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Understanding Peripheral Neuropathy: Causes, Symptoms, and Types

Abhijit Bhattacharyya | MD, PhD, MBA

Medically reviewed by Abhijit Bhattacharyya | MD, PhD, MBA, Tufts University School of Medicine - Miami, Florida on February 18th, 2024.

Key Takeaways

  • Diabetic neuropathy affects up to 50% of people with diabetes and typically develops after 10-20 years of poorly controlled blood sugar, making it the leading cause of nerve damage worldwide.

  • Symptoms follow a distinct pattern—starting with tingling and numbness in toes that gradually spreads upward, while burning pain often worsens at night and can severely disrupt sleep.

  • Blood tests can identify the underlying cause in about 70% of cases, including vitamin B12 deficiency, thyroid disorders, and autoimmune conditions like rheumatoid arthritis.

  • Gabapentin and pregabalin are first-line treatments for nerve pain, typically starting at 300mg daily, while topical capsaicin cream can provide localized relief without systemic side effects.

  • Maintaining hemoglobin A1C below 7% can prevent further nerve damage in diabetics, and existing symptoms may actually improve with strict glucose control over 6-12 months.

Peripheral neuropathy is a condition that occurs when the nerves that carry messages between the brain, spinal cord, and the rest of the body become damaged or diseased. These peripheral nerves form an intricate network connecting the central nervous system to the muscles, skin, and internal organs. When these nerves are damaged, it can lead to impaired muscle movement, abnormal sensations in the arms and legs, and pain.

Causes of Peripheral Neuropathy

There are several factors that can contribute to the development of peripheral neuropathy, making it sometimes difficult to pinpoint the exact cause. Neuropathies can be classified into three main categories based on their origin:

  1. Acquired neuropathies: These are caused by environmental factors such as toxins, trauma, illness, or infection. Some known causes include diabetes, alcoholism, poor nutrition, certain cancers and their treatments, autoimmune disorders, medications, kidney or thyroid disease, and infections like Lyme disease, shingles, or AIDS.

  2. Hereditary neuropathies: These are less common and are genetically passed from parent to child. The most common type is Charcot-Marie-Tooth disease type 1, which causes weakness in the legs and arms, usually appearing between mid-childhood and age 30.

  3. Idiopathic neuropathies: These have an unknown cause, and up to one-third of all neuropathies are classified as idiopathic.

Symptoms of Peripheral Neuropathy

The symptoms of peripheral neuropathy can vary depending on the type of nerves affected. Some common symptoms include:

  • Tingling, numbness, or loss of sensation in the arms and legs

  • A burning sensation in the hands or feet

  • Muscle weakness

  • Sensitivity to touch

  • Digestive issues, such as diarrhea or constipation

  • Bladder or bowel dysfunction

  • Sexual dysfunction

  • Abnormally low blood pressure

Understanding Peripheral Neuropathy: Causes, Symptoms, and Types

Types of Peripheral Neuropathy

Mononeuropathy

Mononeuropathy refers to damage to a single peripheral nerve. It is often caused by physical injury or trauma, such as from an accident or prolonged pressure on the nerve. Carpal tunnel syndrome is a common example of mononeuropathy, resulting from compression of the nerve that travels through the wrist. Other examples include ulnar nerve palsy, radial nerve palsy, and peroneal nerve palsy.

Polyneuropathy

Polyneuropathy involves damage to multiple peripheral nerves throughout the body. It can be caused by various factors, including exposure to toxins, poor nutrition, and complications from diseases like diabetes, cancer, or kidney failure. Diabetic neuropathy is one of the most common forms of chronic polyneuropathy. Guillain-Barre syndrome is a rare but serious type of polyneuropathy that can lead to paralysis if not treated promptly.

If you suspect that you or a loved one may have peripheral neuropathy, it is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan. Early intervention can help manage symptoms and prevent further nerve damage.

For more information on peripheral neuropathy, visit:

The Bottom Line

Early intervention is crucial since nerve damage can be slowed or stopped but rarely fully reversed once established. The key is identifying and aggressively treating the underlying cause while managing pain symptoms. If you're experiencing unexplained tingling, numbness, or burning in your hands or feet, Doctronic can help determine if these symptoms warrant immediate evaluation.

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