep exploring care topics from Zimmer Medical Group.