Neuropathy is a condition that affects the nerves outside of the brain and spinal cord. These are called peripheral nerves, and they help send messages between your body and brain. When these nerves are damaged, it can lead to a wide range of symptoms that affect movement, sensation, and even the organs.
Many people experience neuropathy as tingling, burning, or numbness, especially in the hands and feet. But the condition can affect different parts of the body and feel different for everyone. Some people have mild symptoms that come and go, while others may have more serious, ongoing pain or weakness.
While neuropathy can be difficult to live with, many causes are treatable. Understanding what it is and how it works is the first step toward managing the symptoms and improving quality of life.
What is Neuropathy?
Neuropathy means nerve damage. The term “peripheral neuropathy” is often used because it usually affects the peripheral nerves, which branch out from the spine to the rest of the body. These nerves help control everything from feeling pain or temperature, to moving your muscles, to controlling automatic body functions like digestion and heart rate.
When these nerves are damaged, they can’t send signals properly. As a result, you may feel pain, weakness, numbness, or other problems. The symptoms can range from mild to severe, depending on how many nerves are affected and how badly they’re damaged.
Neuropathy can affect just one nerve (called mononeuropathy), two or more nerves in different areas (multiple mononeuropathy), or many nerves throughout the body (polyneuropathy). Most people with neuropathy have the polyneuropathy type.
Causes and Types of Neuropathy
There are many different things that can cause neuropathy. One of the most common causes is diabetes. High blood sugar levels over time can damage the nerves, especially in the legs and feet. This is often referred to as diabetic neuropathy.
Other causes include:
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Infections such as shingles, HIV, or Lyme disease
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Autoimmune diseases like lupus or rheumatoid arthritis
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Vitamin deficiencies, especially B12
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Alcohol misuse
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Certain medications, including chemotherapy drugs
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Physical injury or pressure on a nerve
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Kidney or liver disease
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Genetic conditions that run in families
Sometimes, doctors can’t find a clear cause. This is called idiopathic neuropathy.
There are also several types of neuropathy depending on which nerves are affected:
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Sensory neuropathy affects the nerves that help you feel pain, temperature, or touch. This often causes tingling, burning, or numbness.
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Motor neuropathy affects the nerves that control movement. It can lead to muscle weakness, cramps, or difficulty walking.
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Autonomic neuropathy affects the nerves that control automatic body functions, such as heart rate, blood pressure, sweating, digestion, and bladder function.
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Mixed neuropathy is when more than one type is affected, which is common in many people.
Common Symptoms
The symptoms of neuropathy depend on which nerves are involved, but many people notice changes in the way they feel, move, or function. Symptoms may include:
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Numbness or tingling, especially in the hands and feet
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Burning or stabbing pain
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Muscle weakness or cramping
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Loss of balance or coordination
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Sensitivity to touch or temperature
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Feeling like you’re wearing gloves or socks when you’re not
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Difficulty moving or using your hands or feet
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Digestive issues like constipation, diarrhea, or bloating
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Dizziness or fainting due to blood pressure changes
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Problems with sweating or temperature control
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Bladder issues or sexual problems
Symptoms may come and go, or they may get worse over time if the underlying cause is not treated. In severe cases, neuropathy can make it hard to walk, drive, or do everyday tasks.
How Neuropathy is Diagnosed
If you think you may have neuropathy, it’s important to see a doctor. Your provider will start by asking about your symptoms, medical history, and lifestyle. They may do a physical and neurological exam to test your strength, reflexes, coordination, and ability to feel touch or vibration.
Several tests may be done to find the cause and confirm the diagnosis:
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Blood tests can check for diabetes, vitamin deficiencies, infections, and autoimmune diseases.
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Nerve function tests, such as electromyography (EMG) and nerve conduction studies, measure how well the nerves and muscles are working.
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Imaging tests, like MRI or CT scans, may be used to look for problems like nerve compression or tumors.
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In some cases, a nerve biopsy (removing a small sample of nerve tissue) or skin biopsy may be done to check for nerve damage.
Getting the right diagnosis is key to finding the right treatment and preventing the condition from getting worse.
Treatment Options
The goal of treatment is to manage symptoms, treat the underlying cause, and prevent more nerve damage. Depending on what’s causing the neuropathy, your doctor may suggest a mix of medications, lifestyle changes, and therapies.
Treatment options may include:
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Medications for nerve pain, such as anti-seizure drugs (like gabapentin or pregabalin), antidepressants (like amitriptyline or duloxetine), or over-the-counter pain relievers.
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Topical treatments, like lidocaine patches or capsaicin cream, for localized pain relief.
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Treating the underlying cause, such as managing diabetes, stopping alcohol use, or taking supplements for vitamin deficiencies.
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Physical therapy to improve strength, balance, and mobility.
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Occupational therapy to help with daily tasks and hand coordination.
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Assistive devices, such as braces, canes, or orthopedic shoes, to support movement and safety.
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Lifestyle changes, like a healthy diet, regular exercise, and quitting smoking, can also improve symptoms.
For people with autonomic neuropathy, treatment may also involve managing blood pressure, digestion, bladder issues, or other body functions that are affected.
Some people may also find relief from complementary treatments like acupuncture, massage, or relaxation techniques. Always talk to your doctor before trying new therapies.
Living with Neuropathy
Neuropathy can be a lifelong condition, but many people find ways to manage it well. The key is early diagnosis and treating the cause, if possible. Even when the cause can’t be fixed, there are many tools and therapies that can help reduce pain and improve your ability to stay active.
Taking care of your overall health is very important. This includes eating a balanced diet, staying physically active, managing blood sugar if you have diabetes, and protecting your feet and hands from injury or pressure.
It’s also helpful to stay in touch with your healthcare team and report any changes in your symptoms. With the right support and care plan, many people with neuropathy can live full, active lives.
