What Causes Peripheral Neuropathy?

Peripheral neuropathy symptoms include pain and numbness in your hands and feet. The outcome of the condition often depends on what causes the problem.                                   

A diagnosis of peripheral neuropathy means you have nerve damage to the part of your nervous system that transmits information between your brain, spinal cord, and other parts of your body — primarily your legs, feet, arms, or hands. However, it’s not one single condition, and there’s not only one cause. In all, there are more than 100 types of peripheral neuropathy.

Where the nerve damage occurs, how severe or minor it is, and what causes peripheral neuropathy are factors that impact the symptoms you may experience and whether they resolve easily or need extensive treatment.

Peripheral neuropathy impacts more than 20 million Americans, according to the National institute for Neurological Diseases and Stroke (NINDS). Symptoms can range from mildly annoying to severely disabling and may include numbness, tingling, a loss of reflexes, problems feeling pain or changes in temperature, and pain that worsens at night.

Depending on what causes peripheral neuropathy, symptoms may develop quickly, over the course of days, or may take months or years to become obvious.

Understanding what causes peripheral neuropathy can help you take action to prevent nerve damage, when possible. And recognizing factors that put you at risk for neuropathy can also help you spot symptoms of peripheral neuropathy early, so you can seek appropriate medical care.

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Diabetes is a main cause of peripheral neuropathy

Whether you have type 1 or type 2 diabetes, you are at increased risk for several types of nerve damage, and the most common kind is peripheral neuropathy. In fact, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) points out one third to one half of people with diabetes have peripheral neuropathy,

The Centers for Disease Control and Prevention explains what causes peripheral neuropathy in people with diabetes: Over time, if blood sugar is not controlled well and is too high, nerves are damaged.

In addition, high levels of fats in the blood from diabetes can clog small blood vessels that normally keep your nerves healthy, which can cause peripheral neuropathy, according to the NIDDK.

Peripheral neuropathy in diabetes most often causes numbness or pain in feet and legs, and sometimes in hands and arms. If you lose feeling in a foot, you may not know you have an injury or infection, which makes neuropathy especially dangerous in people with diabetes.

Anyone with diabetes should have regular doctor visits, including checks for peripheral neuropathy symptoms. To reduce your risk of peripheral neuropathy and potential complications, the NIDDK advises people with diabetes to keep blood sugar levels close to target levels, work with your doctor to keep blood pressure under control, lose weight if you need to, and exercise regularly. It’s also important not to smoke and to avoid or limit alcohol.

Bottom line? Recognize other frequent causes of peripheral neuropathy

• Alcohol abuse. Excess alcohol has a toxic effect on nerves, causing peripheral neuropathy with tingling and burning sensations, often in the legs and feet. Abstaining from alcohol may sometimes halt symptoms and prevent more nerve damage. However, over time, alcohol abuse-caused neuropathy problems may be permanent, according the Foundation for Peripheral Neuropathy.
• Physical injury and trauma. Nerves can be injured in accidents, playing contact sports, and from medical procedures. Even repetitive forceful activities like operating machinery or typing all day can cause ligaments or tendons to swell, narrowing already slender nerve pathways and resulting in nerve damage. Ulnar neuropathy and carpal tunnel syndrome are common types of peripheral neuropathy caused by trapped or compressed nerves in the elbow or wrist.
• Autoimmune diseases. Your body’s immune system mistakenly attacks your own body tissues when you have an autoimmune disease such as Sjögren’s syndrome, lupus, and rheumatoid arthritis. Nerves can be damaged by the disease directly, or surrounding tissues may become swollen, entrap nerves, and cause peripheral neuropathy symptoms.
• Infections. Viruses such as varicella-zoster virus (which causes chickenpox and shingles), West Nile virus, cytomegalovirus, and herpes simplex can cause nerve damage, resulting in peripheral neuropathy that’s often marked by attacks of sharp, lightning-like pain. Lyme disease, spread by infected tick bites, sometimes causes peripheral nerve damage, too. HIV is another infectious disease that can cause neuropathy. Approximately 30 percent of people who are HIV-positive develop peripheral neuropathy, according to the NINDS.
• Medication side effects. Causes of peripheral neuropathy include certain medications, especially chemotherapy used to treat cancer and drugs prescribed to treat HIV/AIDS. Peripheral neuropathy will often resolve if medications causing the nerve symptoms are changed, the dose is reduced, or the drugs are discontinued. However, it may take several months for peripheral neuropathy to completely heal after the medications are stopped or changed, according to the Foundation for Peripheral Neuropathy.
• Nutritional deficiencies or imbalances. Vitamin B12 deficiency, as well as excessive intake of vitamin B6, can cause peripheral neuropathy. Usually, the condition is fully reversible when the nutritional problem is corrected.

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