Peripheral neuropathy
Also called: Diabetic neuropathy, Polyneuropathy
Damage to the nerves outside the brain and spinal cord, typically starting in the feet with numbness, tingling or burning pain.
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Causes
- Diabetes (most common)
- Alcohol
- Vitamin B12 deficiency
- Chemotherapy and other drugs
- Hypothyroidism, kidney failure
- Guillain–Barré syndrome and inherited neuropathies
Risk factors
- Diabetes
- Heavy alcohol use
- Chemotherapy
Symptoms
- Numbness and tingling in a 'glove and stocking' pattern
- Burning or shooting pain
- Loss of balance
- Weakness
- Painless foot injuries
Diagnosis — tests and examinations
- Examination (monofilament, vibration)
- Blood tests: glucose/HbA1c, B12, thyroid, kidney
- Nerve conduction studies
Treatment
Medicines and medical treatment
- Treat the cause: glucose control, B12 replacement, stop alcohol
- Neuropathic pain medicines: duloxetine, amitriptyline, pregabalin, gabapentin
- Capsaicin patches
Self-care, home remedies and lifestyle
- Daily foot checks and proper footwear
- Podiatry care
- Balance exercises
Possible complications
- Foot ulcers and amputation
- Falls
- Charcot joint
Prevention
- Good diabetes control
- Limit alcohol
Outlook
Progression can be slowed by treating the cause; established nerve damage may be permanent.
When to see a doctor
See a doctor for numbness or burning in the feet; urgently for rapidly spreading weakness (possible Guillain–Barré).
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
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