What Is Peripheral Neuropathy?

Peripheral neuropathy (damage to nerves outside the brain and spinal cord) results in pain, tingling, and numbness in hands and feet. Diabetes is a common cause.

There isn’t one single answer to “what is peripheral neuropathy?” In fact, there are more than 100 types of peripheral neuropathy, according to the National Institute of Neurological Disorders and Stroke (NINDS). Some types of peripheral neuropathy develop suddenly, while others progress slowly over many years.

The condition is the result of damage to nerves outside of the brain and spinal cord. Peripheral neuropathy can affect three types of nerves — motor, sensory, and autonomic. Motor nerves control the movement of all muscles under conscious control (including those used for talking, walking, and holding onto objects), sensory nerves transmit information about temperature and pain, and autonomic nerves regulate your body’s functions that aren’t under your direct control, such as breathing, digestion, and how your heart and glands function. The majority of people with peripheral neuropathy have polyneuropathy, which means they have some damage to motor, sensory, and autonomic nerves.

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Symptoms of peripheral neuropathy

Pain, numbness, tingling, throbbing, and weakness, often in your hands and feet, are frequent symptoms associated with peripheral neuropathy. However, the condition can affect other parts of your body, depending on the type of peripheral nerves that are damaged and their location.

Other peripheral neuropathy symptoms can include:

• Extreme sensitivity to being touched or to clothing
• A sensation you are wearing an invisible “glove” or “sock”
• A loss of coordination and feeling off-balance
• Shooting, electric-shock type pains
• Insomnia due to foot and leg pain
• Difficulty walking or moving your arms
• Unusual sweating
• Bowel, bladder, or digestive problems
• Abnormal fluctuations in blood pressure, causing dizziness or lightheadedness

Diabetes is an important cause of peripheral neuropathy

In the U.S., diabetes is the leading cause of peripheral neuropathy, the American Diabetes Association reports. In fact, about 60 to 70 percent of people with diabetes have the condition which, in people with diabetes, is often referred to as diabetic neuropathy. It can occur in both type 1 and type 2 diabetes.

Peripheral neuropathy resulting from diabetes can cause mild to severe damage to nerves, often causing symptoms such as tingling, numbness, and a burning sensation in feet and one-sided bands of pain, weakness, and numbness on the trunk or in the pelvic area.

Diabetic neuropathy is most common in people who have had diabetes for many years. Keeping blood glucose levels controlled with diet, exercise, and insulin or other medication as needed can help prevent or delay nerve damage. If neuropathy has already occurred, getting blood glucose into optimum target levels can help prevent or delay further damage.

Peripheral neuropathy has many causes

Most types of peripheral neuropathy are acquired and not genetic. However, Charcot-Marie-Tooth disease (CMT), one of the most common inherited neurological disorders, affecting approximately 1 in 2,500 people in the U.S., can cause peripheral neuropathy. CMT affects both motor and sensory nerves. A common symptom of this type of peripheral neuropathy includes weakness of the foot and lower leg muscles, which can result in frequent tripping and falls.

Other common causes of peripheral neuropathy:

• Trauma from falls, automobile accidents, sports, and medical procedures can damage nerves.
• Arthritis, prolonged pressure on a nerve (such as wearing a cast for a broken arm), or repetitive, forceful activities can cause ligaments or tendons to swell, narrowing nerve pathways and causing pain.
• Vascular disease, including narrowing of arteries from atherosclerosis, can decrease oxygen supply to the peripheral nerves, resulting in neuropathy.
• Autoimmune diseases (including rheumatoid arthritis and lupus) occur when your own immune system attacks parts of your body — and this can include peripheral nerves. Autoimmune diseases sometimes damage autonomic nerves, part of the peripheral nervous system that regulates involuntary physiologic processes, including heart rate, blood pressure, respiration, and digestion, the Foundation for Peripheral Neuropathy explains.
• Kidney and liver disorders that cause abnormally high amounts of toxins in the blood can cause nerve damage. That’s why most kidney failure patients on dialysis develop varying levels of peripheral neuropathy, according to the NINDS.
• Vitamin B12 deficiency and excess vitamin B6 are vitamin-related causes of peripheral neuropathy. Alcoholism can cause neuropathy symptoms because it depletes vitamin B12. However, alcohol can also have a direct toxic effect on nerve tissue, resulting in alcoholic peripheral neuropathy.
• Certain cancers and benign tumors can press on nerves, causing peripheral neuropathy. Paraneoplastic syndromes, a group of rare degenerative disorders triggered by an immune system reaction to a cancer, can also damage nerves.
• Certain types of chemotherapy result in polyneuropathy (peripheral neuropathy in sensory, motor, and autonomic nerves) in about 30 to 40 percent of cancer patient. Radiation therapy also can cause peripheral nerve damage.
• Several infectious diseases can cause peripheral neuropathy — including the varicella-zoster virus (which causes chickenpox and shingles), West Nile virus, cytomegalovirus, herpes simplex, HIV, and Lyme disease.

Peripheral neuropathy can be mild or disabling, depending on the cause. And, in some cases, the condition may improve on its own over time. That’s especially true if the neuropathy is caused by a condition that can be treated.

If you have any symptoms of peripheral neuropathy, contact your doctor. Medication and lifestyle changes can help reduce symptoms and, in some cases, may keep peripheral neuropathy from progressing.

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