neuropathy overview for patients

Overview

Neuropathy (also called peripheral neuropathy) is damage to the nerves outside the brain and spinal cord. These nerves carry messages between your body and your brain. When they are damaged, you might feel pain, numbness, or weakness, often in the hands and feet.

Yes, neuropathy is quite common. It is especially frequent in people over 60 and in those living with diabetes. Many cases go undiagnosed.

Neuropathy can affect anyone, but it is more likely in older adults, people with diabetes or autoimmune conditions, and those who drink excessively or are deficient in certain vitamins. It can also be inherited.

Symptoms

Common symptoms

• Numbness or tingling in the hands or feet
• Burning, stabbing, or shooting pain
• Muscle weakness or cramping
• Extreme sensitivity to touch
• Loss of balance and coordination

Symptoms in children

• Children with neuropathy may trip often, drop things, or find it painful to walk.
• They may not be able to explain the feeling – you may notice them avoiding touch or rubbing their hands and feet.

Symptoms in older adults

• Older adults may notice unsteadiness or frequent falls.
• They may experience reduced sensation in the feet, making it easy to miss cuts or blisters.

Causes

Main causes

• Diabetes – especially if blood sugar levels have been high for a long time
• Infections like shingles or Lyme disease
• Autoimmune diseases such as lupus or rheumatoid arthritis
• Physical injury from trauma, falls, or pressure on a nerve
• Vitamin B12 deficiency or heavy alcohol use

Risk factors

• Being older than 60
• Having diabetes or kidney disease
• Having high blood pressure or unhealthy cholesterol levels
• Smoking or drinking large amounts of alcohol
• Taking certain medicines that can damage nerves

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if you have new weakness that is getting worse, or if numbness is spreading rapidly.

Book a routine appointment if:

• Make an appointment if you have tingling, burning, or numbness that lasts for more than a few days, or if it affects your daily activities.

Diagnosis

A doctor will talk with you about your symptoms and examine you. They will test your reflexes, strength, and ability to feel sensation. It may take time to find the cause.

Tests that may be done

• Blood tests to check blood sugar, vitamin levels, and markers of inflammation
• Nerve conduction studies to measure how fast signals travel
• Electromyography (EMG) to test how well your muscles respond
• Sometimes magnetic resonance imaging (MRI) of your spine or brain

What to expect at your appointment

Some tests may feel slightly uncomfortable, like small electric pulses, but they are usually not painful. You may need to prepare – for example, not using creams on your skin before the test. Your doctor will give you clear instructions. Results can take up to a few weeks.

Treatment

Treatment for neuropathy depends on the cause. If possible, your doctor will treat the underlying condition – for example, improving blood sugar control. The goal is to ease pain, prevent further damage, and maintain function.

Self-care at home

• Check your feet daily for cuts, blisters, or swelling, especially if you have diabetes.
• Wear comfortable, well-fitting shoes and socks.
• Keep your skin clean and moisturized, especially dry spots.
• Avoid exposing your hands or feet to extreme cold or heat.
• Take breaks if you sit or stand for long periods.

Medical treatments

Doctors may recommend medications for nerve pain that are different from usual painkillers. These may include certain antidepressants or anti-seizure medicines. Some people benefit from topical creams or patches. Physical therapy helps with strength and balance. Always talk with your doctor about any treatment – never start or change a medicine on your own.

When is surgery considered?

Surgery is rarely needed. It may be considered if a compressed nerve – for example in carpal tunnel syndrome – is causing neuropathy, and other treatments have not helped. Your doctor will explain if surgery is an option.

Living with this condition

Living with neuropathy takes practice. You can adapt your routine to avoid falls and injuries. Use handrails, night lights, and non-slip mats. Give yourself extra time for tasks that need fine hand movements.

Lifestyle tips

• Stop smoking, and limit alcohol.
• Keep active every day with gentle exercises like walking or stretching.
• Protect your feet and hands from injury by wearing gloves and proper footwear.
• Manage stress with relaxation techniques, hobbies, or talking with friends.

Diet and exercise

A healthy diet can support nerve health. Eat plenty of vegetables, fruits, whole grains, and lean proteins. If you have diabetes, keep your blood sugar in your target range. Exercise improves blood flow and balance – try to move for 15–20 minutes a day if you are able.

Mental health and emotional wellbeing

Living with chronic pain or numbness can feel overwhelming and lonely. It is normal to feel frustrated or anxious. Talk to your healthcare provider about these feelings. If you have thoughts of harming yourself, seek help immediately – you are not alone. Emergency and crisis services are available in your community.

Prevention

Some causes of neuropathy cannot be prevented, but you can lower your risk. Keep chronic conditions like diabetes and high blood pressure well managed. Avoid heavy alcohol use, and get enough B vitamins from a balanced diet or supplements (as advised by your doctor).

Vaccines

Vaccines can protect against infections that can damage nerves, such as shingles and the flu. Please discuss with your healthcare provider which vaccines are recommended for you.

Screening programmes

If you have diabetes, regular foot exams during your checkups are important. People with other risk factors may need nerve tests if symptoms appear. Ask your doctor about appropriate screening.

Complications

If left untreated

• If neuropathy is not treated, you may lose sensation and not notice cuts or sores, which can lead to serious infections.
• Muscle weakness may cause falls and fractures.
• Nerve damage in internal organs could affect digestion, heart rate, or blood pressure.

Long-term outlook

Many people with neuropathy continue to live full lives. With good medical care and self-management, symptoms can improve, and further damage can be slowed. Research is ongoing. There is every reason to stay hopeful and engaged in your care.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.