Living with neuropathy

Overview

Neuropathy is a condition that affects the nerves outside your brain and spinal cord. These nerves carry messages between your body and brain. When they are damaged, you may feel pain, tingling, or numbness, often in your hands or feet.

Yes, neuropathy is quite common. It can affect people of all ages, but it becomes more common as you get older.

Neuropathy can affect anyone, but it is most often seen in people with diabetes, older adults, and those who have had certain infections or injuries.

Symptoms

Common symptoms

• Tingling or burning feeling in your hands or feet
• Numbness or trouble feeling pain or temperature changes
• Sharp, stabbing, or electric-like pain
• Muscle weakness or trouble gripping objects
• Sensitivity to touch, even light touches
• Balance problems or clumsiness

Symptoms in children

• Children may show clumsiness, frequent falls, or complain of 'pins and needles' in their hands or feet.
• They might have trouble picking up small objects or feel weak during play.
• They may not want to walk or may say their 'feet feel funny'.

Symptoms in older adults

• Older adults often feel numbness in their feet, which increases the risk of falls.
• They may not notice small cuts or blisters, which can lead to infections.
• Weakness in the legs may make it harder to climb stairs or rise from a chair.

Causes

Main causes

• Diabetes – the most common cause, especially when blood sugar levels are not well managed
• Injuries or accidents that damage nerves
• Infections, such as shingles or Lyme disease
• Autoimmune conditions, where the body's defence system attacks its own nerves
• Heavy alcohol use, which can be toxic to nerves
• Vitamin deficiencies, especially vitamin B12

Risk factors

• Having diabetes or prediabetes
• Being older
• Having a job or hobby that involves repetitive movements
• Exposure to certain chemicals or toxins
• A family history of neuropathy
• Misusing alcohol

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe, or quickly worsening symptoms like weakness, confusion, or trouble speaking.
• If you have an injury to your foot or leg but you cannot feel pain from it.

Book a routine appointment if:

• If you have ongoing tingling, burning, or numbness in your hands or feet.
• If you feel unsteady when walking or notice frequent falls.
• If you have diabetes and you notice any change in sensation in your feet.

Diagnosis

Your healthcare provider will listen to your story, ask about your health history, and do a physical exam. They may check your strength, balance, and ability to feel touch, vibration, and temperature.

Tests that may be done

• Nerve conduction study – measures how fast electrical signals move through your nerves
• Electromyography (EMG) – checks how well your muscles respond to nerve signals
• Blood tests – look for conditions like diabetes or low vitamin levels
• Imaging scans, such as MRI – check for anything pressing on your nerves
• Sometimes a small skin biopsy – looks at nerve endings under a microscope

What to expect at your appointment

The tests are usually not painful, though you may feel some mild discomfort. Your provider will explain each step and why it is being done. You may be referred to a neurologist – a doctor who specialises in brain and nerve conditions.

Treatment

Treatment for neuropathy depends on the cause and your specific symptoms. The main goals are to relieve pain, slow down further nerve damage, and help you stay independent and active.

Self-care at home

• Check your feet daily for cuts, blisters, or redness, especially if you have diabetes.
• Keep your hands and feet clean and moisturised, but dry well between your toes.
• Wear comfortable, well-fitting shoes and protect your hands with gloves when working.
• Avoid very hot or very cold water on numb areas – always test temperature with a more sensitive part of your body.
• Take regular breaks from repetitive tasks, like typing or using vibrating tools.
• Limit alcohol and quit smoking to improve blood flow to your nerves.

Medical treatments

Your healthcare provider may suggest treatments that address the underlying cause – for example, helping you manage blood sugar, treat an infection, or correct a vitamin deficiency. For nerve pain, they may talk about prescription medications that are designed for nerve pain, physical or occupational therapy, or other pain-management therapies. Always discuss all options with your care team and never share medicines with someone else.

When is surgery considered?

Surgery is only needed in a small number of cases. It may be considered if a nerve is trapped or squeezed, such as in the wrist (carpal tunnel syndrome) or in the spine, and other treatments have not worked.

Living with this condition

Living with neuropathy means paying attention to your body and making simple adjustments. Keep your feet safe, move carefully, and let your healthcare team know about any changes, so you can catch problems early.

Lifestyle tips

• Get regular sleep and rest – fatigue can make pain feel worse.
• Manage stress through deep breathing, gentle exercise, or hobbies you enjoy.
• Keep your mind active and stay connected with friends and family – you do not have to face this alone.
• Use handrails on stairs and keep your floors clear of trip hazards.
• If you have numbness in your feet, use mirrors to inspect the soles of your feet every day.

Diet and exercise

A healthy diet with plenty of vegetables, fruits, whole grains, and lean protein gives your nerves good fuel. Regular, gentle exercise like walking, swimming, or stretching can improve blood flow and reduce pain. Always check with your healthcare provider before starting a new exercise programme, especially if you have balance issues or foot damage.

Mental health and emotional wellbeing

Coping with chronic pain or numbness can bring up feelings of frustration, anxiety, or sadness. These feelings are normal and important to take seriously. If you are struggling emotionally, talk to your healthcare provider. If you ever have thoughts of self-harm, please call your local emergency number or go to the nearest emergency department immediately – there is always help and hope.

Prevention

Not all neuropathy can be prevented, but you can lower your risk by managing diabetes carefully, limiting alcohol, eating a balanced diet, protecting yourself from toxins, and avoiding injuries that might damage nerves.

Vaccines

Some infections that can lead to neuropathy, such as shingles, may be preventable with vaccines. Ask your healthcare provider whether vaccination is recommended for you.

Screening programmes

If you have diabetes, it is important to have regular foot checks and nerve tests as recommended by your healthcare team. Early detection can make a real difference.

Complications

If left untreated

• Unnoticed foot injuries that can lead to infection, ulcers, or even amputation in severe cases.
• Falls and broken bones due to weak legs or poor balance.
• Progressive weakness that makes it harder to move around or do everyday tasks.
• Long-lasting pain that can deeply affect sleep, mood, and quality of life.

Long-term outlook

Many people with neuropathy improve, especially when a treatable cause is found early. Even if the nerve damage cannot be fully reversed, most people can find effective ways to manage pain, improve strength, and maintain a good quality of life. You are not alone, and taking steps early is the best way to make a positive difference.

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