What Is Neuropathy?

Written by Kelly Elterman, MD | Reviewed by Katie E. Golden, MD Updated on August 3, 2021 (from Good Rx)

Key takeaways:

• Peripheral neuropathy happens when nerves become damaged or dysfunctional.
• Peripheral neuropathy has many causes, but diabetes is the most common.
• There are several different treatments for peripheral neuropathy, which can help improve symptoms or slow the progression of the condition.

Neuropathy, also known as peripheral neuropathy, happens when a nerve or group of nerves does not function normally. Neuropathy can have many different causes, including diabetes, trauma, nerve injury, illness, or medications. The symptoms typically depend on the cause, and which nerves are involved. 

We’ll discuss what neuropathy is, how it is diagnosed and treated, and what you can do to prevent neuropathy and its long-term complications if you are at risk.

What is peripheral neuropathy?

The word “neuropathy” means nerve damage or dysfunction. Our nervous system has two parts: the central nervous system, which is the brain and spinal cord, and the peripheral nervous system, which includes all of the other nerves throughout the body. 

Peripheral neuropathy (PN) refers specifically to damage of the peripheral nerves — the nerves that are outside the brain and spinal cord in the rest of your body. PN can be related to problems in the central nervous system, but it can also happen when the brain and spinal cord function normally. 

There are three types of peripheral nerves:

• Sensory: nerves that help you feel
• Motor: nerves that help you move 
• Autonomic: nerves that perform automatic functions, like sweating, breathing, and digesting food

PN can affect any of these nerve types. In some cases, it can affect just one nerve, while in other cases, it can affect several nerves. The type and number of nerves involved affects what kind of symptoms you have. 

Typically, neuropathy is a long-term condition. Even if it improves, recovery can take weeks or months. 

What causes peripheral neuropathy?

The most common cause of PN in the U.S. is diabetes. As many as 60% to 70% of people with diabetes have PN. 

But diabetes isn’t the only cause of PN. Other causes include:

• Trauma: Accidents, cuts, and broken bones can directly injure a nerve. This can also happen during medical procedures, like surgery.
• Illness: Vascular disease, autoimmune conditions, infections, vitamin deficiencies, alcohol abuse, kidney disease, and cancer can all cause PN.
• Medications: Chemotherapy, blood pressure medications, and antibiotics are common offenders. 
• Genetic disorders: These are rare causes.

What are the symptoms of peripheral neuropathy?

The symptoms of peripheral neuropathy may feel different for different people. This is because the symptoms depend on the type, the number, and the location of the peripheral nerves affected. 

Common symptoms include:

• Numbness, tingling, or a pins-and-needles sensation
• Painful sensitivity to touch
• Loss of pain or sensation
• Muscle weakness
• Loss of muscle (sometimes called ‘muscle wasting’)

Sometimes, these symptoms can be worse at night. Some people with peripheral neuropathy may also experience other types of neuropathy, such as those associated with the autonomic nervous system. These symptoms can be more subtle but include heat intolerance, emotional changes, dizziness and loss of balance, and digestive symptoms.  

How is peripheral neuropathy diagnosed?

PN is often diagnosed based on a combination of symptoms, the history of symptoms, and physical exam. Sometimes, tests to evaluate for other conditions may be helpful. These tests may include blood work, spinal fluid tests, and imaging in some cases.

There are also tests that are specific to nerve function:

• Nerve conduction studies help identify which nerves are damaged.
• Electromyography (EMG) is a test that looks at both nerve and muscle function; it  can help determine if weakness is due to a problem with the nerve or a problem with the muscle. 
• A neurodiagnostic skin biopsy can help diagnose peripheral neuropathy of very small nerve fibers.

What are the treatments for peripheral neuropathy?

Treatment for peripheral neuropathy usually depends on its cause. When PN is caused by an injury, rehabilitation may help improve symptoms. Orthopedic devices, like braces or splints, may help maintain a position that reduces pressure on a nerve and improves pain, numbness, or weakness. Surgery can also help alleviate symptoms caused by nerve damage or compression.

In the case of medication-related PN, stopping the medication often improves symptoms. The same is true for PN caused by diabetes or autoimmune disease. Treating the underlying condition may not cure the condition, but it can help improve symptoms, and prevent PN from becoming worse.

There are several types of medications that can help treat the pain associated with PN. Some of these medications are known to treat “neuropathic pain,” which means pain related to nerve damage. Examples of these medications include gabapentin (Neurontin) and pregabalin (Lyrica). Other types of medications can also help in some cases include antidepressants, seizure medications, and local anesthetics.  

There are also some non-medication options for treating peripheral neuropathy, such as acupuncture and transcutaneous electrical nerve stimulation (TENS). These treatments may be helpful for some people, but more research is needed, particularly for TENS therapy. 

What are the long-term risks of peripheral neuropathy?

You might think you can put up with the symptoms of a peripheral neuropathy, but if the underlying cause of PN is not treated, it can cause some long-term problems:

• Neuropathy involving a motor nerve can cause muscle wasting and weakness. Weakness can make it difficult to do your usual daily activities, and it can also increase your risk of falling.
• Neuropathy of a sensory nerve can cause long-term numbness or inability to feel pain or discomfort. This can make it difficult for you to know if you have accidentally hurt yourself — like if you step on something sharp — and can lead to infection. In serious cases, the injury and infection can become severe and can even require surgery.

What can you do to prevent peripheral neuropathy?

The best ways to prevent peripheral neuropathy are to:

• Treat any medical conditions that may cause nerve damage, like diabetes.
• Avoid taking medications that are known to possibly cause neuropathy, unless absolutely necessary.
• Talk to your healthcare team about the risks of nerve injury from a medical procedure before deciding to have one.
• Maintain a healthy diet and avoid too much alcohol, since some peripheral neuropathies are caused by vitamin deficiency and alcohol use. 

What should you do if you think you have peripheral neuropathy?

If you have been diagnosed with PN, you should talk to your healthcare provider about what you should expect as well as which treatment options may work well for you. You can prevent the neuropathy from becoming worse by taking your medications as directed, eating a healthy diet, and reducing your alcohol use. It may not be possible to cure peripheral neuropathy, but preventing worsening symptoms can help you stay healthy and active.

The bottom line

PN is a common problem, especially for people with diabetes. Symptoms can be mild, moderate, severe, or even debilitating. There are several different ways to ease symptoms, but these do not always offer a cure. Treatment is important because it can help improve symptoms and prevent long-term complications.